APPLICATION FORM

Japanese Speech Contest 2012

Group A	Group B

Please fill in the form below, filling in the text and clicking on the option boxes. Personal data entered in this application will only be used for selection purposes. Application deadline is 12 March 2012.

Name

Gender	Female

Please insert picture	Male

Citizenship

Date of birth

Address

Telephone

Email

Would you like to be added to the Embassy’s mailing list?	No	Yes

Name of school / workplace and position

Japanese language studies background

(1) Name of institution

(2) Period of study outside Japan
(3) Length of studies in Japan (if applicable)

Personal background

(1) Are one of your parents Japanese?	No	Yes
(2) Have you ever lived in Japan?	No
Yes, for ___ year(s) and ___ month(s)
(3) Did you ever go to a Japanese school (excluding studies at language school or university)?	No
No, went to international school in Japan
Yes, in Japan
Yes, outside Japan

(4) Have you ever worked in Japan?	No

Yes, for ___ year(s) and ___ month(s)

(5) Have you ever used Japanese professionally, in a workplace, as guide, translator etc?

No	Yes

Why did you choose to learn Japanese?

Please indicate the theme you have selected for your speech and your main arguments:
Theme/Title:

Main arguments:

Embassy of Japan in Norway

Wergelandsveien 15, 0244 OSLO

Tel: 22 99 16 00

info@os.mofa.go.jp