International Development Exchange Program by jolinmilioncherie


									                International Development Exchange Program
                              for 2012 in Japan
                                               1st – 18th of July

                                          APPLICATION FORM
 This application form should be delivered to by 24th of April, no
                                  later than 13:00 (Latvian time)
                                      Feel free to use as much space as you need.
1.Personal details

      Name:                                         Surname:

     Gender:                                   Date of birth:



Mob. phone.




2. More information about you
Please describe yourself (shortly).

How do you spend you free time? What are your interests and hobbies?

Do you have any experience participating in international programs (school, studies, youth sector,
culture, etc.)? Please describe shortly.

3. Motivation for participating in the program in Japan
Please describe what are the things which come into your mind when you think about Japan?

Have you had any previous connection or experience cooperating with Japan or Japanese people?
Please describe.

What is your motivation to participate in this exchange program? What do you expect from it?

How could you contribute to this program?

If you will be selected as a participant, how will you share/disseminate the outcomes of this
program in Latvia during the exchange and after returning home (please mention concrete activities,
target groups, locations etc.)?

Do you have any further cooperation plans with Japan? Please describe.

4. Support for organizing the visit of Japanese youth in Latvia (9-26 September 2012)
What would you recommend to include in the programme for the visit of the delegation of Japanese
youth in Latvia for them to discover our country better?

Would you be available for supporting us in organizing the programme for hosting Japanese youth in
Latvia: 9-26 September 2012?
     Yes                             No
If yes, describe your availability (please mention which dates and times of the day (approximately)
would you be able to join us and help).

How would you contribute to organizing the visit of delegation from Japan in Latvia? Please, mention
at least 3 concrete things/activities that you personally would be willing and able to organize/be
involved in.

5. Other information
Please rate your foreign language skills:
 English                   Japanese                  Other:__________             Other:__________
    Excellent                 Excellent                 Excellent                    Excellent
    Good                      Good                      Good                         Good
    Average                   Average                   Average                      Average
    Poor                      Poor                      Poor                         Poor
    Very poor                 Very poor                 Very poor                    Very poor
    No skills                 No skills                 No skills                    No skills
 Do you have any special needs (dietary, mobility, special medicine etc.)?

    Your availability to come to candidates’ interview for final selection of participants for the
    program (please mention all times when you are available)1:
    Monday, May 14, 2012 (hour)                       Tuesday, May 15, 2012 (hour)
       09:00                 13:30                        09:00
       09:30                 14:00                        09:30
       10:00                 14.30                        10:00
       10:30                 15:00                        10:30
       11:00                 15:30                        11:00
       11:30                 16:00                        11:30
       12:00                 16:30                        12:00

    I am applying for participation in International Development Exchange Program for 2012
in Japan and confirm that in case I am selected I will participate in all planned events and
activities within the Exchange program both in Latvia and Japan.
    Name, surname
    Date and place

 As part of selection procedure, out of all candidates 15-20 people will be short-listed for the second
round of selection and invited for interviews on 14-th or 15-th of May 2012.

    ESSAY “Three things that could bridge Latvia and Japan”
                       Max. 750 words
Name, surname:

         Please return this form to the e-mail
                   by 24th of April, no later than 13:00 (Latvian time)
  We will inform you about selection results of the first round no later than 7th of May!


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