Homestay in JAPAN!!
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Programs: Homestay in JAPAN!!
Learn: Homestay in JAPAN!!
Stay: Homestay in JAPAN!!
Explore: Homestay in JAPAN!!
homestay in JAPAN!! Application Form
Questions? Comments? Please use this form to contact us, free of charge.
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■Personal Data
Last Name
First Name
E-mail Address:
Postal Code:
Apartment/Room No.
Home Phone Number*
* Please change to English character input
Mobile Phone Number*
* Please change to English character input
Male Female
■About Home stay in Japan
Destination 1
Term 1
y/ d/ m 〜 y/ d/ m
Destination 2
Term 2
y/ d/ m 〜 y d m
Objectives of Your Travel
Learning Japanese  Travel Japan
Home staying  others
Experiences of Your mind
Cooking Japanese home food  Wearing Kimono
Japanese Traditional Culture (Flower Arrangement, Tea Ceremony and etc)
Visiting Japanese Companies  others
General Operations Department Personal Information Manager
[About your personal information]
NEXTAGE uses personal data obtained from you only for the purpose of complying for requests of service. Except for cases required by law, we will never use or share your personal data with for any other purpose without your permission. When answering requests made by third parties, we will do our utmost to protect your personal data. Remember that disclosure of personal information is your option; you may choose not to disclose certain information to us. However, if you do not submit the above documents and forms, please understand we may not be able to respond to your request in a timely fashion or at all. Please direct all comments and questions about requests for disclosure to the contact point below.
We use cookies to better improve site usage and convenience but never to collect personal information without permission.

[Contact point for personal information handling]
Please direct all inquiries regarding our "Personal Information Protection Policy"; requests that we disclose, correct, or discontinue use of personal information; and complaints to: NEXTAGE Co., Ltd. Information Desk
Phone: 03-3592-3940 (Mon. _ Fri. 1:00 pm _ 6:00 pm)
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