Resting rooms for woman

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Application for user registration (resting rooms for women, Building No. 1, No. 3, and No. 5 of the Faculty of Medicine)

Name in kana: (Example: とうきょう　はなこ)
Name: (Example: Hanako Tokyo)

Department: 
(Major/Center of study, etc.)
(undergraduate students please enter your department of
study)
(Example: School of Integrated Health Sciences,
Faculty of Medicine)
Classroom name:
(undergraduate students please enter your year of
study for 2024)
Title:

Student ID no.:
Building in which your classroom is located:
(In principle, please use the resting room closest to your classroom, but you may use the available resting rooms in any other building, if necessary.)







E-mail
(Please provide your email address either XXX@m.u-tokyo.ac.jp or XXX@g.ecc.u-tokyo.ac.jp. Other addresses are not acceptable.)
Emergency contact information:
(please enter your extension number in the research center or your cell phone number)
Main purpose of use:
Anticipated frequency of use and use period
Comments/Special requests

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