Apply - Naoko Mitsui Shirane Foundation

Student

Attach a Headshot Photo of Yourself

Accepted file types: jpeg, pnp, gif, pdf, Max. file size: 50 MB.

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

Essay : Please introduce yourself and explain why you are applying.

Upload a short video (maximum 3 minutes) introducing yourself and explaining why you would like to participate in this program.

Accepted file types: mov, mp4, mwv, avi, Max. file size: 50 MB.

As part of this scholarship trip, we have a homestay program. It is essential for host families to be aware of your health. If you have any food allergies, dietary restrictions, or other health-related concerns, please let us know.

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 Principal's Name

Guidance Counselor's Name

Guidance Counselor's Phone

Guidance Counselor's Email Address

Foreign Language & Travel Experience

Do you currently own a valid US Passport with an expiration date beyond January 2028?

Yes
No

Passport Number

Expiration

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 (Note: The Recommender Will Receive a Link to Submit Recommendation)

Please provide the name, title, email address, and phone number of ONE non-relative recommender who can speak to your character, such as a teacher, counselor, coach, community leader, or clergy member. Your recommender will receive an email with a link to submit the Letter of Recommendation directly. Example: John Smith, High School Principal, john.smith@highschool.edu Important: Please make sure the email address is correct, as the recommendation submission link will be sent directly to your recommender.

Recommender Name

Recommender Title

Recommender Email

Recommender Phone Number

Student Actions & Acknowledgement

The following three (3) actions are required to be completed by the application deadline of November 1, 2026.

1. A current official or unofficial transcript must be submitted to makiwagner@shiranefoundation.org no later than November 1, 2026.

2. After submitting the application, applicants will receive a follow-up email. Applicants must respond to this email with their thoughts and required information by the application deadline of November 1, 2026.

3. Applicants and their parents/guardians must review and sign the trip agreements included in the follow-up email by the deadline.

Please note that the application will be considered incomplete and invalid if all three requirements listed above (1,2, and 3) are not completed by the application deadline of November 1, 2026. If you have read this, please click ‘I Understand’*

I Understand

Miscellaneous

How did you hear about the Shirane Foundation Scholarship Trip to Japan?

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If you submit the form and it does not process, you will need to close it and start again. Please contact info@shiranefoundation.org if you need support.

Note

[Application] We will contact 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] Selected participants are required to: Attend the Bonding Ceremony. Participate in Japanese cultural classes and lectures. Visit the Botanical Garden. Join factory tour (held on weekday) and other scheduled educational activities. Read the book Hiroshima. Complete a post-trip essay and video project. Assist in promoting the program to future scholars.

[Dress Code] For formal business occasions: Male students should wear a navy blazer, white shirt, tie, and khaki slacks. Female students should wear conservative dresses or suits with pumps. For informal tours and activities: Students may wear jeans, appropriate casual tops, and tennis shoes. Students should bring one backpack and one medium-sized suitcase for the trip.

Naoko Mitsui Shirane Foundation

2027 High School Summer Program to Japan Naoko Mitsui Shirane Foundation