Tokyo University of the Arts Gieshin Dormitory Application Form(for International students with JEES guarantee)
Ver.20240105

To Mainichicomnet Co., Limited

Name of buildingRent
Managementfee

Tokyo University of the Arts
Gieshin Dormitory

Roomnumber

Room will be assigned
after selection.

date ofcontract
start

Type B: JPY 76,200
JPY 8,000

Admin Fee

JPY 84,200

date ofcontract
terminationYYYYMMDD

YYYY

MMDD

If you would like to apply for Type B, please confirm the following item and check the box if applicable.

□ If type B is not available, I would like to apply for type A.
Please fill in all items in the bolded box.

Bicycle(registration fee JPY 500 tax included)

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

Motorbike(JPY 3,300 /month tax included)

Applicant (resident)
Furigana

Date of birth
YYYYEnter theaddress as it isshown on theresidence card.

Name→Male / Female

Gender（〒Furigana－DDMMAge）
Nationality

Address

Prefecture（TelephoneCity）（Mobile＠E-mail address*Requiredinformation→）

Residence of primary household earner
Commuting to school

Commutable / Impossible to commute (One-way commuting time when commuting is possible:hourminutes)*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".
■ 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’s Insurance
for Foreign Students Studying inJapan□ 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 ArtsFacultyStudent IDDegree□ Bachelor □ Master □ PhD □ Research □ Special course □ Others (Durationfrom)toYYYYMMDDYYYYMMDD* Status at the University at the time of moving into the dormitory□ Fine Arts □ Music□ Film and New Media □ Global Arts

Faculty
Student IDDegree□ Bachelor □ Master □ PhD □ Research □ Special course □ Others (Durationfrom)toYYYYMMDDYYYYMMDD* 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.

□ 3/27□ 3/28□ 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.

YM

D

Applicant signature

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

BranchTokyo Station
branchContact forapproval

Final approval

/

/

YesNo

Person-incharge
Date

Landlord approval//

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