Application form for the Camp Leader

Name:

氏名:

E-mail address:

メールアドレス:

Your Country(nationality):

Sex:

Age:

Date of Birth(yy/mm/dd):

School' you have attended:

Major:

Address in Japan:

zip-code:

Nearest station :

Tel:

When did you come to Japan, and how long will you stay?:

What langueages do you speak?:

If applicable, how long have you studied Japanese?:

Self-rating of your Japanese speaking ability:

good
fair
poor
none

Hobbies and special abilities:

How did you hear about this camping program? Choose one below and circle the number.:

(複数選択可)

If you checkB tell the name of the friend:

Why would you like to participate in this camp? What do you want to do in this camp?: