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Apartments easily reservable as your home in Japan

Internet Application

⇒日本語版はこちら

    ★Applicant's Information
    Full Name

         Alphabet
     　  Family Name* 　　   Last Name*
     　  Japanese Katakana カタカナ (if possible)
     　  Family Name   　     Last Name  
    Email *
      1.  　      2.
    Phone Number*
      1.  　　   2.
    Skype ID
     
    LINE ID
     
    Nationality
     
    Language of your speak
      EnglishJapaneseOther language
    Occupation
     
    Age     *The subscriber shall be elder than 20 years old.
     

     
    ★Property Information
      The exact address of the property which you wish to install the cable internet.
      Address*
     
      Buiding Name*
        Room Number*
      Buiding type* Condo(own)Apartment(rental)House (own)House (rental)Other
     

    ★Wishing Date for installation work for internet starting *
      What date do you prefer to install the internet into your home?
      The wishing date should be the date of after two weeks or later.

        1st choice :

    ( yyyy-mm-dd )

        2nd choice :

    ( yyyy-mm-dd )

        3rd choice :

    ( yyyy-mm-dd )

      Intend length of use the internet
          about years

     
    ★Option
      1) Rental Wi-fi router YesNo

    Message

     

    Identification

    Please submit one or more ID.
     PassportResidential Card (在留カード)Japanese Driver LisenceJapanese Health Insurance card
         

     

    Confirmation

    I have an intend to continue the contract for more than one year.
    I understand the cancellation policy and I agree that I may have to pay additional cancellation penalty when I cancel the contract in most case.