JACS Interview Form
PERSONAL INFORMATION
Name:
Field of Work or Study:
Address:
Nationality:
Phone/Mobile:
Email:
First Contact Me By:
Please Select
Email
Phone
How long have you been in Japan?
How much longer is your expected stay in Japan?
YOUR JAPANESE GOALS AND EXPERIENCE
How long have you studied Japanese?
Name of textbook(s) you have used?
Hiragana:
Please Select
Read and Write
Recognition Only
Cannot Read and Write
Katakana:
Please Select
Read and Write
Recognition Only
Cannot Read and Write
Kanji:
Please Select
Read and Write
Recognition Only
Cannot Read and Write
How many Kanji?
Japanese Language Proficiency Test:
Please Select
Have Not Taken
Level 1
Level 2
Level 3
Level 4
JETRO Business Japanese Proficiency Test:
Please Select
Have Not Taken
Level 1
Level 2
Level 3
Purpose of your Japanese Study?
Please Select
Everyday Conversation
Business Use
Other
Do you use Japanese at your office/home/school?
Please Select
Yes
No
Comments:
If you have any topics that you'd especially like to study or that you've particularly interested in, please let us know.
Any weakness in learning languages?
(Japanese or in general)
Where did you hear about us?
Thank you for your cooperation
JACS Institute 3-9-27-406, Minami-Azabu, Minato-ku, Tokyo 106-0047, Japan mail@jacsjacs.jp 03-5420-0407 www.jacsjacs.jp