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Application form for “Circolo Festa”
Date: June 19, 2022
Venue: Tsuzuki sports center
Inquiries:
circolo0223@gmail.com
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Email
*
Your email
Sessions you want to join
*
* Please register for one session either in the morning or in the afternoon. Please note that if you apply for more than one session, your application will be invalid.
Morning session (10: 00-12: 00)
Afternoon session (14: 00-16: 00)
Representative’s name
*
Your answer
Please select the age range from the following list for all the participants who are older than junior high school students.
Participant 1 (Representative)
*
* The representative should be a high school student or above.
Choose
High school student
Adults (18-60 years old)
Adults (over 60 years old)
Participant 2
Choose
Junior high school student
High school student
Adults (18-60 years old)
Adults (over 60 years old)
Participant 3
Choose
Junior high school student
High school student
Adults (18-60 years old)
Adults (over 60 years old)
Participant 4
Choose
Junior high school student
High school student
Adults (18-60 years old)
Adults (over 60 years old)
Please select the age range from the following list for all the participants who are younger than elementary school students.
Participants who are under elementary school age 1
*
Choose
0 to 2 years old
3 to 6 years old (preschooler)
Elementary school lower grades (1st to 3rd grades)
Elementary school upper grades (4th to 6th grades)
Participants who are under elementary school age 2
Choose
0 to 2 years old
3 to 6 years old (preschooler)
Elementary school lower grades (1st to 3rd grades)
Elementary school upper grades (4th to 6th grades)
Participants who are under elementary school age 3
Choose
0 to 2 years old
3 to 6 years old (preschooler)
Elementary school lower grades (1st to 3rd grades)
Elementary school upper grades (4th to 6th grades)
Participants who are under elementary school age 4
Choose
0 to 2 years old
3 to 6 years old (preschooler)
Elementary school lower grades (1st to 3rd grades)
Elementary school upper grades (4th to 6th grades)
Connection with Tsuzuki Ward (multiple answers are allowed)
*
* If you or other participants have any connections with Tsuzuki Ward, please select the following choice.
Living in Tsuzuki Ward
Working in Tsuzuki Ward
Studying in Tsuzuki Ward
Other:
Required
If you live in Tsuzuki Ward, please write the town name.
Ex.) Nakagawa Chuo
Your answer
Phone number
*
* Please include hyphens like the example. Ex.) 045-111-2222
Your answer
Are there any participants who have foreign nationalities?
*
Yes
No
If there are foreign participants in your group, please let us know which languages are easy to understand for them.
Simple Japanese
English
Chinese
Korean
Other:
Are there any participants with disabilities?
*
Yes (s/he has a disability certificate)
Yes (s/he doesn't have a disability certificate)
None
Required
In case any participants of your group have disabilities, please write his/her age and the name of disabilities, if you do not mind.
Your answer
Please let us know if you have any other considerations or concerns.
Your answer
Communication memo (If you have any inquiries, please fill in it here.)
Your answer
A copy of your responses will be emailed to the address you provided.
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