Questionnaire about JENESYS *3months away from Japan

Please fill in the blanks below in block letters in English.

We would like you to take the time to answer a questionnaire on the youth exchange program.Please check your answers in appropriate brackets for the following questions.

* Choose your participation year to JENESYS. *Required
Full Name *Required

John F. Kennedy
First Language *Required

e.g. English, Fijian language
Participant ID No. *Required * If you've forgot it, please fill in your group number.

1A-001
Sex *Required
e.g. M / F
School / Institution *Required

e.g. The University of the South Pacific...
Country *Required

e.g. Fiji, Australia...
Age *Required

e.g. 19
Date of birth *Required

(dd/mm/yyyy) e.g., 31/05/1995
E-mail Address (Please enter your e-mail address twice to avoid mistyping.) *Required

(Reconfirmation)

e.g. bunka3@joca.or.jp
SNS Address *Required Humbly request to input your SNS address like above-mentioned.

e.g. https://www.facebook.com/joca.exchangeprogram/

[Transmission through SNS]

A)How many times did you share your experiences of the program within 3 months? Please write down the specific number. *Required
B)When sending by something other than SNS, what is the sending medium?
B-1)Please enter the number of times etc in corresponding item, written above.

C)About what did you share? (Multiple answers allowed)
C-1)If you answered "Other" to Question (C), please specify.

[Implementation of action plan & your future interests]

D)To what extent did you implement the action plan that you announced during your visit to Japan? *Required
E)1 If you answered "a) 100% carried out" to f) 20%" to Question D), Please describe the content of action plan implementation. *Please write down

F)How was the reaction at the receiver side when implementing the action plan? *Required
G)Please enter it concretely, if individuals or participants are taking advantage of the experience of Japan. *Required

H)What are you interested in now, with regards to Japan? (Multiple answers allowed) *Required
H-1)If you answered "Other" to Question (H), please specify.

I)How would you personally improve the future relationship with Japan? (Multiple answers allowed) *Required
I-1)If you answered "Other" to Question (I), please specify.

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