1. Name [Mandatory field]

2. Telephone number

3. E-mail

4. Occupation / Type of visa

5. Visa expiration date

6. Address(Home country)

7. TEL(Home country)

8. School (Office) name

9. School (Office) TEL

10. Intended period of residence in Japan

11. Current residential area

12. Apt. that you are interested in

13. Estimated moving date/How many people?

Q1. An estimated period of stay with Netroom

Q2. Estimated rent

Q3. An area that you’re interested in

Q4. Desired commute time (Maximum)

Q5. Room size

Q6. Do you have any electric home appliances or furniture?

Q7. Do you have any appliances want to rent?

Q8. How did you find out about Netroom?

Q9. Who is your agency?

Q10. What do you think of your agency?

Q11. Do you have a guarantor?

Q12. Do you want pick-up service?

Q13. Other comments