1. Name in English
*
2. E-mail address
*
Confirm E-mail address
*
3. Windows Live Messenger address
Windows Live Messenger
SKYPE account
SKYPE
4. Telephone
5. Address(Country / City)
* (e.g.: USA / NewYork)
Time differences between your place and Japan
-
+4h (GMT+13:00) NZT(DST)
+3h (GMT+12:00) NZT
+2h (GMT+11:00) AEST(DST)
+1.5h (GMT+10:30) ACST(DST)
+1h (GMT+10:00) AEST
+0.5h (GMT+09:30) ACST
0h (GMT+09:00) JST, AWST(DST)
-1h (GMT+08:00) AWST, CCT
-1.5h (GMT+07:30)
-2h (GMT+07:00)
-2.5h (GMT+06:30)
-3h (GMT+06:00)
-3.5h (GMT+05:30)
-4h (GMT+05:00)
-4.5h (GMT+04:30)
-5h (GMT+04:00)
-5.5h (GMT+03:30)
-8h (GMT+01:00) CET, WET(DST), BST
-9h (GMT) WET, GMT
-10h (GMT-01:00)
-11h (GMT-02:00)
-11.5h (GMT-02:30) NST(DST)
-12h (GMT-03:00) AST(DST)
-12.5h (GMT-03:30) NST
-13h (GMT-04:00) AST, EST(DST)
-14h (GMT-05:00) EST, CST(DST)
-15h (GMT-06:00) CST, MST(DST)
-16h (GMT-07:00) MST, PST(DST)
-17h (GMT-08:00) PST, AKST(DST)
-18h (GMT-09:00) AKST, HAST(DST)
-19h (GMT-10:00) HAST
-20h (GMT-11:00)
-21h (GMT-12:00)
Others / not sure
6. Gender
-
Male
Female
*
7. Age
-
0-17
18-19
20-29
30-39
40-49
50-59
60-69
70-
*
8. Occupation
9. Nationality / Mother tongue
* (e.g.: American / English, etc)
Othre languages / the level
(e.g.: chinese / beginner, etc)
10. Teacher's English ability
I prefer a teacher with English speaking ability.
I prefer a teacher who speak only Japanese.
I don't mind it as long as good teacher.
I'm not sure which is better for me.
-
11. How long have you been studying ?
-
Have not studied at all.
0-1month
2-6months
6-12months
12-24months
more than 24months
How / School name
(e.g.: group lesson / J-OS)
Material you have used
(e.g.: Japanese for Busy People)
12. Japanese level(read & write)
Hiragana
-
not at all
a little
nearly all
Perfect
*
Katakana
-
not at all
a little
nearly all
Perfect
*
Kanji (Chinese character)
-
not at all
a little
JLPT4th level
More than JLPT3rd level
*
13.
Main reason for studying Japanese
*
(e.g.: To communicate with my family and relatives more effectively.
I work for an American company with an important customer in Tokyo.
I travel to Japan several times per year and meet suppliers .etc.)
14. Prefered lesson length/frequency and type of tickets
lesson length/frequency:
50mins
75mins
100mins
125mins
150mins
not sure or other
-
lesson,
once
twice
3times
4times
5times
6times
7times
not sure / other
-
a week.
How much do I have to study?
type of tickets:
J-01 (Basic Plan)
J-02 (Standard Plan)
J-03 (Advanced Plan)
J-01 (Basic Plan) or J-02 (Standard Plan)
J-02 (Standard Plan) or J-03 (Advanced Poan)
not sure (I need more information)
-
Price List and Comparison of each service content
15. Prefered schedule.
*
Please suggest as many as possible
(e.g.: Mon: 6.30-8.30pm, Tue:5:30-7:30pm, Wed: 5.30-9.30pm in EST)
Please don't forget to indicate your timezone .
If you dont have a fixed schedule, please let us know about it.
16. PC / Internet
Operating System(OS)
-
Windows Vista
Windows XP
Windows 2000
Windows Me
Windows NT
Windows 98
Windows 95
Mac
Others
*
Japanese letters
-
I can read and type Japanese letters with my PC.
I can read but cannot type Japanese letters with my PC.
I cannot read and type Japanese letters with my PC.
* Use Japanese?
Internet connection speed
-
0-299 kilobits per second
300-499 kilobits per second
500-999 kilobits per second
more than 1.0 megabits per second
*
Check your connection speed? Here (free service) >>
Click [Start]
We recommend 300kilobits per second or more.
17. Web-cam and Headset
-
I have a web-cam and a headset.
I only have a web-cam.
I only have a headset.
I don't have either.
*
Don't have a webcam yet? Please check here .
18. Windows Live Messenger
-
I have used video-chat with Windows Live Messenger.
I have used only voice-chat with Windows Live Messenger.
I have used only text-chat with Windows Live Messenger.
I have not used Windows Live Messenger at all.
*
SKYPE
-
I have used video-chat with SKYPE.
I have used only voice-chat with SKYPE.
I have used only text-chat with SKYPE.
I have not used SKYPE at all.
*
Which do you prefer to use in lessons?
-
I prefer Windows Live Messenger
I prefer SKYPE
I can use both.
I'm not sure which is better for me.
*
19. Where did you hear about J-OS?
Search engine
Other homepage
Advertisement
Through a friend
Handout
Others
-
and the name is
20. Any other questions and/or requests.
21. Terms of use
-
Yes, I agree.
No, I don't agree.
terms of use *