Application

Name *

First Name

Last Name

Address *

Please enter your residential address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number

Country

(###)

###

####

Date of Birth *

must be at least 20 years old

MM

DD

YYYY

Duration of Stay *

4 weeks

4 to 6 weeks

6 to 8 weeks

8 to 10 weeks

10 to 12 weeks

Do you have prior experience with ceramics? *

If yes, please answer the following questions

Yes

No

Have you previously visited Japan? *

If yes, please answer the following questions

Yes

No