ADMISSIONS | APPLICATION | Jinseki International School

Fields marked with ※ are required.
See our privacy policy page for details about how we handle your personal information.

First Name ※
Middle Name
Last Name ※
Gender ※	Male Female
Date of Birth ※	/ /
Nationality ※
Additional Nationality
Preferred Start Month ※	* Students entering Grade 1 entry begins in April of the following year. Transfer students may start one month after acceptance.
Grade Applying ※	Grade 1 Grade 2 Grade 3 Grade 4 Grade 5
Candidate lives with (Both parents, Mother, Father, Other) ※
Expected length of study at JINIS ※
How did you hear about JINIS? ※	Website Magazine or Newspaper Google Search Friends Institution or Agent Other

Is the candidate presently in school or kindergarten? ※	Yes No
Name current school or kindergarten
Has the candidate ever repeated or skipped a grade? ※	Yes No
If yes, which grade and for what reason?
Has the candidate ever been dismissed? ※	Yes No
If yes, when and for what reason?
Has the candidate ever been diagnosed with a learning difference? (e.g. dyslexia, dysgraphia, dyscalculia dyspraxia, or ADHD) ※	Yes No If yes, please submit copies of any psycho-educational evaluations and individualized education plans the student has received to the admissions office via email.
Has the candidate ever received learning support and or/ tutoring? ※	Yes No
If yes, which subjects and for how long?
It is our primary concern that pupil is happy, healthy and safe at JINIS. Is there anything we need to know about your child’s physical or mental healthy, dietary issues, or other personal needs?
If yes, please write this further below, and make us aware of information about diagnoses, follow-up care, psychoeducational evaluations, or any other documents that will help us better understand your child.

Has your child studied in English? ※	Yes No
Has your child studied in Japanese? ※	Yes No

Parent/Guardian 1 ※	First Name Last Name
Relation to candidate (Father, Mother, Legal Guardian, Other) ※
Preferred Language ※	English Japanese
Mobile phone number (Include country code) ※
Email address ※
Confirm contact email address ※
Address ※	First Street City State/ Province Postal Country
Place of employment
Parent/Guardian 2	First Name Last Name
Relation to candidate (Father, Mother, Legal Guardian, Other)
Preferred Language	English Japanese
Mobile phone number (Include country code)
Email address
Confirm contact email address
Address	First Street City State/ Province Postal Country
Place of employment

Please fill below who are authorized to pick up the candidate, need to receive school-related information.

Name	First Name Last Name
Relation to Candidate (Grandparent, Aunt/Uncle, Nanny/Caretaker, Agent, Other )
Mobile phone number (Include country code)
Email address
Confirm contact email address
Address	First Street City State/ Province Postal Country
Emergency Contact ※	Parent 1 Parent 2 Related Contact
Financial Sponsor ※	Parent 1 Parent 2 Related Contact

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ADMISSIONS APPLICATION