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New-Student Enrollment Form

Thank you for your interest in learning Japanese online at JOI. We're eager to meet you in class. To sign up for service, please review the terms and conditions of use and complete this form. Then, scroll down and click Sign Up to submit your information.
First Name: 
Family Name: 
Sex:  Male    Female
Age: 
years
FlexLessons are available only for students 16 years of age or older.
If under 16, please contact us for private lesson arrangements.
Address: 
City:      State/Province: 
Country: 
Nationality or Citizenship: 
Birthday: 
Telephone: 
 
Please include your country's calling code (North America = 1)
Email Address: 
 
Example: yourname@domain.com
Re-enter email address: 
How did you hear about JOI?  
Which JOI classes are you most interested in taking? (check all that apply)
Introductory
Beginner 1
Beginner 2
Intermediate
Advanced
JLPT Classes
Discussion Classes
Private Lessons
Which times of day are you interested in taking classes? (all times are Japan time; check all that apply)
06:00 – 09:00
09:00 – 12:00
12:00 – 15:00
15:00 – 18:00
18:00 – 21:00
21:00 – 24:00
Which days of the week are you interested in taking classes? (all days are Japan time; check all that apply)
Monday   Tuesday   Wednesday   Thursday   Friday   Saturday   Sunday
Other remarks: (optional—please limit to 1000 Japanese and/or English characters)