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- Which school will you attend? (If you are studying at multiple locations, what is the first school you will study at?) / 通う予定の学校*
- Which school will you attend? (If you are studying at multiple locations, select all schools you will study at.) / 通う予定の学校*
- Date of birth / 生年月日*
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- Will you come to Japan with a long-term visa such as a student visa or working holiday visa? / 長期滞在ビザですか?*
- Gender / 性別*
- I am over 100kg in weight / 体重100kg以上*
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- I am over 190cm in height / 身長190cm以上*
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- Have you ever done a homestay before? / ホームステイ経験
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- Will you have anyone accompanying you when you move into your host family’s home?/ 同行者がいますか?
- What is your relationship to the accompanying person? If there are multiple applicable options, please select all that apply./どなたが同行しますか?
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- Are you comfortable with a family that has a young child/children (aged 3 to 6)? / 3歳~6歳の子どものいる家庭でもいいですか*
- Are you comfortable with a family that has a baby/babies (aged 0 to 2)? / 2歳以下の子どもがいる家庭でもいいですか*
- Would you be comfortable being placed with a single mother living alone? / ホストマザー一人暮らしの家庭でもいいですか*
- Would you be comfortable in a family that also hosts other guests/students? / 他のゲストがいる家庭でもいいですか*
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- Do you smoke? / 喫煙しますか*
- Is it OK if a member of the family smokes ? / 喫煙するファミリーでもいいですか*
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- Do you have any food or drink restrictions, and for what reason? / 食事制限はありますか*
- Do you have any food or drink restrictions, and for what reason? / 食事制限はありますか*
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- Which of these do you -NOT- eat/drink? 食べられない食材*
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- Which kind of meat do you -NOT- eat? 食べられないお肉の種類*
- Which of these would you -NOT- eat?
- Details for Meat*
- What is the reason you do not eat the meat?*
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- Details for Beef*
- What is the reason you do not eat Beef?*
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- Details for Pork*
- What is the reason you do not eat Pork?*
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- Details for Chicken*
- What is the reason you do not eat Chicken?*
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- Details for Lamb / Mutton*
- What is the reason you do not eat Lamb / Mutton?*
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- Details for Other (Meat)*
- What is the reason you do not eat the meat?*
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- Which kind of seafood do you -NOT- eat? 食べられないシーフードの種類*
- Details for Seafood*
- What is the reason you do not eat the Seafood?*
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- Details for Shrimp*
- What is the reason you do not eat the Shrimp?*
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- Details for Squid*
- What is the reason you do not eat the Squid?*
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- Details for Octopus*
- What is the reason you do not eat the Octopus?*
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- Details for Shellfish/Clam*
- What is the reason you do not eat the Shellfish/Clam?*
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- Details for Other (Seafood)*
- What is the reason you do not eat the Seafood?*
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- Details for Fish*
- What is the reason you do not eat the Fish?*
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- Details for Eggs*
- What is the reason you do not eat the Eggs?*
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- Details for Milk/Dairy*
- What is the reason you do not consume the Milk/Dairy?*
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- Details for Alcohol*
- What is the reason you do not consume the Alcohol?*
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- Which kind of nuts do you -NOT- eat? 食べられないナッツの種類*
- Details for Nuts*
- What is the reason you do not eat the Nuts?*
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- Details for Walnuts*
- What is the reason you do not eat the Walnuts?*
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- Details for Pecans*
- What is the reason you do not eat the Pecans?*
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- Details for Cashews*
- What is the reason you do not eat the Cashews?*
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- Details for Almonds*
- What is the reason you do not eat the Almonds?*
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- Details for Pistachios*
- What is the reason you do not eat the Pistachios?*
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- Details for Hazelnuts*
- What is the reason you do not eat the Hazelnuts?*
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- Details for Other (Nuts)*
- What is the reason you do not eat the Nuts?*
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- Details for Flour*
- What is the reason you do not eat the Flour?*
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- Do you have any medical conditions, allergies, or disabilities diagnosed by a medical professional? / 診断された病状、アレルギー、障害はありますか*
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- Is your condition entirely self-manageable? / 自分で対応可能ですか*
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- Will you need any special support or infrastructure at school or at your accommodation? / 学校や滞在先で特別なサポートは必要ですか*
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- Is there any other important information for your host family to know (religion, personal habits, etc.) ?
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- Should be Empty: