Tsukuba International School
Mission: WHO are we? Our mission describes the nature of our school community and serves as the basis for our school programmes. It also informs our day- to-day interactions with each other. Tsukuba International School A compassionate learning community, centered in nature, celebrating diversity, equality, and opportunity Vision: WHAT are we aiming for? Our vision describes our identity as a school and serves as the basis for our strategic planning. Tsukuba International School is a small school that uses an “at home” approach to deliver a world-class education in a natural environment. The school fosters its noted strengths, including its highly professional teachers, its location in Tsukuba Science City, and its strong community spirit to reach its goals. School-Wide Learning Objectives: WHY are we here? Our school-wide learning objectives describe the kinds of students we want to graduate from our school. Our students learn: to be critical thinkers in order to foster peace and understanding . to be creative thinkers in order to find innovative solutions to problems great and small . to demonstrate integrity in all interactions in order to foster trust . to become ethical stewards of our shared resources . . to communicate and collaborate in order to make a positive contribution to their communities
Definition of International Mindedness
At Tsukuba International School, we believe that international-mindedness is: understanding, accepting, and celebrating human diversity . having a sense of our own identity while respecting others, regardless of their cultures, beliefs, or values . . engaging with the global community to gain a variety of perspectives and to foster a belief in our shared humanity and guardianship of the planet being able to communicate with empathy and compassion, by speaking with our own voice and listening with an . open mind . being a responsible global citizen by making a contribution and taking action to make the world a better place for all
Pledge of Non-Discrimination
Tsukuba International School is an equal opportunity educator and employer. We will not discriminate against any student, prospective student, employee, or job applicant on the basis of race, color, gender, nationality, national origin, age, religion, creed, disability, sexual orientation, gender identity or gender expression. We will take measures to ensure against such discrimination in all of our services and practices. ...
Eligibility
Age of Student at Admission
Tsukuba International School accepts students from age 3 to Grade 10. In special cases, students may be accepted into G11 at the start of the academic year only. Due to the nature of the High School programme, we do not accept new students into Grade 12. Students entering the preschool must be turning 3 years old, fully toilet trained (meaning able to go to the toilet without assistance or special equipment), and able to separate from their primary caregivers in order to be eligible for admission.
adjusted within the first two weeks in light of the student's history and ability.
Knowledge of English at Admission
Student's Knowledge of English All of our subjects are taught in English, with the exception of Japanese language classes. Our school provides an English language immersion programme. Students' English proficiency is assessed during the initial interview. Students entering the younger years of the Primary Years Programme (e.g., preschool) are expected to have some knowledge of English. They do not have to be proficient in English upon entry as it is expected that these students will gain fluency through exposure to the language in the educational context. From Grades 1 to 10, students are eexpected to have functional English at or near grade level in order to be able to keep up with the demanding academic programme that we provide. The following is a basic guideline for families to gauge whether their children are likely to be able to enter our Middle Years Programme (which starts at Grade 6) or Diploma Programme (which starts at Grade 11) based on their English language ability. . Entry to Grade 6 - Approximately Eiken Pre-2 or higher (英検準2級以上) Entry to Grade 8 - Approximately Eiken 2 or higher (英検2級以上) . Entry to Grade 11 - Approximately Eiken Pre-1 or higher (英検準1級以上) .
Parents' Knowledge of English
In order to honour the obligation to cooperate with the school in the child's education, at least one of the parents, preferably both, should be capable of communicating with the school staff in both spoken and written English. In addition, parents must demonstrate a positive attitude towards English. If parents have the attitude that "English is too hard", they will not be able to foster a positive attitude towards English for their children.
Inclusion
Admission of Students with Special Educational Needs The school is committed to developing its capacity to offer inclusive education to all students, including those with special educational needs (SEN). To that end, it is important for parents to inform the school of any previously identified special needs when registering their children at Tsukuba International School. However, it must be recognized that, due to the size of the school, the number of staff members, and/or the resources available in the school and local community, the school may be unable to meet the needs and requirements of some students with SEN. If, after considering all available options, and the best interests of the child and those already enrolled at the school, it is deemed that Tsukuba International School is unable to meet the needs of a registering child, then a place on the roll will not be offered.
Class Size Limits, Waiting Pools, Delayed Entry
Class Size Limits We have a limit of 14 students in Pre-Kindergarten 1, 16 students in Pre-Kindergarten 2, 20 students in Kindergarten to G5, and 23 students in G6 to G12.
Waiting Pools
For students who have been through the admissions procedures and who have been accepted for enrollment, there are three possible next steps. The student is ready to start immediately, and there is space in the class, so the student joins the class. . The student is going to start in the following term, and there is space in the class so a place is reserved for him/her. . He/she starts the class in the following term . The class is full, so the student is placed in a waiting pool until a space becomes available. The school considers a range of factors to determine the order of acceptance of students in the waiting pool. It is not "first come, first in".  When a place becomes available, the parents will be contacted and will continue the enrollment procedure. Students can remain in the waiting pool for the rest of the current school year, and the next school year.  After that point, students may need to be interviewed again to keep their place in the waiting pool.
Delayed Entry
Students who are accepted for admission can delay their entry and reserve their place up to a maximum of one quarter before enrollment by paying the one-time enrollment fees (application, registration). In all cases, if the class is full, the student will remain in the waiting pool until a place becomes available. ...
From Eligibility to Application
1. Confirm Eligibility Determine your child's eligibility for applying to Tsukuba International School. http://tis.ac.jp/admissions/eligibility/
2. Check Waiting Pools
Take note of any waiting pools that might exist for the grade that your child is applying to. http://tis.ac.jp/admissions/waiting- pools/
3. Express Interest in Enrollment
Fill out the online form to express your interest in finding out more about Tsukuba International School. You can use this form to ask for more information before you decide to go further in the process. http://tis.ac.jp/admissions/expression-of-interest/
4. Attend a School Information Session
Attend one of our regular School Information Sessions. This will give you a chance to meet the teachers, see the facilities, and ask questions about the curriculum. http://tis.ac.jp/admissions/school-information-sessions/
5. Apply
If you have determined that you are interested in having your child enroll at Tsukuba International school, and you have followed the above procedures to determine if your child is eligible to apply, follow the application procedures.
Application Procedure
1. Fill out the Application for Admission Form If you have read through all of the information about admissions (including eligibility, waiting pools, school information sessions, etc.), and you have decided that you would like to enroll your child in Tsukuba International School, download the application package (PDF or Word format) and fill out the Application for Admission Form.
2. Request an Interview
Request an interview through our online interview request form. http://tis.ac.jp/admissions/application-procedure/request-an-interview/ The admissions officer will contact you after you submit the form and let you know where to send the application documents: (1) Application for Admissions Form, (2) copy of your child's most recent report card, (3) any additional transcripts from previous school(s). Please be aware that if there is a substantial waiting pool for the grade(s) that you are applying for, then we may not be able to accept your request for an interview at this time. In that case we will keep your application documents on file and will inform you when we are ready to offer an interview for the grade(s).
3.  Attend the Interview
Students will have an assessment interview with a teacher, and parents will be interviewed by the principal. Applicants for Grade 6-11 will be required to do online screening tests in Reading and Math prior to the interview. Please be aware that both parents (or legal guardians) must be present at the interview, in principle (Exceptions may be made in extenuating circumstances, so please contact the school if it is not possible for both parents to attend the interview). Bring a copy of your child's most recent report card to the interview if you have not already included it in the application package.
4. Notification of Results
After the interview, the school will decide whether or not your child will be offered enrollment, based on the teacher's and principal's recommendations. If the teachers feel that they need more information to make a decision, further assessment may be arranged. Notification of the decision will be given within one week of the completion of the interview and any further assessments. ...
5. Acceptance of Offer of Enrollment
The Acceptance of Offer of Enrollment form must be completed and returned within two weeks of receiving the form. You will be required to fill out the Parent (or Legal Guardian) Agreement and Health Appraisal and return them and any supporting materials (immunization records and health insurance card) to the school. In addition, you will be required to pay the application fee at this time.
6.  Waiting Pools
In cases where the student is placed in a waiting pool, the school will contact the family when a place becomes available.
7. Register
When a place is available for your child, the school will send you an online registration form for the academic year that your child is enrolling in.
8.  Pay Registration Fee
Based on the information in your registration form, the school will send you an invoice for the school fees. Transfer the registration fee by bank transfer. Payment of the registration fee will hold your child's place (up to a maximum of one quarter in advance).
9.  Pay Remainder of School Fees
Pay the remainder of the school fees by the deadline indicated on the invoice.
Potential Outcomes of Admission Procedure
Acceptance of Admission If your child meets the eligibility criteria, he/she will be either offered enrollment or placed in a waiting pool (if there is no space in the class).
Provisional Acceptance of Admission
In cases where the entrance interview does not provide enough information for an admission decision to be made, or when the school is not sure whether the candidate meets the eligibility requirements, the school may ask the applicant to return at a later date for further evaluation. If the school is not able to come to a clear conclusion about whether the student will be able to thrive and succeed at the school, but feels that there is that potential, the school may offer the student "provisional acceptance". This means that the student will be admitted for one school quarter for observation and evaluation. At the end of the quarter, the student's parents and teachers will meet to discuss the student's progress and make a decision about whether to grant the student full acceptance of admission.
Admission Declined
When the teachers decide that a student will not be well-served by receiving the education that is provided at TIS, the student will be declined admission.
Admission Discretion
Tsukuba International School is a private institution and consistent with legal requirements, reserves the right to accept or reject any application at its discretion at any stage of the application process, and will not publically disclose the reasons for its decisions. This practice allows the admissions committee to consider a broad range of factors contributing to a student's potential fit and success in the school, while maintaining the confidentiality of the committee's deliberations. ...
Tuition Policies
Payment of School Fees The fees for the entire school year can be paid in one lump sum (due June 1) or three payments (due June 1, October 1, and February 1). The fees for April Enrollment can be paid in one lump sum (due April 1) or three payments (due April 1, May 1, and June 1).
Non Refundable Registration Deposit
Once a student is enrolled, the registration period for the subsequent school year will be from February 1 to March 1. Parents who are registering children for the subsequent school year will be asked to pay a non-refundable registration deposit (equivalent to the facilities fee) to confirm their registration for the next school year.  (*Please note, this is not the same as the Registration Fee which is a one-time enrollment fee due upon acceptance).
Discounts
Lump Sum Discount (10%) Tuition fees can be paid in one lump sum (on or before August 1), or in three payments (due August 1, November 1, and February 1). Families who pay total annual fees in one lump sum on or before August 1 receive a 10% discount on tuition fees. Sibling Discount (25%) The tuition fees for the second (and any subsequent) child who enrolls from a particular family are discounted by 25%. The sibling discount cannot be combined with any other discount. Tsukuba Science City Network Agreement (Discount for children of international researchers) Tsukuba International School has a cooperative agreement with Tsukuba Science City Network. International researchers who work for research institutes and universities that belong to the Tsukuba Science City Network can benefit from reduced tuition fees. This is the school's way of contributing to an environment that allows research institutes in Tsukuba to invite top level researchers from abroad to come to Tsukuba. Note: The school fees are comprised of two one-time enrollment fees (application and registration fees) and four annual fees (facilities, materials, tuition, and activity fees). The above discounts only apply to the tuition fee. The one-time enrollment fees and the annual fees must be paid in full by all students, including siblings.
Accepted Payment Methods
All fees must be paid by bank transfer (furikomi) by the due dates. No cheques or foreign currencies will be accepted.
Penalties for Late Payments
Please note that failure to pay school fees, including the deposit, lump sum, or any of the installments, by the respective due dates may result in the school withholding the student's school reports, references, and/or examination results until payment is made. If payments are not made in a timely manner, the student may be suspended or permanently expelled from the school.
Pro-rated Fees for Mid-Year Enrollment
Tuition fees will be assessed on a pro-rated basis for any partial year that a student attends upon enrollment. The facilities, materials, and activities fees will be assessed in full for any student starting at any time before the first day of second semester. For April Enrollment, the April Enrollment fees apply.
Pro-rated Fees for Partial Year Enrollment with Known Withdrawal Date
In cases when a student will not stay for a full year, and when that situation is reported to the school before the student commences study for that year (by August 15 at the latest), a pro-rated fee may be negotiated based on the amount of time the student will be in attendance. Note that once a pro-rated fee has been negotiated, the student will lose his/her place on the roster as of the final negotiated day of fee payment. Please consult the school for more details about pro-rating fees for a known mid-year withdrawal date. Refunding Tuition Fees All school fees are due in full regardless of the chosen payment plan (lump sum or three installments). The three installment payments are meant to ease the financial burden of a lump sum payment. Refunds for early withdrawal can be given based on the following REPORTING schedule.  Please note that a completed Withdrawal Form must be received by the reporting deadline in order for the refunds to be issued.
Please note that discounts for lump sum payments are revoked when students are withdrawn mid-year.
Tuition Rates
Please see the following pages for the tuition rates for the following grades. . . . Pre-Kindergarten 1, Pre-Kindergarten 2 Kindergarten and Grades 1 to 10 Grades 11 to 12 In addition, please see the information about the following fees. Special Class Trip Fees . External Assessment Fees . User Fees . Bus Fees o After School Care Fees o Enrichment o Students in Grades 4 to 12 are asked to bring their own computers (laptops) to school. ... ... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  www.tis.ac.jp
Unless otherwise noted, all fees must be paid by bank transfer by the due dates. No checks or foreign currency will be accepted. The school's bank account information can be found in the Parent Handbook. Application Fee 20,000 yen (one time, payable within one week of interview) Registration Fee 80,000 yen (one time if admitted, payable by June 1) Activities Fee 10,000 yen (annual, payable by June 1) Facilities Fee 150,000 yen (annual, payable by June 1) Materials Fee 180,000 yen  (annual, payable by June 1) Tuition Fees - Grades K to 10 One payment of 1,320,000 yen (payable by June 1) OR Three payments of 440,000 yen each (payable by June 1, Oct.1 and Feb 1) Application Fee interview.
Registration Fee Must be paid in full before the first day of school. Activities Fee Must be paid in full before the first day of school. Facilities Fee and Materials Fee Must be paid in full before the first day of school and may not be paid in installments. Tuition Fees The Tuition Fee for the entire year may be paid in one lump sum before the first day of the first semester or, in order to meet the needs of those for whom a large lump sum payment may be difficult, TIS offers payment by 3 installments. If payment is not made within two weeks of the deadline, the student will be dismissed from classes.
2025 April Enrollment
Application Fee 20,000 yen (one time, payable within one week of interview) Registration Fee 80,000 yen (one time if admitted, payable by Apr 1) Activities Fee 10,000 yen (annual, payable by Aug 1) Facilities Fee 50,000 yen (payable by Apr 1) Materials Fee 60,000 yen (payable by Apr 1) Tuition Fees - Grades K to 10 One payment of 440,000 yen (payable by Apr 1) OR Three payments of 150,000 yen, 150,000 yen and 140,000yen (payable by Apr 1, May 1, Jun 1) Application Fee Must be paid by bank transfer within one week of the interview. Registration Fee Must be paid in full before the first day of school. Activities Fee Must be paid in full before the first day of school. Facilities Fee and Materials Fee Third term installment must be paid in full before the first day of school. Tuition Fees The Tuition Fee for April Enrollment may be paid in one lump sum before April 1, or in order to meet the needs of those for whom a large lump sum payment may be difficult, TIS offers an installment plan of three payments on April 1, May 1, and June 1. If payment is not made within two weeks of April 1, the student will be dismissed from classes. ...
Unless otherwise noted, all fees must be paid by bank transfer by the due dates. No checks or foreign currency will be accepted. The school's bank account information can be found in the Parent Handbook. Application Fee 20,000 yen (one time, payable within one week of interview) Registration Fee 80,000 yen (one time if admitted, payable by Aug 1) Activities Fee 10,000 yen (annual, payable by Aug 1) Facilities Fee 150,000 yen (annual, payable by Aug 1) Materials Fee 180,000 yen (annual, payable by Aug 1) Tuition Fees – Grades 11-12 One payment of 1,440,000 yen (payable by Aug 1) OR Three payments of 480,000 yen each (payable by Aug 1, Nov 1 and Feb 1)
Please note that Grade 11 and 12 students will need to pay the Diploma Programme Assessment Fees (in their graduating year) and the Diploma Programme Online Subject Fees for any online courses they take. Diploma Programme Assessment Fees 85,000 yen (estimate) paid in graduating year This includes fees for registration, up to six disciplinary subjects, and three core subjects. This amount is accurate as of January 2023. The exact amount will change depending on the students' enrollment in DP courses and the IB fee structure. Please note that these fees are set by the International Baccalaureate Organization and are subject to change. Diploma Programme Online Subject Fees US$ 1390 or US$ 1500 per subject per year High school students can take a maximum of one Diploma Programme subject online. Please note that these fees are set by Pamoja and are subject to change. This amount is accurate as of January 2023 Please note that discounts do not apply to DP Programme Assessment Fees or DP Online Subject Fees as they are paid to external organizations.
In addition to our regular educational field trips (cove-red by the Activities Fee), our students go on a special excursion with their classmates every year. This trip is a mandatory part of the TIS educational program. We ask parents to contribute the following amounts for these trips. The amounts may vary slightly each year based on the costs of the trips, but this is the approximate estimate of the cost per grade. PYP parents will be informed of the actual amount, and the deadline for payment, closer to the time of their child's class trip. MYP / DP parents will be invoiced for the trip fees at the beginning of the school year.
Parents must pay the necessary fees for external assessments. Some of these tests are mandatory and some are optional. Parents will be informed of the amount, and the deadline for payment closer to the test dates Japanese Language Examination (Nihongo Kentei) - from 1400 yen to 6000 yen, depending on the level - Held in June. . Japanese Language Proficiency Test - 5500 yen • • Kanji Proficiency Test – from 1400 yen to 4500 yen, depending on the level - Held in Feb. MAP Tests – school funded - Held two to three times during the school year. . TOEFL ITP Test –school funded - Held in Dec.
The following fees only apply to those who use these services. Bus Fees To and from Banpaku Kinen Koen Station . Return Trip = 15,000 yen per month Y A One Way Trip = 10,000 yen per month To and from all other stops (See https://tis.ac.jp/about/school-bus/ for the list of stops) . Return Trip = 18,000 yen per month A Y One Way Trip = 12,000 yen per month Bus fares can be paid in one lump sum for 10 months (due August 1) or at the beginning of every month (due on August 1 and then the first day of every month from October to June). Bus can be used on a one time only basis for a fee of 1000 yen to all stops.
After-School Care Fees
Parents can use this service on a per-day, per-month, or per-year basis. Reservations must be made at least one day in advance. Parents who chose to pay on a per-day basis must remit the payment at least one day in advance. Parents who choose to pay on a per- month basis must remit the payment before the 1st of the month. Parents who choose to pay on an annual basis must remit the payment before September 1. When the monthly or yearly rates are chosen, refunds will not be issued for days missed.
Enrichment Fees The school offers various after-school enrichment programs to our students. These programs are designed to enhance the student's knowledge, abilities, and understanding of particular fields.  Fees vary according to the programme.  Some are free and some have a fee.
August 2024 20-22  Staff Focus Days Annual Community Orientation 23 Q1 Starts, First Day of School 26 September 4 18 23 25 DP Information Session (4:30pm) 16-17 Parent-Teacher Conferences (No School) MYP Information Session (4:30pm) National Holiday (No School) PYP Information Session (4:30pm) October 9 11 24 25 31 MYP ManageBac Session (4:30pm) MYP/DP School Spirit Day 14-18  Fall Break (School Holidays) Student Health Checks (PYP) PYP School Spirit Day Student Health Checks (MYP)
November
2 4 S Fall Festival National Holiday (No School) Day off in Lieu of Fall Festival (No School) Q2 Starts TIS Futures Event Staff Focus Day (No School for Students) 14 8 22 December 6 13 15 20-5 MYP/DP Indoor Sports Day G9 Play (5:00pm) TOEFL ITP Test for MYP, DP Winter Break (School Holidays) January 2023 6 7 13 30 Staff Focus Day (No School for Students) Classes Resume National Holiday (No School) 29-10 G12 Mock Exams Q3 Starts February Student-Led Conferences Day (National Holiday) 11 12 G9 High School Information Session (4:30pm) 24 National Holiday (No School) 26-28 G10 Personal Project Presentation Days March Deadline for Registration for 2025-26 School Year 1 3-7 Spring Break (School Holidays) G10 DP Subject Selection Evening (4:30pm) 12 Life Celebration Event 14 MYP/DP Indoor/Outdoor Sports Day 19 20-21  Staff Focus Day (No School for Students) April April Enrollment 1 DP Art Exhibit 4 14-25  PYP Three Way Conferences Lower PYP Sports Day 19 Q4 Starts 22 28-21  DP Final Exams Period 29 Staff Focus Day (No School for Students) May 1-2 5-9 14 29 30 30-6 G6-9 MYP Overnight Trips (Tentative) Golden Week Break (School Holidays) G10 Debate Upper PYP Sports Day Staff Focus Day (No School for Students) G11 Mock Exams June 2-4 6 11 20 24 25 26 G9-G10 Assessment Week G12 Graduation Ceremony (Half Day for Students) G5 PYPX Expert Consultation 11-13 G10 Overnight Trip (tentative) 16-20 MYP/DP Music Festival Senior Dance (G9-12) Completion Ceremonies (K, G5, G10) Last Day of School Year PYP/MYP/DP Final Reports Issued Summer Break Begins Total number of school days: 180 Items in BOLD TYPE are events that parents are likely to attend. Please consider arranging your schedule accordingly if you plan to attend. Checklist of Application Procedures
Please keep copies of all forms for your records. ...
2024-25 Academic Year Please read the information in this package and on our website and make sure you have a clear understanding of the objectives of our school before you decide to enroll your child.  Please contact the school if you have any questions. Please fill out pages 17-20 of this form and return it to the school on the occasion of your child's interview. If you have not already scheduled an interview, please do so at the following site: http://forms.tis.ac.jp/interviewrequest.html. Please fill out pages 21-26 after your child has been accepted for enrollment (after the interview). Information about Student and Family (please include one form for each student who will be applying) All students must reside together with either (1) at least one parent or (2) a named legal guardian who is at least 20 years of age, who has been specifically introduced to the school, and who has been approved by the school. . STUDENT Last name
FATHER
or legal guardian
□ Student's home address Address
MOTHER or legal guardian
□ Same as above
... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp Language Profile of the Student List all languages spoken by the student What language does the student speak at home? What language does the father use to speak to the student? What language does the mother use to speak to the student? What language do siblings use to speak to the student? At what age was the student first exposed to English? Has this student ever attended an English-based school? Has the student taken any form of English tests, and if so, what are the scores? Additional comments regarding the student's language profile.
Has your family ever lived outside Japan or your home country? If so, please provide a brief explanation □ YES    □ NO Previous Education (list all previous schools attended, including kindergarten) Location (City, Country) Name of School Grade(s) ... ... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp Motivation Why do you want to enroll your child in Tsukuba International School? ___ The following section is for the student to fill out him/herself. This section should be filled out by students who would be entering Grade 5 or higher. Why do you want to come to Tsukuba International School? ___ ___ (use extra paper, if necessary) ... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp Educational History Has this student ever been retained in a grade? If so, please provide a brief explanation □ YES Briefly describe any special extra-curricular interest, hobby, talent, or aptitude possessed by this student. Has this student ever been suspended from school? If so, please provide a brief explanation o YES o NO Does this student have any educational, physical, emotional and/or behavioural needs? If so, please provide a brief explanation □ YES □ NO Please describe the nature of any past disciplinary problems. Please indicate the email address for a contact at your child's current school who we can contact to provide a confidential reference.  (This should be the child's homeroom teacher, or principal/head of school) ... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp Grade: ___
1. I understand that Tsukuba International School does not discriminate on the basis of race, color, gender, nationality, national origin, age,
8. I have read and understand the Community Policies on Finance and Penalties for Late Payments and I understand that all school fees are due in full regardless of the chosen payment plan (lump sum or three installments). The three installment payments are meant to ease the financial burden of a lump sum payment. Signatures Father/Legal Guardian Mother/Legal Guardian Refunds for early withdrawal can be given based on the REPORTING schedule in the Community Handbook.  Please note that a completed Withdrawal Form must be received by the stated reporting deadline in order for any refunds to be issued, with October 1st being the latest reporting deadline for a withdrawal in the third or fourth quarter of that
information that may lead to the identification of the child or the school.
Date Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp
Date: STUDENT Last name

Emergency Contact Information
Please provide many different ways to contact you in case of emergency. Parent/Legal Guardian
Parent/Legal Guardian
TEXT/SMS Email Contact other than Parent/Legal Guardian Last name
Relationship
... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp
Regular Doctors, Clinics, Hospitals
Please list the contact information for your child's regular physicians.  This will assist the school in providing your child with the best care options in case of an emergency. Regular Doctor (if any)
Regular Dentist (if any)
Other Physician (if any) Last name
List any clinics/hospitals in TSUKUBA where your child has been for treatment. (In case of emergency, we will attempt to take your child to a clinic or hospital where your child is a patient, if it is feasible. ... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp
Please explain any problems noted above. Does your child take any medication regularly? If so, please indicate what medication and the reason for taking it. □ YES o NO ... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp
Immunizations
Please indicate the date of the most recent immunization.  Statements such as "up-to-date" will not be accepted.  You may attach a copy of the most recent immunization record. Date 1. Diphtheria, Pertussis, and Tetanus (DPT): first series 2. Diphtheria and Tetanus of TD Booster 3. Oral Polio (most recent) 4.A. Combined Mumps, Measles, and Rubella (MMR) *or* B. Rubeola (Red Measles) Live Virus Vaccine *and* Rubella (3-day or German Measles) *and* Mumps 5. Hepatitis B 6. TB Other (list with dates) Physical Examinations, Inspections, Tests, and Measurements If your child has had any of the following tests, please list the results here.
... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp
Physician's Recommendations
Does the student have any visual or auditory (or other) problems that the school should accommodate (arranging seating plans, etc.)? □ YES
Should the student's activities be restricted due to any physical condition or illness? ¤ YES    ¤ NO If yes, please explain the necessary accommodations and/or the degree of restriction.
Date
Dentist's Recommendations
Does the student have any dental issues that the school should be made aware of? □ YES    □ NO If yes, explain the issues. Dentist
Date Signatures If I cannot be reached, I give TIS personnel permission to seek emergency treatment for my child. Father/Legal Guardian Date Mother/Legal Guardian Date Please attach a copy of the child's current health insurance card to this form. This will greatly assist the school when seeking emergency treatment for your child. ... Tsukuba International School Kamigo 7846-1, Tsukuba, Ibaraki, JAPAN 300-2645 Tel: 029-886-5447  Fax: 029-886-5562  www.tis.ac.jp