*FULL Name in Eng |
Please write your FULL name in Alphabet
※ アルファベットでフルネームをご記載ください
ex) Jack Johnson
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なまえ in JPN(日本語) |
Please write down your FULL name with JAPANESE if you can.
※ 日本語で名前を入力ください
ex) ジャック ジョンソン
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*Sex 性別 |
※ 性別をご選択ください
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*Nationality 国籍 |
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*Category 専門区分 |
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*E-mail メールアドレス |
Enter an ACTIVE ADRESS that can receive important info & attachments
大切な情報やファイルをお送りします
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*Cell phone 携帯電話 |
--
Please enter your ACTIVE PHONE NUMBER where we can reach you at immediately in case of emergency.*Participation is not possible without a mobile phone.
緊急時にご連絡できる電話番号をご記入ください。
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*Birthday 誕生日 |
YEAR / MONTH / DAY
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*Blood type 血液型 |
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*Date of Camps |
★Select camp & station you can attend FOR SURE *If you become unable to attend, contact us ASAP
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*Address line 1 |
ex)大田区花町1−1−1 101号室
Enter your FULL home address in Japanese, INCULDING the building&room number
*If difficult, English is OK
建物名がある場合は号室も含め、ご自宅住所を全て日本語で入力してください
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Address line 2 |
Please DO NOT fill out
こちらには何も入力しないでください。
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*City 市町村 |
City 市町村
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*ZIP 郵便番号 |
ex)1300015
※郵便番号
※Please don't use "-".
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*State/Province/Region |
ex) Saitama-ken
※ 都道府県を入力します。
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*Country (Adress) |
ex) Japan
※ 国名(住所)
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Occupation |
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*Afflication 所属 |
Those who are a student write your school's name.
Those who are a worker write your company name.
Ex)XYZ university
※ 学生さんは所属の学校の名前、社会人の方は会社名・組織名などをご記入ください。
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* Japanese level 日本語レベル |
※ 日本語のレベルをご記入ください。
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* ENG level 英語レベル |
※ 英語のレベルをご記入ください。
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*About Food 食事関連 |
Select food allergy severity. For dietary restrictions, fill in the details in "Food Restrictions2"
食物アレルギーと食事制限について
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*food restriction |
Please check your food restrictions which you cannot eat.
※if you choose "other" please fill in the the next box(food restrictions 2)
食べもので何を避けるかお選びください。
その他をお選びの方は次のfood restrictions 2の欄にご記入ください
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food restrictions 2 食事制限 |
If selected "Other Food Restrictions" or "Other" above, please provide details (e.g. Halal)
「その他食事制限」や「その他」の詳細
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* Public bathhouse 公共のお風呂 |
If you have any reason you cannot take the Public bathhouse, please check this.
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*Times to join "Bousai camp" |
How many times did you join our "Bousai camp for kids"
※ 防災キャンプの参加回数をご記入ください。
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*English camp |
Times to join "English camp"
(International and English Camp by The Recovery Assistance Center of MIYAGI)
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*about this event |
How did you find this event?
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Remarks 備考 |
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*Certification 確認 |
If there is no problem with your final confirmation of the bellow, please click "送信" after you click check
It could take for a while until your form will be sent after you click "送信". Click "送信" just once. If you click more than twice, your application will be duplicated.
<Final Conformation>
■Important!!
(1)You must be able to join the camp for sure.
(2)You must have both an email address and a phone number which we can contact to you directly.
(3)You just need to pay the transportation fee from your house to meeting place.
(4)You need to join as a volunteer.
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