@HAYATO NEW YORK
@@@@@@@@@@@ INTERNATIONAL ACADEMY@@
Back To Home
@Registration Form@
‘---Required to fill in
---Only for our imformation
About Yourself
‘
Name
(First name/Last name)
‘
Age
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
‘
Gender
male
female
‘
E-Mail
‘
TEL
Home Phone
cellphone
company
@@ number
I don't want my number to give to students.
FAX
‘
Postal Code
‘
Address
‘
Closest station from your house
‘
Country of Origin
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua & Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia-Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Chad
Chile
China
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
East Timor
Ecuador
Egypt
El Salvador
England
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
Gabon
Gambia
Germany
Ghana
Greece
Greenland
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
North Korea
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Christopher and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Scotland
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
U.S.A.
Uganda
Ukraine
United Arab Emirates
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zaire
Zambia
Zimbabwe
‘
Date of Birth
(Month/Day/Year)
‘
Visa Status
‘
Highest Level of Education
High School
College
University
Graduate School
Other
‘
@
Name of Institution
(highest education)
Major/course
Level of Qualification
None
High School
B.A.
B.S.
M.A.
M.S.
M.B.A.
Ph.D.
Other
‘
Teaching Experience
less than 6 months
6-12 months
1-3 years
3-6 years
more than 6 years
Teaching License
Yes
No
‘
Language Speak
Hobbies
Job Experience
Length of Stay in Japan
‘
Comments to Students
Portrait
(file)
File Type : gif or jpg/jpeg
About Lessons
‘
Language levels you teach
1. beginners
2. low intermediate
3. high intermediate
4. advanced
‘
Types of Lessons you teach
1. Private Lesson
2. Group Lesson
3. Children
4. Company Class
‘
Lesson Location
student's home
teacher's home
other
‘
Teaching Method
textbooks
free conversation
games
teacher's own materials
role play
other
‘
Schedule
Please check the times
you are available to teach.
Morning
Afternoon/Evening
Mon
12 A.M.
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
-
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
12 P.M.
12 P.M.
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
-
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
12 A.M.
Tue
12 A.M.
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
-
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
12 P.M.
12 P.M.
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
-
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
12 A.M.
Wed
12 A.M.
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
-
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
12 P.M.
12 P.M.
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
-
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
12 A.M.
Thu
12 A.M.
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
-
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
12 P.M.
12 P.M.
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
-
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
12 A.M.
Fri
12 A.M.
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
-
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
12 P.M.
12 P.M.
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
-
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
12 A.M.
Sat
12 A.M.
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
-
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
12 P.M.
12 P.M.
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
-
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
12 A.M.
Sun
12 A.M.
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
-
1 A.M.
2 A.M.
3 A.M.
4 A.M.
5 A.M.
6 A.M.
7 A.M.
8 A.M.
9 A.M.
10 A.M.
11 A.M.
12 P.M.
12 P.M.
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
-
1 P.M.
2 P.M.
3 P.M.
4 P.M.
5 P.M.
6 P.M.
7 P.M.
8 P.M.
9 P.M.
10 P.M.
11 P.M.
12 A.M.
‘
Do you understand the
Terms and Conditions of Hayato New York International Academy
?
Yes
No
You need a copy.