Application

Thank you for looking at managing our apartment. If you wish your tenants to stop temporary recruitment room. Please proposed in this application screen. Please sign up below please note on the FAX or this page in a form.

“Notes”

1.
(※)Signs are always please input.Please do not make mistakes. If we can’t communicate with you, we will cancel your application.
2.
We use the personal information only to proposed the room.
3.
Proposed order of arrival. If we cannot secure your preferred room, so please beforehand. (Please contact in advance beyond viewing after two weeks, and ensuring your room is difficult, so. )

※Fax registration is 025-374-5666

▼Application Form
Apartment (*)required
Room Number (*)required
Date of move (*)required year month day
Message
*If you want again before you move it freely please input.
▼[Contractor Information] *Your name and your phone number is always please input.
Name (*)required
Date of Birth year month day
Sex  Male Female
Zip Code (without hyphen)
Address
Phone Number
Employer (School)
E-mail
Department (Faculty of)
Cohabitation's Name
Cohabitation's Birthday year month day
Cohabitation's Sex  Male Female
Cohabitation's Phone Number
Cohabitation's Employer (School)
▼[Solidarity Guarantor Information] * Only if you decide, please input
Name
Phone Number
Relationship


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