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〒430-0905 Shizuoka-ken Hamamatsu-shi Chuo-ku Shimoikegawacho 68-1 Seiwa Building 4F
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Name
E-mail
Age
Age*
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
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45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
Birthday
Month*
01
02
03
04
05
06
07
08
09
10
11
12
Day*
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year*
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
Phone Number
Gender
Gender*
Male
Female
Prefecture
Prefecture*
Aichi
Akita
Aomori
Chiba
Ehime
Fukui
Fukuoka
Fukushima
Gifu
Gunma
Hiroshima
Hokkaido
Hyogo
Ibaraki
Ishikawa
Iwate
Kagawa
Kagoshima
Kanagawa
Kochi
Kumamoto
Kyoto
Mie
Miyagi
Miyazaki
Nagano
Nagasaki
Nara
Niigata
Oita
Okayama
Okinawa
Osaka
Saga
Saitama
Shiga
Shimane
Shizuoka
Tochigi
Tokushima
Tokyo
Tottori
Toyama
Wakayama
Yamagata
Yamaguchi
Yamanashi
City
City*
Nationality
Nationality*
Brazil
Peru
Philippines
Japan
Thailand
Vietnam
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brunei
Burkina Faso
Bulgaria
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Croatia
Cuba
Cyprus
Czech
Denmark
Dominican Republic
Ecuador
England / Great Britain
Egypt
El Salvador
Estonia
Eithiopia
Fiji
Finland
France
Gambia
Germany
Ghana
Greece
Greenland
Guatemala
Guinea
Haiti
Holland / The Netherlands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Jordan
Kenya
Kosovo
Kuwait
Laos
Latvia
Lebanon
Liberia
Libya
Lithuania
Luxembourg
Madagascar
Malawi
Malaysia
Malta
Maldives
Mauritius
Mexico
Moldova
Monaco
Mongolia
Morocco
Mozambique
Myanmar
Nepal
New Guinea
New Zealand
Nicaragua
Nigeria
North Korea
Norway
Oman
Pakistan
Palestine
Panama
Papua New Guinea
Paraguay
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saudi Arabia
Scotland
Senegal
Serbia
Seychelles
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sweden
Switzerland
Syria
Tahiti
Taiwan
Tanzania
Tunisia
Turkey
Uganda
Ukraine
Uzbekistan
United Arab Emirates
United Sates of America
Uruguay
Vatican
Venezuela
Wales
Yemen
Zambia
Zimbabwe
Marital status
Marital status*
Married
Single
Japanese Language Proficiency
Speaking
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Undertanding
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Hiragana - Reading
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Hiragana - Writing
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Katakana - Reading
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Katakana - Writing
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Kanji - Reading
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Kanji - Writing
Select...
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Licenses
Regular Licence
Regular Licence*
No
Yes
50cc Scooter Licence
50cc Scooter Licence*
No
Yes
Truck
Truck*
No
Yes
Lift
Select...
No
Yes
Tamakake (Guindaste)
Select...
No
Yes
Commute Method
Commute Method*
Car
Motorcycle
Bycicle
Transportation Required
Scooter
Transporte Público
Shift Preference
Shift Preference*
Day Shift
Night Shift
Alternated
Available for Extra Hours?
Available for Extra Hours?*
No
Yes
Are you able to move?
Are you able to move?*
No
Yes
Past Work History 1
Factory Name
Job Agency
Industry Category
Select...
Auto Parts
Automobile Manufacturing
Motorcycle Parts
Fabricação de Motocicletas
Electronic Components
Industrial Componets
Naval Equipment
Cosmetics
Musical Instrument Components
Construction Materials
Rubber Products
Food Industry
Services
Other
Type of Service
Occupation
Start
Select...*
01
02
03
04
05
06
07
08
09
10
11
12
Select...*
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
End
Select...*
01
02
03
04
05
06
07
08
09
10
11
12
Select...*
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
The reason for leaving the job
Select...
Power Harassment
Accident
Workforce Reduction
Financial Crisis
Caring for Small Child(ren)
Distance from the Factory
Study
Pregnancy
Incompatibility with the Environment
Incompatibility of Schedules
Incompatibility with the Job
Maternity Leave
Residential Relocation
Job Change
Personal Reasons
No Overtime
Relationship Issue
Decrease in Production
Factory Renovation
Return to Home Country
Contract Termination
No Explanation
Low Salary
Contract Expiration
Service Termination
Medical Treatment
Getting a Driver's License
Past Work History 2
Factory Name
Job Agency
Industry Category
Select...
Auto Parts
Automobile Manufacturing
Motorcycle Parts
Fabricação de Motocicletas
Electronic Components
Industrial Componets
Naval Equipment
Cosmetics
Musical Instrument Components
Construction Materials
Rubber Products
Food Industry
Services
Other
Type of Service
Occupation
Start
Select...*
01
02
03
04
05
06
07
08
09
10
11
12
Select...*
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
End
Select...*
01
02
03
04
05
06
07
08
09
10
11
12
Select...*
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
The reason for leaving the job
Select...
Power Harassment
Accident
Workforce Reduction
Financial Crisis
Caring for Small Child(ren)
Distance from the Factory
Study
Pregnancy
Incompatibility with the Environment
Incompatibility of Schedules
Incompatibility with the Job
Maternity Leave
Residential Relocation
Job Change
Personal Reasons
No Overtime
Relationship Issue
Decrease in Production
Factory Renovation
Return to Home Country
Contract Termination
No Explanation
Low Salary
Contract Expiration
Service Termination
Medical Treatment
Getting a Driver's License
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