Online Japan in the Schools Request Form

All fields are required.

General information

Program:

Japan in a Suitcase

Taro (Elementary)
Hanako (Middle)
Tokaido (Middle & High)
Other

Japanese Language & Culture Visits

Custom
Shopping (2nd)
Restaurant (3rd)
Other

Teacher's Name:

Teacher's Email Address:

School Name:

School Address:

City:

State:

Zip Code:

Daytime Phone:

Nighttime Phone (for emergency):

Grade Level of Students:

Number of Students in Class:

Room Number:

Do you have PowerPoint? Yes No

Do you have a projector? Yes No

For JLCV; How many years have you studied Japanese?

How much knowledge about Japan, Japanese culture and /or Japanese Language do your students already have?

Date & Time

Date

Time

First Choice:

Second Choice:

Third Choice:

If you have PowerPoint or projector capability in your classroom, please make sure it is working prior to the JIS visit. Most of the JIS curriculums use PowerPoint, but if you don’t have access to it, please let the coordinator know so that she can prepare an alternative presentation.