Lesson Enquiry Form for Japanese4all.com
1.
Title
Mr
Mrs
Miss
Ms
other
2.
Name
3.
Age
under 10
between 11 and 15
between 16 and 20
between 21and 30
over 31
over 41
over 51
4.
Phone number
5.
Email
6.
Address
7.
Objectives
Objectives/reason(s) for learning Japanese
8.
Number of students
1
2
between 3 and 5
over 5
9.
Speaking level
10.
Listening level
11.
Writing level
12.
Reading level
13.
Any exam?
Have you sat any Japanese-language exam(s) before?
14.
Lesson venue
Where would you like your lesson to be held?
15.
How often?
How often would you like to take lessons?
16.
J4A?
How did you hear about J4A?
17.
When?
When would you like to take lessons?
18.
What key words?
If you used a Search engine to find J4A, what key words did you type in?
19.
Search Engine
What search engine did you use - Google, Netscape, etc.?
20.
Any questions?