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English Conversation Partner Application 2010

April 22, 2009 - 2:17pm — yoshizawa.1

Requirements
A. Native English speaker
B. Available 6 hours per week for the weeks indicated (two different programs).
C. Willing to travel to a convenient meeting place for the student (they don't drive)
D. Attend introductory meeting on Monday, June 21 (program 1) or Monday, August 2 (Program 2)

General Information

First Name: *

Last Name: *

Address 1: *

Address 2:

City: *

State: *

Zipcode: *

Phone (primary): * * please include areacode

Phone (secondary):

Email: *

Gender: *

Adult T-shirt Size: *

Major: *

Smoking Status: *

Availability

Please mark one of the slots that you are willing to be a conversation partner:: *

Program 1: June 21 - July 30

Program 2: August 2 - August 20

Available for both Program 1 and Program 2

Please indicate your available afternoons during the week:: *

Mon

Tue

Wed

Thurs

Fri

Sat

Sun

Unavailable on afternoons

Unknown

Please indicate your available evenings during the week:: *

Mon

Tue

Wed

Thurs

Fri

Sat

Sun

Unavailable on evenings

Unknown

Interests

Please let us know a little about yourself:: *

Please indicate your hobbies/interests:: *

Consent

I understand using Japanese language during conversation hours is not allowed.: *

YES

NO

I qualify for all of the requirements listed at the top of the page.: *

YES

NO