Apply - Naoko Mitsui Shirane Foundation

Student

Attach Passport Size Picture of Yourself

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First Name

Middle Name

Last Name

Nickname:

Date of Birth

Email Address

Home Address

Mobile Phone

Alternate Phone

Birth Country

Gender

Are you currently a Junior in High School?

Yes
No

Reason for Applying

Please upload a short video clip introducing yourself and comment on why you want to join this program

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Parents

Father's Full Name

Father's Address

Father's Email Address

Father's Mobile Phone

Mother's Full Name

Mother's Address

Mother's Email Address

Mother's Mobile Phone

High School

School Name

School Address

School Website

School Principal's Name

Guidance Counselor's Name

Guidance Counselor's Phone

Guidance Counselor's Email Address

Do you currently own a valid US Passport with an expiration date beyond January 2025?

Yes
No

Passport Number

Expiration

Foreign Language and Travel Experience:

What is your native language?

Additional language spoken?

Additonal language spoken fluency?

Additional language written fluency?

Do you speak Japanese?

Yes
No

Fluency

Have you traveled to Japan?

Yes
No

When

Have you ever traveled to any other foreign countries?

Yes
No

Please list the other countries you have been to:

Character Recommendation

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Note

[Application] We will reach out to you within a few days after receiving your application. If you do not hear from us, please contact us at info@shiranefoundation.org. [Mandatory Requirements for Selected Participants] Attend the Bonding Ceremony, Participate in a Japanese cultural class and lectures, Visit to the Botanical Garden, Join factory tours, Read the book "Hiroshima", Complete an essay and video (post-trip), Assist in promoting the program to next year’s scholars. [Dress code]Male students will wear a navy blazer, white shirt, tie, and khaki slacks on formal business occasions; jeans, t-shirts and tennis shoes on informal tours. Women wear conservative dresses or suits and pumps on formal business occasions, and jeans, conservative tops, and tennis shoes on informal tours. Students carry one backpack and bring one medium suitcase.

2025 High School Summer Program to Japan
Naoko Mitsui Shirane Foundation

Please complete all fields in the form below.

Student

Parents

High School

Foreign Language and Travel Experience:

Note

Naoko Mitsui Shirane Foundation

2025 High School Summer Program to Japan Naoko Mitsui Shirane Foundation

Please complete all fields in the form below.

Student

Parents

High School

Foreign Language and Travel Experience:

Note

2025 High School Summer Program to Japan
Naoko Mitsui Shirane Foundation