Your Emergency Contact Information

The information you provide in this survey will be used as emergency contact for any crucial situation [OIST Privacy Policy]

First name *

Last name *

Category of Student *

*If you don't have student ID yet, please choose "Incoming"

Student ID number *

if you are an incoming student, please put "incoming".

Is this your first time to submit your Emergency Contact Information? *

Do you want to change your Emergency Contact Information? *

Please update information where necessary.

Please "submit" and finish. Thank you!

Email address (other than OIST email address)* *

Email address (other than OIST email address)_n

Do you have your contact number in Japan? (Cellphone number or etc.) *

Do you have your contact number in Japan? (Cellphone number or etc.)

Your contact number in Japan (Cellphone number or etc.) * (+81)

Your contact number in Japan (Cellphone number or etc.) (+81)

Your current contact number (Cellphone number or etc.) *

Please put your contact number with your country code.

Your current contact number (Cellphone number or etc.)

Please put your contact number with your country code.

Do you currently live in Okinawa? *

Do you currently live in Okinawa?

Your building name *

Your building name Other...

Please fill in if you have already reside in Okinawa. If you choose "Other", please write the room number, building name and address.

Your building name

Your building name Other...

Please fill in if you have already reside in Okinawa. If you choose "Other", please write the room number, building name and address.

Your room number * Room #

Your room number Room #

Your current address *

Your current address

Please fill out your emergency contact of your Contact 1 and Contact 2 below

First Contact (Your family's information)

Name (Given/ Family ) *

Relationship to You *

Address *

Country *

Postal Code *

Phone number (HOME) *

Please put contact number with country code.

Phone number (Business)

Please put contact number with country code.

E-mail address *

Does the person speak English? *

Yes

First Contact (Your family's information)

Name (Given/ Family )

Relationship to You

Address

Country

Postal Code

Phone number (HOME)

Please put contact number with country code.

Phone number (Business)

Please put contact number with country code.

E-mail address

Does the person speak English?

Yes

Second Contact (Your family's information)

Name (Given/ Family )

Relationship to You

Address

Country

Postal Code

Phone number (HOME)

Please put contact number with country code.

Phone number (Business)

Please put contact number with country code.

E-mail address

Does the person speak English?

Yes

Second Contact (Your family's information)

Name (Given/ Family )

Relationship to You

Address

Country

Postal Code

Phone number (HOME)

Please put contact number with country code.

Phone number (Business)

Please put contact number with country code.

E-mail address

Does the person speak English?

Yes

Do you have any dietary preference (e.g. vegetarian, vegan etc…)? Other...

Allergy *

What code is in the image? *

Enter the characters shown in the image.

Leave this field blank