Contact

Contact

Contact

In addition to the form below, we accept applications for information sessions
and various inquiries by phone or on LINE 24 hours a day. Please feel free to contact us.

At the bottom of the form, you can choose how Dr. Polaris will contact you. Please choose the method that is most convenient for you.

In addition to the form below, we accept applications for information sessions
and various inquiries by phone or on LINE 24 hours a day. Please feel free to
contact us.

At the bottom of the form, you can choose how Dr.
Polaris will contact you. Please choose the method that
is most convenient for you.

必須

Required

任意

Optional

Inquiry Details

必須

Other cases

必須

Applicant

必須

Other cases

必須

Surname

必須

*Please enter the student’s name

First Name

必須

*Please enter the student’s name

Middle Name

任意

*Please enter the student’s name

Grade in School

必須

Other cases

必須

Middle Name

任意

Grade in School

必須

Other cases

必須

Phone Number

必須

*No hyphens, with country and area codes

Email Address

必須

*Please make sure there are no writing errors.

Email Address

必須

*Please make sure there are no writing errors.

Subject

必須

Questions, Messages, etc.

必須

Preferred Method of Contact

必須

If you would like us to contact you on LINE, please first add a friend by clicking on the “Ask on LINE” link on the right/below.

郵便番号

必須

※半角数字、ハイフンなし

住所(宛名)

必須

※半角数字、ハイフンなし

件名

任意

ご質問やメッセージなど

任意

ご希望の連絡方法

任意