Japan Cultural Camp by AYFN

Kyoto, Japan

12 – 17 March 2017

Please insert photo
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APPLICATION FORM

Please complete in English.

The information you provide in this form will be used solely for the purpose of this program. Please, send back this application form along with scanned of Identity card and financial statement.

1. PERSONAL INFORMATION
Last name
First name
Name shown on passport
Type of participation / ( ) New
( ) Alumni of previous AYFN Program
Nationality
Date of birth (DD/MM/YYYY)
Place of birth
Sex / ( ) Male
( ) Female
Current address
Phone number (including country code)
Email addresses / (Main Email)
(Alternative Email)
If you are student, please specify the name of your school and your major, year of entrance
Organization where you involve
Position or role in this organization
Website of the organization
English language proficiency / ( ) Excellent ( ) Good ( ) Fair
Allergy
T Shirt Size
(Normal Indonesian size) / ( ) Small ( ) Medium ( ) Large ( ) Extra Large
2. TRAVEL INFORMATION (If you currently hold a valid passport, please provide information below. If you don’t have any yet, please write N/A) and you still can apply this program.
Passport number
Country which issued your passport
Date of issue (DD/MM/YY)
Expiry date (DD/MM/YY)
3. QUESTIONS
Q1: Please describe your personal information related to yourself, your daily activity, your talent, etc. (300 words)
Q2: Why do you wish to take part in this Japan Cultural Camp by AYFN? How would you contribute to its success? (min 150 words)
Q3: This program is SELF –FUNDED program. So, who will financially support you to take part at this program?
Fee option:
( ) Program fee only
( ) All in = Program fee + Flight Ticket
Q4: Please specify the kind of commitment you are ready to make in order to advance program after 2016.
4. Essay
In what ways do you think youth can be a driving force for action in better world? (min 300 words)

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