Inquiry, document request

Document request, please refer than a telephone, an email or the following form.
About the privacy policy, I would like confirmation in this page.
 
   Fukuyama Akenohoshi girl's junior and senior high school
    〒721-8545 3-4-1, Nishifukatsucho, Fukuyama-shi
    TEL. 084-922-1682 (main) FAX. 084-925-1533
Apply for the cram school of the document request from this.
The name ※required
Furigana ※required
(Katakana)
Address ※required
〒 
Phone number ※required
Document request
Applicant ※required
Current being on the register roll school of person or child
※An example: 0 0 ritsu 0 0 Elementary School [junior high school]
School year
(Half-width number)
Year student
Inquiry contents ※required
A case to take time for an answer depending on inquiry contents may not answer it.
Thank you for your understanding beforehand.