NAME:
SEX: Male Female
Home Address:
PRESENT MAILING ADDRESS:
Telephone:
Fax:
Email:
BIRTHDATE:
COUNTRY OF BIRTH:
COUNTRY OF CITIZENSHIP:
NATIVE LANGUAGE:
LEVEL OF EDUCATION (Freshman, etc.)
College:
High School:

If you are now living in Japan, give your Japanese address, phone number, and immigration status.

Address In Japan:
Telephone No.:
Immigration Status:
If your spouse and/or children will come to Japan with you, give their names, and ages:

TERM for which you are applying (we advise you to apply at least more than 30 days before the term begins):
*Please give the check mark on the line.
2010: Spring Course A Feb. 1 - April 28 Spring Course B Mar. 1 - May 28 Summer Course A June 7 - Aug. 27

TO BE CONSIDERED FOR ADMISSION, MAIL OR EMAIL TO IEC:
1. 5,000 yen or $50.00 deposit by check or money order, payable to IEC. Deposit is not refundable.
2. Two passport-size photographs.
3. Educational summary or transcript.

If you have questions, fax us at 0965-32-0232; or email info@iec-college.ac.jp
ADMISSION TO ISPIS DOES NOT GUARANTEE ADMISSION TO IEC COLLEGE DEGREE PROGRAMS