Tokyo University of the Arts Geishin Dormitory Application Form(for International students with JEES guarantee)

To Mainichi Comnet Co., Ltd.

Ver.20240105

Tokyo University of the Arts
Geishin Dormitory

Name of building

RoomnumberRent
Type A: JPY 37,900
Management
Admin Fee
JPY 8,000
fee(Please fill in all items in the bolded box)
Please circle desired option.
Option※In principle, up to one vehicle per roomYYYYMMDD

JPY 45,900

date ofcontract
terminationYYYYMMDDBicycle

Motorbike(registration fee JPY 500 tax included)(JPY 3,300 /month tax included)Music practice room: JPY 15,000 per month (tax included)*The number of rooms available for registration is limited. If you use the room for more than 6 months, thefee can be deducted from your bank account together with the dormitory fee.

Please circle desired option.
※In principle, up to one room per roomOption

Room will be assigned
after selection.

date ofcontract
start

Applicant (resident)
Furigana

Date of birth

YYYYEnter theaddress as it isshown on theresidence card.

Name（〒Furigana－DDAge）
NationalityAddress

Prefecture（TelephoneRequiredinformation

Male / Female

Gender→MMCity））

＠E-mail address*→（MobileResidence of primary household earner

Commuting toschool

Commutable / Impossible to commute (One-way commuting time when commuting is possible:*If you have set your e-mail settings to reject all e-mails at once or to receive only the specified e-mail,please change your settings to be able to receive e-mails from "maicom.co.jp".

hourminutes)■ Please be sure to check the following items.
International students who would like to apply for JEES guarantee system need to join the "Comprehensive Renter's Insurance for Foreign Students Studying inJapan"offered by the Japan Educational Exchanges and Services. (Failure to join this system will result in revocation of permission to enter the dormitory)*"Comprehensive Renter's Insurance for Foreign Students Studying in Japan" (Annual insurance premium: JPY 4,000, renewed annually)
Comprehensive Renter’sInsurance for Foreign Students
Studying in Japan□ I understand it.
□ I don’t understand it.
□ I do not request JEES guarantee.

If my application is accepted,□ I’ll enroll in this system.

□ I’ll not enroll in this system.

* Status at the University at the time of application□ Fine Arts □ Music□ Film and New Media □ Global Arts

Faculty
Student IDDegree□ Bachelor □ Master □ PhD □ Research □ Special course □ Others (Durationfrom)toYYYY

MMDD

YYYY

MMDD

* Status at the University at the time of moving into the dormitory□ Fine Arts □ Music□ Film and New Media □ Global Arts

Faculty
Student ID

Degree□ Bachelor □ Master □ PhD □ Research □ Special course □ Others (DurationfromtoDD

YYYY* Would you like to apply for housing support if you are unable to enter a dormitory after the selection process?

□Yes □No■ Please be sure to check the box below to agree.
□ We will explain the dormitory rules and regulations when you move in. Please select a date to move in.

□ 3/28YYYYMM□ 3/27

MMDD□ 3/29□ If the "Cancellation Date" is less than the advance notice period for cancellation, an amount equivalent to the rent will be charged for shortfall.
□ I will move out of the dormitory by March 20 if I move out in March.
□ I have read and agree to the contents of the attached “Handling of Personal Information”.
I confirm that the above statement is correct.
I have read the attached application guidelines and agree to the following terms and conditions before applying for the dormitory.
(1) I agree to waive any and all rights related to the application in the event of any falsehoods or discrepancies in this information.
(2) If my application is turned down because of whatever reason of the Landlord, I’ll not ask for disclosure of the reason.
(3) Mainichi Comnet Co., Ltd. or the Landlord can contact me and my joint guarantor directly for confirmation of the information I have provided here.

YMD

Applicant signature

Additional information (e.g., change of contract shipping address, etc.)

BranchTokyo Station
branchPerson-incharge
Date

Landlord approval

Contact forapproval

Final approval

/

/

Yes
No/

/

Tokyo University of the Arts
Dormitory Application Information Desk(within Mainichicomnet)
TEL 03-5204-8502
FAX 03-5204-8503)