Application Form

Global Kids Academy(グローバルキッズアカデミー)
2-13-9 Moto Azabu, Minato-ku, Tokyo
Telephone Number: 03-5419-8277
Fax Number: 03-5419-8278

■ Parent/Guardian Information
Name
Relationship to Student
Home Address
Tel (Home)
Tel (Office)
Tel (Mobile)
Fax
E-mail
Are you willing to participate in activities at Global Kids Academy? Would you like to share your travel experiences with children? Would you like to be a guest speaker or invite children to your workplace? Any special interests or hobbies you want to share with the children?
■ Student Information
Name of Student
Student likes to be called
Gender Boy  Girl
Age
Date of Birth (Month/Day/Year)
name of School
Grade/Level at current school
Language(s) used at home
Please select English is native language
Japanese is native language
wish to focus on developing English skills
wish to focus on developing Japanese skills
Programs
Please let us know the days of the week and time slots for which your child is available and the programs you are interested in having your child attend. We will schedule a meeting and discuss the ideal program and scheduling for your child.