Please fill in the form below if you wish to send your child to GKA.

Request for School Brochure
Click "Confirm" button after completing the form.

Student's Name
(Eng.)
Family NameFirst Name
Sex
Date of Birth20 /  /  (Y/M/D)
Nationality   Non-Japanese(Country)
 
Parent's Name
(Eng.)
Family NameFirst Name
Occupation
Postal Code
Prefecture(e.g.) Gunma
City(e.g.) Ota
Neighborhood block and Number(e.g.)69-1 Nishihon-cho
Name of Apartment
Phone
Fax
E-mail Address
Re-enter Email
How did you get to know about GKA?
(Please check all that apply.)
Name of newspaper
Name of magazine  
Name of program   
Others
Please fill in if you have any questions or comments.
Comments - approximately 400 characters
 
The input contents will be safely transmitted via SSL encryption.