My last name: Romaji ________________ Hiragana (if Japanese)/Katakana if not a Japanese name_________________

My first name: Romaji __________________ Hiragana (if Japanese)/Katakana if not a Japanese name________________

What is your major (school) in your home country? (for example: International Relations)

My personal interests, hobbies and free-time activities in my home country are:

Language knowledge

Besides English, I also speak these languages well: ___________________________

Besides my home country, I have spent more than a month in these countries? (Use the back if necessary.)

Country:
What did you do and how long did you stay?

Country:
What did you do and how long did you stay?

Vision (the ability to see)

___ I have no problems seeing the blackboard and reading. My eyesight is excellent or I have glasses that give me excellent vision.
___ I do have problems seeing the blackboard or reading. I need glasses or better glasses, or I have some other problem with my eyes.

 

Other information about me: