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Waiting list application form

Please fill in the form bellow.
We will contact you as soon as possible, when there's a vacancy.

Questionnaire with required must be answered.

NOTE:This is not a reservation form. Your reservation will not be completed until we receive your deposit.

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EXE corporation

Building and the room you wish to reserve

Building YOTSUYA HOUSE (Apartment)
Room number 206
Planned move in date (required) ,
Planned move out date (required) ,
Number of people (required)

Note:Room rate for double(2 people use) is 20,000yen higher than single (1 person use).

Your personal information

Sex (required)
years old
Note:If you are under 18 years old, we require your gurantor's conscent.
Purpose of your stay in Japan (required)


Note:If you stay in Japan for sightseeing within 90days, choose "temporary Visitor".
Time limit of visa : ,

If you wish to use credit card, plsese input below.
Credit card number :
Please input four digits in the alphanumeric character.
- - -
Cardholder's name：
Please input it by the normal-width alphabet.exapple) Taro Yamada

Expiration date : /

Substitute information

When the substitute applies, please input below.

Questionnaire

Where did you know this site?
  • ()

  • ()
  • ( )
  • （）
Why do you interest in this building?
(The plural can be selected. )
  • （）
  • （）
Did you use this site before?
  • (Building name :)

Questions & comments

After the input ends, please push "CONFIRM" button.

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