The 29th JAPANESE SPEECH CONTEST

in BRUNEI DARUSSALAM

APPLICATION FORM
n PERSONAL INFORMATION OF APPLICANT / Please paste your photo here.
(Passport size)
Name in Block Letters
Gender / o Male o Female / Age
Nationality / I.C. No.
Local Address
E-mail Address
Telephone No. / Home: Office: Hand Phone:
Social Status / o Student o Civil Servant o Private Firm o Retired o Others ( )

n SPEECH INFORMATION

Speech Title / In Japanese: / Category / o Beginners
In English: / o Advanced
o Open

n PERSONAL HISTORY OF STUDYING JAPANESE LANGUAGE

NO. / School / Study Method / Period (MM/YY – MM/YY) / Total (Year & Month)
EXAMPLE: Personal Lesson (by Mrs Naomi Brown) / Jan 2004 - May 2005 / 1 Yr & 6 Months
1
2
Should you need more space use the table provided at the back of this form. / TOTAL

n PERSONAL HISTORY OF STAYING IN JAPAN

NO. / Purpose / Period (MM/YY – MM/YY) / Total (Year & Month)
EXAMPLE: Study (Sakura University) / Jun 2005 - Mar 2008 / 2 yrs & 6 months
1
2
Should you need more space use the table provided at the back of this form. / TOTAL

n PERSONAL HISTORY OF PARTICIPATING JAPANESE SPEECH CONTESTS

NO. / Name of Contest / When (MM/YY) / Prize Awarded
1
2
Should you need more space use the table provided at the back of this form.

I hereby agree to the conditions stated in the rules and regulations of the contest and declare that the above statements are true and correct to the best of my knowledge and belief (Typed signature is acceptable).

Date / Signature

n PERSONAL HISTORY OF STUDYING JAPANESE LANGUAGE (Continued)

NO. / School / Study Method / Period (MM/YY – MM/YY) / Total (Year & Month)
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8
TOTAL

n PERSONAL HISTORY OF STAYING IN JAPAN (Continued)

NO. / Purpose / Period (MM/YY – MM/YY) / Total (Year & Month)
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8
TOTAL

n PERSONAL HISTORY OF PARTICIPATING JAPANESE SPEECH CONTESTS (Continued)

NO. / Name of Contest / When (MM/YY) / Prize Awarded
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