Application Form
for
Japanese Conversation Program Spring Semester 2013
Please fill in this application form and send it to Office of Graduate Studies (s-igs@st.ritsumei.ac.jp)
by April 5
(Fri.), 2013.
Name
Student No. (ID)
Department
Year ()
E-Mail
Professor
*If this is your first time to join this program, please answer the following questions. If you joined the
program last semester, you do not need to answer the questions.
Ⅰ．レベルチェック Please tick the items indicating your Japanese proficiency.
１） 話す Speaking
□全く話せない I cannot speak Japanese at all.
□あいさつ程度の会話ができる
□日常会話ができる
I can greet in Japanese.
I can have daily conversation in Japanese.
２） 聞く Listening
□全く分からない I cannot understand Japanese by listening.
□あいさつ程度の会話がわかる
□日常の会話がわかる
I can understand greetings in Japanese.
I can understand daily conversation in Japanese.
３） 読む Reading
□全く読めない I cannot read Japanese at all.
□ひらがな・カタカナが読める
□漢字が少し読める
I can read Hiragana and Katakana.
I can read some KANJI (Chinese characters.)
いくつ How many words? （
）字
４） 書く Writing
□全く書けない I cannot write in Japanese at all.
□ひらがなが書ける I can write Hiragana. □カタカナが書ける I can write Katakana.
□漢字が少し書ける
I can write some KANJI (Chinese characters.)
いくつ How many words? （
）字
Ⅱ．経 験 Experience of studying Japanese
１） 日本へ来たのは初めてですか。
Is this your first time to come to Japan? □はい Yes □いいえ No
いいえの場合,今まで日本にどのくらい滞在しましたか。
If no, how long have you stayed in Japan last time?
年間 years
ヶ月 months
日 days
２） 今まで日本語を勉強した経験がありますか？
Have you ever studied Japanese before?
□はい Yes
□いいえ No
① 期間はどのくらいですか。
How long have you studied Japanese?
② 場所はどこですか。
Where did you study Japanese?
③ どういう形式で勉強しましたか。 How did you study Japanese?
□先生と 1 対 1 で in private lesson
□クラスで in class
□自分一人で by yourself
④ 先生は？ Who was your teacher?
□日本人 Japanese
□自国人 same nationality as yourself
□日本人と自国人 Japanese & same nationality as yourself
□その他 other
⑤ 先生は何語を使って教えましたか。
Which language was used for teaching in the class?
⑥ どんな教科書でしたか。
What kind of study materials did you use?
Ⅲ．目的 Purpose of studying Japanese
１）日本語を勉強するのは何のためですか。
For what reason do you want to study Japanese?
Thank you for your cooperation.