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JLA - Japanese Language Academy

Registration Form for Japanese Language Course

Full name
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Required
Title Required First Name Required Last Name
Gender *
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Male
Female
Age
*
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Date of birth *
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dd-MMM-yyyy
Address
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Required House / Flat / Door no Street Address Required City Required State/Region/Province Required Postal / Zip Code

Required
Country
Email *
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Mobile Number *
N/A
WhatsApp Number *
N/A
Educational Qualification *
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Are you a student? *
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If Yes, Name of School / College / Institution?

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In which standard / grade / Semester / year are you presently studying?

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Are you an employee?
*
N/A
If Yes, Name of company / Institution / Organisation you are working for?

N/A
Which course are you applying for?
*
N/A

Please select your preffered course
Preferred Mode of Teaching?
*
N/A
Preferred Type of class?
*
N/A
Have you ever visited Japan?
*
N/A
If yes, Please describe

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Have you ever worked in Japan?
*
N/A
If yes, Please describe

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Have you ever visited any other country?
*
N/A
If yes, Please describe

N/A
Have you ever worked in any other country?
*
N/A
If yes, Please describe

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Passport Size Photo *
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Upload file Capture image using webcam
Please upload a recent passport size photograph
Rules & Regulations *
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• Total course fees should be paid on or before the day of the commencement of the course. Upon confirmation of admission, students have to remit 100% of course fees without fail to the bank account of JLA - Japanese Language Academy Pvt. Ltd.

• Every student is expected to follow the rules and regulations of the institution as well as basic etiquettes while they are in the premises of the Institution and during online classes. Failure in following these may be treated as disciplinary misconduct and the institute reserves the right to cancel the enrolment of the student without any refund of fee.

• The photograph of the student may be used by the institute for advertisement purposes, if required.

• Course fee once paid is not refundable under any circumstances.

• The study materials and its contents provided to students are bound by copyright. Any attempt by the students to copy or share these materials may be considered illegal and may be dealt with applicable copyright infringement rules.

• You are not permitted to record, screen record or take screen shots of the class or computer screen presentation by our faculties.

• In all matters pertaining to the functioning of the institute, the decision of the administrative authority shall be final.

I accept the Terms and Conditions.
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JLA - Japanese Language Academy

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