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Application

Please fill out the form to book a room.

* These sections must be completed.

Sharehouse name

Domingo Sakurashinmachi

Domingo Ayase

Domingo Sasazuka

Room No

Move in date

Move out date

Your name

Nationality

Sex

Male

Female

Age

+ -

Email address

Telephone number

Your post Number (Now)

Your address (Now)

Workplace or school name

Workplace or school address

Workplace or school phone number

Emergency contact name

Emergency contact address

Emergency contact phone number

Relationship

Initial cost payment method

Bank transfer

Paypal (credit card）

Message

プライバシーポリシーが適用されます

メモ: * は入力必須項目です

Please feel free contact us.