Ship for World Youth Program FY2017 Application Form Please type in ENGLISH Please attach a scanned copy of your passport Family name First name Middle name Name (As shown in your passport) Nationality Photograph 4.5 cm x 3.5 cm National Delegation Leader Position you are applying for (insert digital photo here) Participating Youth Must be of upper body Gender Male Female / No hats or sunglasses Must have be taken Spouse within the last 6 Yes / No months Age: No selfies Date of Birth (YYYY/MM/DD) White background (as of April 1, 2017) Mobile number: Country Code ( ) Current address Phone: E-mail: *Please write your E-mail address clearly Nearest international airport from current address *The travel agency designated by the Cabinet Office will arrange flight tickets. Name: Relationship to Applicant: Address: Mobile Number: Country Code ( ) Emergency Contact Phone: E-mail: *Please write the E-mail address clearly Teacher Government Employee Employee (Private Company) Current Occupation Employee (NGO/NPO) Self-employed - Specify: Student Other - Specify: Name of workplace/school and position/title
Ship for World Youth Program FY2017 Application Form Please type in ENGLISH Please attach a scanned copy of your passport Name (As shown in your passport) Family name First name Middle name Nationality Photograph 4.5 cm x 3.5 cm (insert digital photo here) Must be of upper body No hats or sunglasses Must have be taken within the last 6 months No selfies White background Position you are applying for National Delegation Leader Participating Youth Gender Male / Female Spouse Yes / No Date of Birth (YYYY/MM/DD) Age: (as of April 1, 2017) Current address Mobile number: Country Code ( ) Phone: E-mail: *Please write your E-mail address clearly Nearest international airport from current address *The travel agency designated by the Cabinet Office will arrange flight tickets. Emergency Contact Name: Relationship to Applicant: Address: Mobile Number: Country Code ( ) Phone: E-mail: *Please write the E-mail address clearly Current Occupation Teacher Government Employee Employee (Private Company) Employee (NGO/NPO) Self-employed - Specify: Student Other - Specify: Name of workplace/school and position/title
000263407.docx