The 16th ASEAN-Korea Future-Oriented

Youth Exchange Programme: ASEAN-Korea Youth Square

Seoul & Gangwon-do, Korea / 5 to 10 February 2015
Please complete this form based on your passport. (The title of e-mail should be 'ASEAN-Korea_name of participant')

Personal Information
First Name:
Last Name:
Full Name (with Middle Initial):
Gender (Female/Male):
Nationality as shown on passport:

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Year of Birth (YYYY-MM-DD):

Passport Number:
- Date of Expiry:
Religion:

Contact Information
Current Address:
City:
Country of residence:
Contact e-mail:
Telephone with country code (e.g. 82-2-000-000):
Mobile with country code:

Additional Information
Name of your latest school (or work) :
English proficiency (Advanced/Native):
Preferred t-shirt size

Special Requests & Medical Conditions

Prohibited food(s):
Allergies to (food, medicine, plant, and etc):
If you are on special medication, let us know:

Why should you be selected ?

XS / S / M / L / XL / XXL / XXXL

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