toggle
Furnished Apartments for Rent for Foreigners

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.