Name

Postal Code

PrefecturePlease select your prefectureHokkaidoAomoriIwateMiyagiAkitaYamagataFukushimaIbarakiTochigiGunmaSaitamaChibaTokyoKanagawaNiigataToyamaIshikawaFukuiYamanashiNaganoGifuShizuokaAichiMieShigaKyotoOsakaHyogoNaraWakayamaTottoriShimaneOkayamaHiroshimaYamaguchiTokushimaKagawaEhimeKochiFukuokaSagaNagasakiKumamotoOitaMiyazakiKagoshimaOkinawa

Address

Email

Phone Number

Notes

Student Name

Postal Code

PrefecturePlease select your prefectureHokkaidoAomoriIwateMiyagiAkitaYamagataFukushimaIbarakiTochigiGunmaSaitamaChibaTokyoKanagawaNiigataToyamaIshikawaFukuiYamanashiNaganoGifuShizuokaAichiMieShigaKyotoOsakaHyogoNaraWakayamaTottoriShimaneOkayamaHiroshimaYamaguchiTokushimaKagawaEhimeKochiFukuokaSagaNagasakiKumamotoOitaMiyazakiKagoshimaOkinawa

Address

Email

Phone Number

Course Applied For2-Month Intensive Training Course

GenderMaleFemale

Date of Birth

Dominant HandLeftRight

Food Allergies

Cooking ExperienceYesNo

Name

Phone Number

Emergency Contact AddressSame as the above addressDifferent address (if applicable)

Uniform SizePlease select a sizeML2L3L

Shoe SizePlease select a size23.0cm23.5cm24.0cm24.5cm25.0cm25.5cm26.0cm26.5cm27.0cm27.5cm

Please select an optionDo Not PurchasePurchase (For Right-Handed) 80,000 yen (including tax)Purchase (For Left-Handed) 100,000 yen (including tax)

Payment MethodPlease select an optionBank TransferCredit Card

Notes

Name

Email

Phone Number

Notes