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Application Form Workshop Leipzig 2015
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* Indicates required question
Name, First Name / 氏名
*
日本語の場合は漢字とローマ字（パスポート表記）を併記してください
Your answer
Age / 年齢
*
Your answer
Gender / 性別
*
Your answer
Profession, Institution / 職業・所属
*
Your answer
Knowledge of language(s) / 言語能力
*
English
Japanese
German
Required
Email
*
Your answer
Email
*
（Confirm / 確認）
Your answer
Phone / 電話番号
*
Your answer
Address / 住所
*
Please include postcode. / 郵便番号を忘れずに表記してください。
Your answer
Choose your program / 参加日程の選択
*
A-1:From Sep. 4th to 13th [with accommodation] 480 Euro / ７万２千円
A-2:From Sep. 4th to 13th [without accommodation] 380 Euro
B-1:From Sep. 7th to 13th [with accommodation] 180 Euro / ３万円
B-2:From Sep. 7th to 13th [without accommodation] 80 Euro
Self‐introduction and your motivation and expectation to join this workshop / 自己紹介、ワークショップ参加の動機、期待することなど
*
Please write with approx.300 words. / 300文字程度で書いてください。
Your answer
How did you find this workshop? / どうやってこのワークショップを知りましたか？
*
Your answer
Remarks / 備考欄
Your answer
※お預かりする個人情報を厳重に管理・保護し、その取り扱いについて法令その他の規範を遵守する事をお約束致します。
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