Payment Form

当社について

お問合せ

I understood that I will be charged 4% for online payment handling fees and it will added to the total amount due.* オンラインでのお支払い手数料として、お支払い金額に4％を加算させていただきますのでご了承下さい

Indicates required fields * （ * は必須項目です。）

Your Child and School

First Child Name (First) (氏名（名）) *
First Child Name (Last) (氏名（姓）) *
School (学校名) *

Your Name

Parent Name (First) (氏名（名）) *
Parent Name (Last)( 氏名（姓）) *

Contact Information

Address 1 *
Email (E-mailアドレス) *
Address 2
Your Contact Phone Number (電話番号) * No hyphen ハイフン無し
Prefecture (都道府県)*
City (市区町村)*
ZIP code (郵便番号) * No hyphen ハイフン無し

Deposit Amount

Amount (お支払い金額) * Enter a number with no special characters e.g. 10000
I have read and agree to the condition of use (上記の使用条件に同意いたします)
This field is required.