NATIONAL SPIRITUAL ASSEMBLY

OF THE BAHÁ’ÍS OF JAPAN

YOUTH DESK

7-2-13 Shinjuku, Shinjuku-ku, Tokyo 160-0022 JAPAN

TEL +81(3)3209-7521 FAX+81(3)3204-0773 E-Mail: office@bahaijpn.com

HP: www.gecities.jp/oneworld_international/youth.htm

APPLICATION FOR BAHA’I YOUTH SERVICE IN JAPAN

1. Surname:

2. Given Name:

3. Gender:

4. Current Address:

5. Phone:

6. Date of Birth

7. Citizenship:

8. Ethnic Background:

9. Languages Spoken:

10. Marital Status:

11. Type of visa to enter and stay in Japan:

12. Your intended period of stay in Japan:

13. Ruhi courses or other training courses completed:

14. List special qualifications, talents, and skills that might be of use to the Baha’i community:

15. Type of service you are interested in rendering:

16. List any health problem you have that might affect your life in Japan:

17. Living in a foreign country can be very challenging. How would you prepare yourself for life in Japan?

18. Freely comment on why you wish to come to Japan and serve the Cause here:

If you have not sent us a reference letter from a Baha’i institution (.e., an LSA, Youth Desk, ABM, etc.), please do so at your earliest convenience. Also, please attach an ID photo or send it as an e-mail attachment.

I hereby state that the above information is true to the best of my knowledge.

Signature: Date: