Apply - Naoko Mitsui Shirane Foundation

Student

Attach Passport Size Picture of Yourself*

First Name*

Middle*

Last Name*

Nickname:*

Date of Birth*

Email*

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*

Parents

Father Name*

Fathers Address*

Father Email Address*

Father Mobile phone*

Mother Full Name*

Mother Address*

Mother Email Address*

Mother Mobile Phone*

High School

School Name*

School Address*

School Website*

School Principle Name*

Guidance Counselor Name*

Guidance Counselor Phone*

Counselor Email Address*

Do you currently own a valid US Passport with an expiration date later than Jan. 2020?*

Yes
No

Passport number*

Expiration*

Foreign Language and Travel Experience:

What is your native language?*

Additional language?*

Written fluency*

Spoken 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 Recommendations*

Note

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.

2020 High School Summer Program to Japan
Naoko Mitsui Shirane Foundation

Please complete all fields in the form below.

Application deadline: January 15, 2020

Student

Parents

High School

Foreign Language and Travel Experience:

Note

2020 High School Summer Program to Japan Naoko Mitsui Shirane Foundation

Please complete all fields in the form below.

Application deadline: January 15, 2020

Student

Parents

High School

Foreign Language and Travel Experience:

Note

2020 High School Summer Program to Japan
Naoko Mitsui Shirane Foundation