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日本語
Home
Testimonials
News
Japan Summer 2025
USA Summer 2025
China Summer 2025
Registration
Gallery
About Us
日本語
Registration (old)
registration form
Program
Program of choice
*
Please select the program you wish to apply for.
Eaglebrook School 2025
Japan Summer 2025 Schedule A (7/22-7/25)
Japan Summer 2025 Schedule B (7/28-7/31)
Japan Summer 2025 Schedule C (7/22-7/25)
Japan Summer 2025 Schedule D (7/28-7/31)
Luoyang Summer 2025 (7/30~8/10)
Luoyang Summer 2025 (8/12~8/23)
Information about Applicant
Applicant's Name
*
First Name
Last Name
Street Address
*
City
*
State
*
Zip Code
*
Country
*
Home Telephone, with country code if applicable
*
Current Grade
*
Date of Birth
*
MM
DD
YYYY
Gender
*
Male
Female
Other
Information About Applicant's Current School
Name of Applicant's Current School
*
Has your child applied to Eaglebrook for the regular school year?
Yes
No
Information about Applicant's Guardian
Guardian's Name
*
First Name
Last Name
Guardian's Preferred Email Address
*
Guardian's Telephone Number
*
Check all that applies
Parents divorced
Parents separated
Mother deceased
Father deceased
Child adopted
Emergency Contact Information
Name and Address of a Relative who may be reached in an emergency, provided that parents cannot be reached
Telephone Number
Relationship to Applicant
Final Information
I wish to enter my child in the following year of the Global Leadership Program, in accordance the policies listed
*
2025
In consideration of the undertaking by the Sponsors of the Global Leadership Program (ConnectEd U Co., Ltd.) to process the undersigned candidate's application for admission and related forms, you agree that the information furnished on the Registration form, together with all the information and materials of any kind received by the company from any source, or prepared by anyone at its request, shall be completely confidential and shall not be disclosed to anyone, including the candidate and his or her family, except that the company may, for official purposes at their discretion, disclose any part or all thereof to such person or persons as they deem advisable.
*
I agree
I disagree
Name of Person Submitting Application (if not Applicant's Parent or Applicant)
First Name
Last Name
Relationship to Applicant
Email Address
Deposit (500 USD) to be paid by December 8th, 2023. The remaining tuition is to be paid by January 10th. In case the deposit is paid by December 8th, 2023, tuition will be reduced to 5250 USD.
Thank you for submitting your application.
