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Tell us about yourself - Contact us!

 

Name

E-mail

Tel/Fax

Mobile Phone

Address

BIRTHDAY
Month

Day

Q1. Where do you want to study?
Tenjin Home Cafe
Other (place)

Q2. What type of lesson do you want?


Small Group Private (home)
Private (cafe) Family / Circle


Q3. What is your level of English
?

Basic Beginner
Intermediate Advanced


Q4. Have you studied at other English schools?

yes no


Fot those who answered "yes"

Name of School
How long?



Q5. What course are you interested on?


Preschool/K ids English course Daily conversation
Kids English TOEIC/TOEFL/test course
Culture Course Business course
Travel English Native cooking


Check if you want to receive information on the following:

Culture, Social events Homestay, travel Overseas Info.

 

Q6. How did you find out about Passport School

Seen website before Friend has mentioned school
Seen flyers Found school on the www.!
Seen advert in Magazine

 

Q7. .Do you want to subscribe to our free b-monthly Newsletter?

yes No

 

Q8. How often do you use the internet?

Everyday Once a week
Once/twice a month Rarely

 

 

 

Q9. What magazines do you usually read?

Hotpepper Messajyu
Gariya Elf
Other

 

Q11. What places do you usually use for meeting people?
Ex.: Solaria's Lobby

 

Q12. If you have kids, where do you usually buy toys for your kids?
Example: Toys R`Us?


Thank you very much!.


 

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