Student Name: お子様の名前 *

First Name

Last Name

Child Birth Date: 誕生日 *

MM

DD

YYYY

What are you interested in? *

Learning ways to stimulate my young child and meet other families.

I am looking for a pre-school.

I am interested in attending every Friday from 2-3pm for JPY10,000

I am interested in attending per class as my schedule allows and pay JPY3,000 per visit.

Parent Name: お母様かお父様のお名前 *

First Name

Last Name