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The application form for the temporary childcare service

This is the application form for the "Temporary Childcare Service" of Nara Institute of Science and Technology.
・This service is available for children (6 months old to 6 years old) of faculty, staff, and students who are in charge of operations on the day of events such as Open Campus.
・The service is also available to students as long as they are in charge of the event.
・There is no charge for this service.
・For details on the childcare center and what to bring, please contact the Office for Gender Equality by e-mail after submitting this form.

*are required


*Occupation (if you are a student, please state whether you are in the first or second semester and your year of study)

*Name of user

Last name First name

*Email address

*Emergency contact details such as phone number

- -

*Name of user’s child, gender, age (Date of birth)

e.g. ) Sentan Taro, male 5 years old (born October 3, 2013)
※ If you have multiple children, please state the other child’s details in a new line.

*Other relevant information (preferred childcare hours, allergies, etc.)

*Consent (Japanese only)

Agree Disagree

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