(individual) Recruitment of students essential point request form

When a recruitment of students essential point, an entrance to school application is requested, please fill in the item of the following forms.
I would like input by all means in all items.
Address ※required
〒 
Phone number ※required
Child, student name ※required
School name ※required

※An example: 0 0 ritsu 0 0 Elementary School 0 student
   * 0 ritsu 0 0 Junior High School 0 student
Recruitment of junior high school students essential point
(Half-width number)
Part
Recruitment of high school students essential point
(Half-width number)
Part
※I do not use the information that I obtained with this request foam other than the management of a recruitment of students essential point, the entrance to school application shipment.
Please see this about the privacy policy of the principal school.
Institute of educational foundation Fukuyama Akenohoshi
〒721-8545
3-4-1, Nishifukatsucho, Fukuyama-shi, Hiroshima
TEL. 084-922-1682 (academy direct communication)
FAX. 084-925-1533 (academy direct communication)