Application for INA Membership

重要：もうしこみが　おわりましたら、かならず　かくにんの　メールが　とどきます。　メールを　チェックしてください。

「＊」のついた　項目は　すべて　入力してください。
手順：
１）必要　項目を　入力
一番下に、申し込むレッスンを選べるようになっています。
２）「内容確認」をクリック
３）「送信」をクリック
４）「終了」をクリック

IMPORTANT:　Please check your email after sending this form. You must receive our auto-return confirmation email.

This application form is for INA free caregiver membership for foreign caregivers working already in Japan, except for TITP trainees who are waiting for documentation and preparing to come to Japan in their home countries. Also, foreign students who are studying at school for kaigofukushishi can join our free membership

Qualification for INA membership:
1) Foreign nationality
2) Residing in Japan
3) Working as a caregiver
*TITP trainees waiting for their documentation to come to Japan are also qualified.

All the items marked with 「*」must be filled otherwise your application form will be an error.

Input Procedure:

1) Complete this form
*We suggest you to check the button at the end of "対応する項目の入力内容をクッキーに保存する" for a case your form results in error. This button will keep your input data for re-writing.
2) Click button of 内容確認(confirmation of input contents)
3) Click button of 送信(send)
4) Click button of 終了(end)

Please note that we will contact you later basically via Facebook messenger from our representatives so that you shall check your inbox.

After filling out this form and sending it by clicking "終了" button, you will see INA's Facebook page. Please drop your message saying that you have sent your application in that fb page, otherwise we may not be able to contact you to confirm your membership.

INA Facebook is here https://www.facebook.com/InternationalNursingCareWorkersAssociation/

After sending this form, do not forget to follow the procedure which we will send you by email also. (Check your email.)

There are 2 important steps to join us as below.

1) Please visit our INA Facebook page and send us your message saying that you have just sent us your application.

-> https://www.facebook.com/InternationalNursingCareWorkersAssociation/

2) Come to our INA Caregiver Member Group and request group join.

-> https://www.facebook.com/groups/INA.Caregivers/

Please kindly be noted that this application form is created by FCS (Foreign Caregivers Support Center Inst.) on behalf of INA while waiting for new application form to be replaced. FCS website is http://caregiverjapan.org/

Thank you.

どのグループ？Which group you want to join? *
Please check it.

日本での名前　Name in alphabet and nihongo *
Your full name in alphabet and nihongo both. かならず　ローマ字と　にほんごの　２つの　なまえを　かいてください。
あなたのフェイスブックの名前　Your fb name as appears in fb *
Write your fb name as it appears in fb. DO NOT WRITE your email address here. If you do not write correct fb name, your application will be rejected.
あなたの　フェイスブックでの　なまえを　かいてください。
年齢　Age *
誕生日　Birthday(year/month/day) *
性別　Sex *


都道府県　Your prefecture (living area) in nihongo
Please select your prefecture in Japanese.
郵便番号　Zip code *
-
日本での住所　Your postal address *
If possible, write in nihongo. できるだけ　にほんごで　かいてください。
国籍　Nationality *
在留カードの種類　Residential status in Japan *








日本に何年いますか？How long you are in Japan *





携帯の番号Mobile Phone Number *
Mobile phone in Japan　まだ持っていない人は「まだありません」と書いてください。
Gメールか携帯のメールGmail or mobile E-mail Address (No Yahoo mail accepted) *
Please write twice your mobile or gmail email address twice. Do not copy and paste it.　かくにんのため　２かい　かいてください。

(確認用)
介護の資格Your caregiver license in Japan *




日本語のレベルNihongo Proficiency Level *





特定技能の人だけ→For SSW caregiver only: Date of passing Prometric skills test
For SSW caregiver only
特定技能の人だけ→For SSW caregiver only: Date of passing Prometric Japanese test
For SSW caregiver only
介護の仕事は何年？Total caregiver experience in Japan *







介護施設の名前／専門学校の名前　Name of nursing care company/name of senmongakkou where you are working or studying *
いま　はたらいている　しょくばの　なまえを　かいてください。りゅうがくせいは　がっこうの　なまえを　かいてください。If you are still in your country, please write your agency name or hiring company name.
今の会社で何年？How long in your current company *
How long have you been working with your current company?　いまの　しょくばで　何年ぐらい　はたらいていますか？
何を勉強したいか？What do you want to study? Any message? *
なにを　べんきょうしたいですか？かならず　なにか　メッセージを　おねがいします。
じつむしゃけんしゅうについて