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Student Application Nonvisa

Application: Non-Student Visa /申込書(記入はアルファベットで)

*required field /必須

Personal Information /申込者

First Name* /名

Family Name* /姓

Gender* /性別

Date of Birth* /生年月日(例: 月月/日日/年年年年)

Country of Citizenship* /国籍(例: Japan)

Contact Information /連絡先と住所

Your Email* /メールアドレス

Street Address* /番地(例: 3-3-9-604,Kamiosaki)

City/Town* /町市区(例: Shinagawa-ku)

State* /都道府県(例: Tokyo)

Postal/Zip Code* /郵便番号(例: 141-0021)

Country* /国(例: Japan)

Primary Phone* /電話1(例: 03-5555-0123)

Secondary Phone /電話2

English Programs /英語プログラム

Select a Program* プログラムを下記よりお選びください

Teens & Kids English Program and Activities /ティーンズ&キッズプログラム

Select a Program* プログラムを下記よりお選びください

Select a Level* /英語レベル

Period of Study /参加期間

Start Date* /スタート日(例: 08/01/2016)

End Date* /最終日(例: 08/26/2016)

Accommodation Information

Choice of Accommodations* /滞在先手配

Accommodation Start Date* /滞在先チェックイン
(weekend before class start date is recommended)

Accommodation End Date*/滞在先チェックアウト
(weekend after class end date is recommended)

Do you require an airport transfer? ($130 round-trip airport transfer is mandatory for homestay)

Notes or Messages?

Your Message /コメント

Tuition /授業料
  • Full payment of tuition or payment of first 12 weeks (if studying longer) is due 15 days before the student's first day of classes. 12週間以上の滞在の場合、最初の12週分の授業料を授業開始日の15日前までに支払う。
  • If registering 30 days or less before first day of class, full payment is due upon registration confirmation. 授業開始日より30日前以降のお申込みの場合、お申し込みを以って全額を支払う。
  • Email registrar@icchawaii.edu for payment. お支払いは registrar@icchawaii.edu まで。

How will you pay application fee(s)?* /支払い方法

(in person, via phone, or with authorization form) (直接、お電話又は専用フォームにて)
(Visa, MasterCard, American Express, Dinners, JCB, and UnionPay)

payments accepted paypal

Terms & Conditions:

In order to submit your application, you must pay the $175 registration fee by PayPal, credit card, cash, check, or wire transfer. After the receipt of your online application, you will receive an email from Intercultural College within three business days with a confirmation of your application. If you are applying for accommodations, you are required to pay the $195 Accommodation Placement Fee. The Registration Fee and Accommodation Placement Fee are nonrefundable. Full payment is due 30 days before the student's first day of study. If registering 30 days or less before first day of class, full payment is due upon registration confirmation. ICC accepts PayPal, cash, check, credit card, or wire transfer. Please make checks payable to Intercultural Communications College. The payee is responsible for all wire transfer fees. For more information, please contact our registrar at registrar@icchawaii.edu.

*I agree to the terms and conditions above and have read and understand ICC tuition and accommodation cancellation policies.上記のterms and conditionsを読み、ICCの授業料及び滞在費のキャンセル規定を読み、理解しました。

Contact Us

Intercultural Communications College
810 Richards St #200
Honolulu, HI 96813
Hours
Monday – Friday
8:00am-5:00pm
Telephone
+1 808 946-2445
Fax
+1 808 946-2231
Email
info@icchawaii.edu

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