"Youth Camp for Asia's Future 2012" APPLICATION FORM

"Asian Youth, Stay in Touch with Korea" / Republic of Korea / 6 -20 August 2012 Personal Information
Please complete this form based on your passport First Name Last Name Middle Initial

Full Name(with Middle Initial)

Gender

Year of Birth

Month of Birth

Day of Birth

Age 2012

Photo Here

Area of your country's Asia Passport Number

Nationality

City

Expiration Date on your Passport

Contact Information
Please complete current address and contact number Country Code Contact e-mail Address Telephone Mobile

English fluency Korean fluency Additional Information

Name of your latest school (or work) Major(or Department) Grade(or Period) e.t.c.

Religion Prohibited food(s) Allergies If you are on special medication, let us know Any Comments

T-shirt size