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PW JUNIOR GLOBAL CITIZENS SUMMER CAMP 2018

APPLICATION FORM

Personal Information
Title
First Name
Middle Name
Last Name
Date of Birth / Gender
Nationality / Passport Number
(Overseas applicants only)
Applicant’s email
Re-enter email
Home Address / Postal Code
Home Telephone
Country / Cell Phone
Academic Information
Current School Name / Location
(City, Country)
Current Grade Level / Medium of Instruction
Capacity in Communication
1)What is your native language? (If English, please go to question 5
2)If English is not your native language, how would you describe your English ability?
In speaking?
In listening?
In writing?
3)Do you have any chances to communicate in English daily?
4)Do you study English at school? If so, how many times per week?
5)Do you study or use English outside of school? If so where, and how many times per week?
6)Do you speak or understand Japanese?
7)What other languages do you speak or understand?
Parent/ Guardian Information
Title
First Name
Middle Name
Last Name
Relationship to Applicant
Home Address
(if different fromApplicant’s) / Postal Code
Home Telephone
Cell Phone
Occupation / Company Name
Email
Re-enter Email
To help us understand the applicant more so to provide the most suitable environment for their learning, please spend some time to answer the following questions.
What do you expect the applicant to learn in this summer camp?
How would you describe the applicant? What strengths and weaknesses you found in him/her?
Any diagnosed physical, psychological or health issues about the applicant that we should be aware of?
How did you learn about our summer camp?
Help us know more about you(for the applicant to fill out)
How would you describe yourself?
One thing you are proud of yourself is:
One thing you don’t like so much about yourself is:
Could you tell us about your country/ hometown?
Among the issues below, please pick ONE and tell us:
- How does this particular issue interest you?
- Why do you think this issue is important?
- What can you do to make others care about this particular issue?
- Or, what can you do to help improve the situation?
We have suggested some examples for each issue for your reference, but you could use your own example to illustrate your idea.
Issue 1:Human Rights (E.g. Freedom of Religion, Freedom of Expression, Right of Education, Protection from [gender, race, color, language] discrimination etc.)
Issue 2:Environment (E.g Global Warming, Deforestation, Sea Garbage, Industrialization and Pollution, Oil-spill etc.)
Issue 3:Humans and the Treatment of Animals (E.g., Farm Animals, Zoo-keeping, Circus, Factory Farming and Commercial Fishing, Animal Testing and Animal Experiment etc.)
(within300 words)

Enrolment Procedure

Documents listed below should be sent as attachments toon or before 15th June 2018.

a)Completed Application Form (attach download link)

b)An ID-sizephotoof the applicant

c)Recommendation Letter from school(attach download link)

Applicants who wish to apply for financial aid must submit d) Completed Financial Aid Application Form(attach download link), together with the abovedocuments in the same email. Late submissionswill not be accepted.

An Application Result Notification Email will be sent to applicants and their guardians by email not later than 22nd June 2018. Successful applicants will also receive a (1) parental consent form,and a (2) participant health and physical condition questionnaireat that time inthe same email.

Successful applicants will have to deposit the program(me)fee by 6th July 2018.

After finishing the transaction, participants should reply to the Application Result Notification Email with the following documents attached not later than 6th July 2018.

  1. soft copy of the program(me)fee transaction slip
  2. completedparental consent form signed by parent/ guardian
  3. completed participant health and physical condition questionnaire

After the above email is received, a detailed summer camp schedule will be sent to participants.

Important Dates

15th June / Summer Camp Application Deadline, below documents should be submitted.
a)Completed Application Form
b)A photo of the applicant
c)Recommendation letter from school, signed and scanned
d) Completed Financial Aid Application Form(applicants who apply for Financial Aid only)
22nd June / Check Application Result Notification by Email
22nd June~6th July / Program(me)fee deposit
Before 6th July / 3 documents should be submitted by replying to the Application Result Notification Email
  1. soft copy of the program(me)fee transaction slip
  2. completedparental consent form signed by parent/ guardian
  3. completed participant health and physical condition questionnaire

7th July~ / Check detailed Summer Camp Schedule

For any questions, please contact:

Peace Winds Japan

Completed application form should be sent to on or before 15th June 2018