International Youth Development Exchange Program for 2015 in Latvia (05.-22.09.2015) and Japan (22.09-07.10.2015) APPLICATION FORM This application form should be delivered to japana@jaunatne.gov.lv by June 1st 2015, no later than 13:00 (Latvian time) Feel free to use as much space as you need. 1.Personal details Name: Surname: Gender: Date of birth: Current address: Mobile phone: E-mail: Facebook name: Education: Current occupation(s): I am able to participate in the interview on July 7-9, 2015: Yes No Comments 2. More information about you Please describe yourself. What makes you special as a person? What is your experience of being an active citizen in your community/country? Please describe. Please mention also if you are a member of some youth organization. As one of the sub-topics for the exchange will be “Youth for Society”, please describe shortly what are your achievements so far in this regard? How have you contributed to development of local society? 1 What ideas do you have on how you could contribute to the exchange programme with Japan? What experience and skills could you share? 3. Motivation for participating in the exchange program in Japan (22.09.-07.10.2015) Have you had any previous connection or experience cooperating with Japan or Japanese people? Please describe and mention also if you have been there. What is your motivation to participate in this exchange program? What do you expect from it? How will you use the experience from participation in this exchange? How could you share the ideas, experience and competencies gained during the exchange with local society in Latvia (please mention concrete activities, target groups, locations etc.)? 4. Support for organizing the visit of Japanese youth in Latvia (05.-22.09.2015) What would you recommend to include in the programme for the visit of the delegation of Japanese youth in Latvia for them to discover our country better? Are you available for supporting us in organizing the programme for hosting Japanese youth in Latvia: 5-22 September 2015? Yes No Comments How would you contribute to organizing the visit of delegation from Japan in Latvia? Please, mention at least 3 concrete things/activities that you personally would be willing and able to organize/be involved in. 5. Other information Please rate your foreign language skills: English Japanese Excellent Excellent Good Good Average Average Poor Poor No skills No skills Other:__________ Excellent Good Average Poor No skills Other:__________ Excellent Good Average Poor No skills Do you have any special needs (dietary, mobility, special medicine etc.)? I am applying for participation in the International Youth Development Exchange Program for 2015 and I confirm that in case I am selected I will participate in all planned events and activities within the exchange program both in Japan and will be available for some events in Latvia. Name, surname Date, place 2 ESSAY „Ideas and experience that I could bring back from Japan and share with my community” Max. 750 words Name, surname: 3 CV in English 4