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Teacher registration form１／３

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You can register using either the Japanese or English registration form. If you can read and write Japanese well, and/or if you want to register as interpreter and/or translator, please use the Japanese form.

◆For the person who wants to register. NOTICE: International Language Academy cannot accept applicants whose visa is going to expire within 6 months. Required fields are marked ※. Please fill in as much information as possible.

◆To update your registration. 1, Select “This is to update my registration.” 2, Fill in your “Teacher ID number” provided to you by E-mail when you registered for the first time. 3, Fill in your family name and first name in the requested spaces. 4, Fill in your E-mail and reconfirm in the requested spaces. 5, And then please fill in only the spaces where you want to update. 　　※The information from 1-4 are essential to identify and update your registration.

◆Registration/Update※	This is the first time to register. This is to update my registration.┓ 　　Teacher ID number
◆Which language do you want to teach?※	▼Selection English Chinese Korean French Italian Spanish German Cantonese Portuguese Japanese Other language If you answered “other language”, what is it?：
◆What is your native tongue?※
◆Which plan do you want to apply for? ※	For see detail of each plan, see “Outline of the school” ▼Selection Normal Plan Teacher only Select Plan Teacher only Normal Plan Teacher & Select Plan Teacher Note: Normal plan teachers cannot apply to be translators
◆How long have you been in Japan? ※	▼Selection less than 6 months more than 6 months less than 1 year more than 1 year less than 2 years more than 2 years less than 3 years more than 3 years less than 5 years more than 5 years less than 7 years more than 7 years
◆What is your level of Japanese?※	▼Selection Native Native level Interpreter level Business negotiation Business conversation Daily conversation Manage a daily conversation Beginner None at all
◆Do you have any Japanese qualifications?
◆Academic background (university level and higher)※	e.g.) 　graduate from ABC university in 2000 If you are a student, please include your student ID number (Gakuseki Bango).
◆What is your present occupation?※	▼Selection University student Graduate student Company employee School teacher Housewife other
◆Do you have any experience working in a company?	e.g.) 　from 1999 to 2003 worked for ABC company
◆Do you have any experience teaching individually or in a language school? (If yes, please indicate the name of the school.)	Individually Language School e.g. ABC English School in Ikebukuro from 2000 Feb. to 2004 March
◆Name※	Family NameFirst name
◆Sex※	Male ｜ Female
◆Current address in Japan※	Zip code: e.g.123-4567 - ▼Selection Hokkaido Aomori Iwate Miyagi Akita Yamagata Fukushima Ibaraki Tochigi Gunma Saitama Chiba Tokyo Kanagawa Niigata Toyama Ishikawa Fukui Yamanashi Nagano Gifu Shizuoka Aichi Mie Shiga Kyoto Osaka Hyogo Nara Wakayama Tottori Shimane Okayama Hiroshima Yamaguchi Tokushima Kagawa Ehime Kochi Fukuoka Saga Nagasaki Kumamoto Oita Miyazaki Kagoshima Okinawa
◆Nationality※
◆Date of birth※	▼Selection 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 Year ▼Selection 01 02 03 04 05 06 07 08 09 10 11 12 Month ▼Selection 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Date
◆E-mail address※	We usually contact you by E-mail, so please indicate the address that you read regularly. PC： Please fill in your E-mail address again! 　PC：
◆E-mail address of your mobile phone.	To facilitate our correspondence, if possible, please let us know your E-mail address of your mobile phone. Mobile： 　 Please fill in your E-mail address again! Mobile：
◆TEL What time is convenient for you? ※	※First best　 -- ▼Selection Home Office Mobile What time is convenient for you? e.g. 22:00-23:00
	Second best -- ▼Selection Home Office Mobile What time is convenient for you?
	Third best -- ▼Selection Home Office Mobile What time is convenient for you?
◆Address in your home country
◆Period of home leave
◆What kind of VISA do you have and when will it expire?※	→Expiration date
◆When do you plan to go back to your country?
◆Closest train line & station to your home	line station
◆Where do you want to teach?※	Please fill in the name of one station per square. List as many places as possible. line station station station station station line line line line line
◆Can you teach in another area which is nearby but not exactly the station you listed?	Negotiable No
◆Additional information regarding the stations and train lines where you want to teach, if any.
◆Where do you want to teach? You can select more than one.※	Cafe　 Family restaurant Fast food shop　 at the student’s house　 at my house　 others Note) Our school recommends female teachers to refrain from holding lessons in a private environment. We cannot take any responsibility for any problem that may arise.
◆When can you teach?	e.g.） Saturday 10：00〜12：00 and 15：30〜18：00 Day Hour Hour Monday 〜 〜 Tuesday 〜 〜 Wednesday 〜 〜 Thursday 〜 〜 Friday 〜 〜 Saturday 〜 〜 Sunday 〜 〜 The more available time you have, the easier and faster it will be for us to introduce you to potential students.
◆Additional information on the days and times you want to teach, if any.
◆Levels that you can teach (you can select more than one)	Beginner Intermediate 　 Advanced 　 Most advanced 　 Business 　 Travel conversation 　 For qualification test----------- name of the test： Other----------------------- Other：
◆Can you teach children? ※	Yes　 No
◆Why do you want to teach?※	(within 800 letters)
◆What are your strengths as a teacher? ※	(within 800 letters)
◆Hobbies and interests: ※	(This information is essential for matching you with students, so please list concisely as many as possible) (within 800 letters)
◆Your recent picture.	Please send a recent (within the last 6 months) picture which shows your face clearly. (Your picture enables us to introduce you students better. If you don't have one now, please send it to us later using this form. Select "to update my registration" and attach your picture. ←Browse (Please send it in GIF, JPG, PNG format, the max 100 KB)
◆Please inform us where you have known our academy (the name or address of the website, google, yahoo, etc). Any questions, comments, or requests are also welcome.

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