MAX International School Application Form - MAXインターナショナルスクール|新宿区|高田馬場|幼稚園|保育園

First Name *

Last Name *

Preferred English name *

漢字氏名(if available)

Date of Birth *

Gender *

Nationality(ties) *

Postal Code *

Address in Japan *

(In Kanji, if available)

1st Language *

2st Language

Additional Languages

When do you wish your child to start in Max? *

School History

In which program would you like your child to be enrolled? Please check the applicable days.

Age Group *

Preferred Days *

Mon (9am - 5pm)
Tue (9am - 5pm)
Wed (9am - 5pm)
Thu (9am - 5pm)
Fri (9am - 5pm)

Other (Special cases)

Extended Care (Please specify time)

Mon

Tue

Wed

Thu

Fri

Other (Special cases)

Application for Lunch Service *

School Lunch Home Lunch

Lunch (Bento) *

Mon
Tue
Wed
Thu
Fri

Other (Special cases)

Application for Bus Service *

Use school bus service No need for school bus service

Note (other request)

Sibling Information

Name

Date of Birth

School

Parent/Guardian Information

Parent/Guardian 1

First Name *

Last Name *

漢字氏名(if available)

Relationship to Child *

Nationality *

Mobile Phone *

Email *

Employer *

Business Address *

Business Phone *

Parent/Guardian 2

First Name

Last Name

漢字氏名(if available)

Relationship to Child

Nationality

Mobile Phone

Email

Employer

Business Address

Business Phone

Invoice & Billing Information

For tuition, I would like to be billed *

Per Term Per Academic Year

Note

In order to best accommodate your child's needs, please answer the following questions briefly.
Please answer them in Japanese, English, or Chinese.

What were your reasons for choosing our school? *

Does your child have any special dietary requirements, restrictions or health concerns?
(i.e., food allergies, religious reasons, etc.) Please indicate the seriousness of the allergy and whether
your child requires medical treatment for any exposure. Allergies are NOT a factor in admission decisions. *

What kind of primary/elemantary school you wish your child to enter in the future? Please kindly add comments. *

Please describe your child's personality. Is there anything else we need to know about your child? *

Tuition Policy

Tuition and all other fees will not be refunded under any circumstances.
In case of a school closure for reasons beyond the school's control, no tuition will be refunded. These reasons include but are not limited to weather conditions, natural disasters, terrorist attacks, public transportation disruptions/strikes, political/civil unrest, epidemics, pandemics, and any preventive and risk management measures taken for the safety of our students and staff.
Tuition fees may be paid by term or by year. Tuition fees must be paid by bank transfer or in cash for all core programs.
A one-time non-refundable Registration Fee is payable upon the child's entrance to the school.

Medical and Emergency Authorization

I understand that the school will make every effort to reach the parents/guadrians or designated emergency contact in the event of an emergency. However, if the parents/guardians cannot be contacted, I authorize MAX International School to take any emergency measures necessary. I agree to be responsible for any expenses incurred in such an event. (We will collect additional emergency contact information upon enrollment.) My child has all the appropriate immunizations or will have, by the beginning of the school term and I will provide documentation to the school upon enrollment.
Note: If there are any concerns regarding the statements above, please contact the school.

Agreement *

I / We have decided to enroll our child at MAX International School and agree with the school's admissions policy and all the authorizations required stated on this form.
I / We certify that all the information stated here are true and correct.
I / We have read the Tuition Policy and agree to the requirements stated therein.
I / We understand that all fees are non-refundable and the school does not offer makeup classes for any reasons.

Media Consent

School events, classroom activities and special programs are sometimes photographed or videotaped by school for documentation and promotion purposes. The videos and photographs may be used on our website, blog, and newsletter and in print advertisements such as magazines or event postcards.

Do you give permission to MAX International School to use your child(ren)'s photographs, video, audio recordings on the school's promotion materials,journals, blogs and social media page? *

Yes No

Upload Student Photo *

Choose file

Please upload a copy of your child's insurance card *

Choose file

Please upload a copy of your child's free medical care certificates *

Choose file

Upload photo of routine vaccination *

Choose file

Parent/Guardian Online Signature *

Signature

Date