Interview Request Form

Please fill out and submit the following interview request form.
If the request form is submitted successfully, you will receive an automatic confirmation email straight away.
Please check that you have received this email.
The person in charge will contact you shortly.
Please note that it may take some time to respond on Saturdays, Sundays, national holidays,
year-end and New Year vacations, and during the summer holidays.

【 Contact information 】
Hiroshima University, Public Relations Group
Email : koho[at]office.hiroshima-u.ac.jp (Change [at] into @)

※Fields marked with an asterisk * are required

About the interview

Subject of the interview *
Interviewee *
Interview method * (email, video-conferencing, etc.)
Preferred date and time *

About the interviewer

Name *
Company name *
Mail address *
Mail address * (Please re-enter the information for confirmation)

※The personal information you enter will be used only to confirm the submitted details and to contact you.