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