Email ＊

（確認用）

Batch Available ＊

----- 選択してください ----- GLTP Batch.7

Your name (Please use the same name though the course). The name registered here will be printed on the certificate. ＊

Gender( Female/Male/Prefer not to say/Others) ＊

Date of Birth ＊

• 年
• 月
• 日

Nationality ＊

Current country of residence ＊

Employer(working):ORUniversity(student): ＊

Position Held (if working):ORUniversity degree/major (if student): ＊

Your experiences on education and leadership development programs if any. ＊

Why do you want to undertake this program? Will this program help you to make a contribution to your workplace or community? ＊

Who are some of your top role models, why do they inspire you? ＊

(Approximately 150 words) How would some of your closest friends describe you? ＊

(Approximately 150 words) If you have a project that you would want to implement that will have great impact to the community, w ＊

Where do you see yourself 5 years from now? ＊

I will commit to full participation in the Program. ＊

----- 選択してください ----- Yes No

I have arranged my schedule to ensure I will complete this program. ＊

----- 選択してください ----- Yes No

If required, I am prepared for information from this application to be shared with specific session providers. ＊

----- 選択してください ----- Yes No

I agree to be part of photographs and other media required by GLTP Training team. ＊

----- 選択してください ----- Yes No

Please mark the checkbox if you are from one of these following programs ＊

• TOBITATE!
• International Youth Exchange Program by Cabinet of Japan (SSEAYP, SWY, INDEX, Japan-China, Japan-Korea, CORE)
• SIPS
• JDS Scholarship Program
• MEXT Scholarship Program
• I don't belong to any of those