5-13-39 Shirokanedai, Minato Ku, Tokyo 108-0071 (MAP)
〒108-0071 東京都港区白金台5-13-39

03-5421-4186 / 03-3446-3478
enquiries@kspacetokyo.org

Kspace@Home Enrolment Form

Parent's Name (first/family) *
Email Address *
Phone Number *
Home Address *
Have you ever attended Kspace before? * No   Yes
Sr. No. Child’s Name (first/family) Child’s Gender Child’s Date of birth (dd/mm/yyyy)
Child 1)
Child 2)
Child 3)

Leave a list of the other programmes you are interested in, if any:

After School Classes
Private Tuition (Academic/Language/Assessments/Interview etc.)
Saturday School
Private Music Tuition (Various instruments)
Birthday Parties
Seasonal School
DATA PROTECTION STATEMENT

The information you provide on this form is required by Kspace International School as part of the admissions process. The data is stored and processed in-house, and not shared with any other parties or organisations.
Parent/Guardian Online Signature
Signature *:
Date *: