Entry Form for Special Study Camp for ICU by Asian Rural Institute * are required fields. Name * (Last) (First) Katakana name * (Last) (First) Nickname ICU student ID (6 figures) * Major/minor (if any) Sex * MaleFemaleOther Date of birth (yyyy/mm/dd) (sample: 19870913) * (Click year/month/date to enter or click calendar mark to select.) Zip code * - Address in Japan * Telephone number (figures only; sample: 0287363111) * Emergency contact (figures only; sample: 0287363111) * Email * Email confirmation * How did you know this program? Multiple choice allowed (With PC, Ctrl+click). PosterFlyerAcquaintanceARI StaffOther Detail What about ARI are you interested in? Multiple choice allowed (With PC, Ctrl+click). Organic agricultureInternational relationsSustainabilityCommunity lifeOther Motivation of entry (around 300 characters) * Hobbies and special skills Do you need any special care such as food restrictions and physical conditions? YesNo If “yes,” what do you need? Do you want newsletters from ARI? * YesNo Questions and remarks Δ