STUDENT INFORMATION
First Name
Last Name
Nationality (same as passport)
Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan The Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile People 's Republic of China Republic of China Christmas Island Cocos(Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Polynesia Gabon The Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea - Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kosovo Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno - Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Turkish Republic of Northern Cyprus Northern Mariana Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Islands Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Timor - Leste Togo Tokelau Tonga Transnistria Pridnestrovie Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands Isle of Man US Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe
Date of Birth
Email
Whatsapp, LINE or Skype contact
Medical Issues or Allergies list
Name of your DEOW Japan Cousellor
EMERGENCY CONTACT INFORMATION Required for all students joining any of our programs in Japan.
First Name
Last Name
Email
Phone Number
Relationship
Other information
PARENT OR GUARDIAN INFORMATION If different than above. Required for all students who will be less than 18 years old by the start of the program.
First Name (Parent or Guardian)
Last Name (Parent or Guardian)
Email
Phone Number
Relationship
Preferred method of contact
MANGA PROGRAM INFORMATION
Program Type
2-Week Intensive Manga Program Private Intensive Manga Program Online Private Intensive Manga Program
Program Month
January February March April May June July August September October November December
Program Year
Date restrictions? (Please indicate dates *available*)
Favourite Manga works and/or artists?
What genre(s) do you like or wish to create?
What are your goals related to learning Manga?
What specific skills are you hoping to learn or improve upon?
PAYMENT OF PROGRAM We accept two methods of payment:
1. Direct Bank Transfer ¥3,500 flat-rate transfer fee Example of total for group program: ¥377,404
2. PayPal 3.6% transfer fee Example of total for group program: ¥387,365
Requests or remarks (if any):
ACCOMMODATION All 2-Week Group Manga Programs already include a private room in our Manga-themed guesthouse called "Casa Tokiwa" one day before the program starts until one day after the program ends. All classes are held at Casa Tokiwa for all 2-Week Group Manga Programs. For Private Manga Programs, classes can be arranged either at Casa Tokiwa or our office in Shinjuku.
Custom dates or requests for rooms in Casa Tokiwa?
FLIGHT INFORMATION (if known) Please skip this section if your counselor has not told you the dates for the month that you are interested in.
Date & Time of Arrival in Japan
Date
Time
Flight number
Departing from city
Airport terminal (if known)
AIRPORT PICK-UP We can arrange private airport pick-up through our partnered VIP taxi services from either Narita or Haneda airports for ¥35,000 JPY.
PASSPORT COPY We require all participants in our manga programs in Japan to submit a copy of their passport so that we have a form of identification on file in case of emegency or incident.
File Upload
It is possible to submit this at a later time.
EMERGENCY MEDICAL INSURANCE We require all participants who join our manga programs in Japan to obtain emergency medical insurance for at least the duration of the program (14 days). It is possible to use any insurance company that you'd like. We are partnered with WorldTrips by Envisage Global Insurance Group, which provides reliable and comprehensive travel insurance throughout your stay in Japan for ¥280 yen a day plus a one-time enrollment fee of ¥3,000 yen. You can read more about it here .
If you have already obtained Emergency Medical Insurance, please submit a proof of coverage:
PORTFOLIO SUBMISSION Please feel free to share with us any one-shot manga, manga art, other art or illustrations, rough sketches etc. that you have so that our teacher can get an idea of your style and prepare accordingly.
Share URL or website(s)
File(s) Upload
Additional Information, Requests, etc.
Submit
