Inquiry

Please do not hesitate to ask any kind of questions.
Just write down in the form below.
I f you have any questions, you can contact us by filling the form below.
We will respond you as soon as possible.
i¦Questionnaire in *orange must be answered.j

*Given name:(required)


*Family name:(required)


* Sex : male@ Female

*Nationality(required)


*E-mail address(required)


*Contact phone number:(required)


*Planned length of stay:
month(s)

–Room type:(required)
- Dormitory - - Singleroom -

*Planned move in date:(required)
Month january February March April May June July August September October Novemaer December . Day 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 16 15 14 13 12 11 10 9 8 7 6 5 4 3 2 1 . Year 2006 2007

*Purpose of your stay in Japan (required):
Business Studying Tourism Other

Please enter your campany name, school name,or description if you selected "Other"


*Your Visa type (required) :

Are you under 18 years old?:
Yes (If you are under 18 years old,
we require your gurantor's conscent.)
Your are: 18 17 16 15 14 13 12 11 10 years old

Questions, requests, comments

Submit to bettak House !!