CONFIDENTIAL

Form 1

CURRICULUM VITAE
Please use a black or blue ball-point pen. Application documents and forms may also be downloaded and completed by PC.

1. FULL NAME (as written in your passport) Sur Name Given Name 2.

ADDRESS FOR CORRESPONDENCETELEPHONE

PHOTO 3.5cm4.5c m

MAIL ADDRESS

3.

( ) NAME AND ADDRESS OF PERSON TO BE NOTIFIED IN CASE OF EMERGENCYTELEPHONE(Relationship to you)

4. 7.

DATE OF BIRTH
Month Year

5. 8.

AGE

6.

SEX

Date

MALE

FEMALE

MARITAL STATUS SINGLE MARRIED

NATIONALITY

9. RELIGION

10. UNIVERSITY OF CURRENT ENROLLMENT

NAME

INSTITUTION

OF / COUNTRY

CITY

/ MAJOR SUBJECT

11. LANGUAGE PROFICIENCY

Please, place an X at the level corresponding to your grade of language proficiency test or equivalent. Score ENGLISH EXCELLENT GOOD POOR NOT AT ALL Score JAPANESE EXCELLENT GOOD POOR NOT AT ALL Personal information contained in application documents will be used for [1] all manner of contact from application to program completion and return to home country, and [2] creating statistical documents that summarize the results of the program.

CONFIDENTIAL
Form 2-1

Application Form
To: Yozo Kaneko, President, Japan Overseas Cooperative Association I wish to participate in the Youth-Exchange Project with Asia-Oceania and North America (Kizuna (bond) Project) Long-term Invitation Program that your association is implementing. I consent to the attached Terms and Conditions, and I hereby make my application with the relevant documents attached. SURNAME NATIONA LITY GIVEN NAME COUNTR Y

MAIL ADDRESS (for notification of acceptance into the program)

1.

Desired Training Course Name of Course (A,B,C,D) 1st choice Name of University, if C or D course

2nd choice 3rd choice

CONFIDENTIAL
Form 2-2

SURN AME 2.

GIVEN NAME

What are you currently studying at your university or school?

3.

What would you like to study about in Japan?

4.

What are your aspirations for participating in this program?

5.

Why would you be a good choice for this program?

CONFIDENTIAL
Form 2-3

SURN AME 9.

GIVEN NAME

How are you planning to relay the results of this program to the people in your country after you finish participating in it?

10. How would you like to utilize the experiences you had in Japan after this program finishes?

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Appendix

Terms and Conditions

Yozo Kaneko, President, Japan Overseas Cooperative Association If I am chosen as a participant in the program, I agree to devote myself to the program while strictly adhering to the following. 1 2 3 4 I will observe the laws of Japan and the rules of the accepting institution, and behave myself as a good participant. I will faithfully follow the instructions and decisions of the implementation group and the university. I will redeem on my own responsibility any obligations incurred due to deliberate or flagrant delinquency. In the event that any of the following are deemed to apply and I am ordered to leave the program, I will return to my home country at my own expense in accordance with such order. (1) It is impossible to continue the program for reasons of my deliberate or flagrant delinquency or negligence (2) I decide to quit the program at my own discretion (3) I commit an act that disturbs the order of society (4) A false statement is discovered in the information filled out in an application document I will promptly return to my country after the prescribed program ends, and I will utilize the knowledge and experience I have gained to actively disseminate such information to my local community. End of document