• Kinmon Gakuen Saturday Afternoon Program Application Form

    Japanese Classes for Kids Ages 5 to High School

  • Note: If the minimum number of students is not met, the class may be canceled and a refund will be issued. Registration will close once capacity is reached.

     

    Program Schedule

    September Course
    The September course will be held on four Saturdays:
    September 5, 12, 19, and 26, 2026.
    Classes will take place from 1:00 PM to 3:00 PM (2 hours per session).

    October Course
    The October course will be held on four Saturdays:
    October 3, 10, 17, and 24, 2026.
    (No class on October 31.)
    Classes will take place from 1:00 PM to 3:00 PM (2 hours per session).

    November Course
    The November course will be held on three Saturdays:
    November 7, 14, and 21, 2026.
    (No class on November 28.)
    Classes will take place from 1:00 PM to 3:00 PM (2 hours per session).

    Class Format
    The Afternoon Class is held in person at Kinmon Gakuen. Google Classroom is provided for parents to see what students worked on in class, check homework if assigned, and access videos or other materials used during class.

  • Course Selection*
    Rows
  • Course Selection*
    Rows
  • Course Selection*
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  • Student Information

    We kindly ask that siblings also fill out separate registration forms.
  • Date of Birth
     - -
    2 digit month, 2 digit day, 4 digit year


  • Parent(s)/Guardian(s) Information

  • Please list in order of whom to contact first*

  • Emergency Information

  • ※ Please provide an Emergency Contact who is NOT the same person as the applicant.
    For safety reasons, the applicant and the emergency contact must be two different people.
    If they are the same, we may not be able to reach anyone in an emergency.

  • Format: (000) 000-0000.

  • Health Information

  • Please let us know if this child has any allergies.
  • List medications if this child is currently taking

  • School Policies, Waiver and Release of Liability

  • Photo Release Permission

    We respect students’ privacy. When sharing photos on our website or social media, we make reasonable efforts to avoid clearly identifying individual students, including through cropping or editing when appropriate. Photos may also appear in printed materials such as newsletters or community publications, where images are typically smaller or lower resolution.
  • As a parent or guardian of this student, I hereby consent to the use of photographs/videotape taken during the course of the school year for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet, SNS or other media sources).  I do this with full knowledge and consent and waive all claims for compensation for use, or for damages.*

  • How did you learn about this program?

  • How did you learn about this program?

  • Signature

  • Date of Registration*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Payment

    Please make payments separately for each student. We kindly ask that siblings also fill out separate registration forms.

  • If you are attending only selected dates, please do not make an online payment below. Please make your payment at the office on your first day.

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    Afternoon Class September Product Image
    Afternoon Class September


    $200.00$200.00
      
    Afternoon Class October Product Image
    Afternoon Class October
    $200.00$200.00
      
    Afternoon Class November Product Image
    Afternoon Class November
    $150.00$150.00
      
    Total
    $0.00$0.00

    Payment Methods

    creditcard
    After submitting the form, you will be redirected to Apple Pay to complete the payment.
    After submitting the form, you will be redirected to Google Pay to complete the payment.
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