Experience Japan Project 2017

Application form
Name
Date of birth Age
Nationality
University/Grade/Major

E-mail address
Cell phone number (if you have one)
Address

Blood type Sex malefemale

Airport where you arrive in Japan

Passport number (if you have a passport)

Have you ever been to any foreign countries YesNo

(To those who answered yes in the question above)
How many times have you been abroad? Where have you been?

Do you have a sickness, an injury or disability

If you have some disability, what kind of disability do you have?

If you have some disability, do you need some caregivers from your country?
Yes ( persons)No
If you have some sickness, injury or disability, how can we support you? (please write as
concretely as possible.)

Write any other information that we should pay attention to (ex: allergies, foods you cannot
eat due to religious reasons, etc).

Emergency contact

Relationship

E-mail address
 Cell phone number

In order to participate in the Experience Japan program 2017, you need to satisfy the
qualifications below. Please check the boxes if you can satisfy them.
Get a passport and Japan visa.
Pay about 40,000 JPY (this is estimation) for the expenses during your stay in Japan.
The maximum subsidy for your plane ticket is 30,000~50,000 JPY. If your flight ticket is
over this subsidy, you must pay the excess cost.
Even if your flight ticket is below the subsidy, the surplus of the money is not given to you.
Stay in Japan from Aug. 23, 2017 to Sep. 1, 2017.
(According to your flight plan, it is possible for you to leave on the night of Aug. 31, 2017)

Below are three questions to answer. We will select participants based on these answers.
Write your answers concretely in this sheet.
What do you usually do? Please write about your major, research, activities, etc.

Why did you apply to this project? (Max. 200 words)

What do you want to learn through this project? (Max. 200 words)