1、長期青少年交換ApplicationForm（申請書）,青少年交換（YE)長期交換申請書作成指導要領,460-0003名古屋市中区錦2丁目15番15号豊島3F国際第2760地区事務所青少年交換委員会事務局,LTEP用ApplicationRIJYEC取得。各項目入力、保存（save）、完成。PDF書類作成次記入上注意点参考作成,長期青少年交換申請書正確記入,青少年交換長期申請書初記入人解説書次頁以降、同一項目記入、下記時効適用氏大文字、名第1文字大文字。入力、手書体（活字体）氏名順番先（名+氏統一）秋山Akiko AKIYAMA二者択一、該当選四角（）中、大文字小文字X入。、点文字化場合注意。
2、住所日本郵便屋迷配達表記心。新町1丁目32、Shinmachi 1Chome32親切。132Shinmachi、番地順序逆丁目判。電話番号+81-（0）52-722-5530+81-（0）90-2186-7408書。 +国際番号表。81日本国番号。局番（0）不要、日本国内掛場合必要入。国籍欄Nationality、JapaneseCitizen of続Japane.g.for example略。例、意味日付普通日/月/年順数字。月英語書、月/日/年。順番指定特場合、英語月/日/年間違避。2017年5月10日10/05/201710/May/2017May/10/2017兄弟姉妹情報。幼稚園pr
3、eschooler小1stgrader小22ndgrader小33rd小44thgrader小55thgrader小66thgrader1年生高3年生通番号表記、小学校、中学校、高校呼称省略中学1年7thgrader中学2年8thgrader中学3年9thgrader高校1年10thgrader高校2年11grader高校3年=12grader学年数日本高校3学年生3学年3grades在籍学年、中39thgrade、高110thgrade、高211thgrade学校英文成績書出、名履修科目申請者学校表記、先生尋。一般例普通科General course理数 Science and Math M
4、ajor course芸術 Art and Music course商業科 Business and Commerce course工業科 Engineering and Technology course全校生徒数申請者属学年全生徒数成績順位分母学年生徒数。【組】生徒数。担任IchirouSUZUKI、Homeroomteacher。校長Jiro FUJI、Principal右上申請者名前記入。別紙足時、同様別紙右上必氏名書。万一時、誰。1月間薬5mg1日3回、服用5/3 times/day for a month1992年罹、Measles(rubeola)横Had in 1992罹、No
5、ne N/A5.上病名横他含、埋。6.疾病対予防注射（接種）受留学条件、空欄得。医師氏名入力、手書体（活字体）。校長名、Principal例、Jiro FUJI、Principal空港http:/k- SATO、President,+81-(0)52-722-5530,Katsumoto KURODA,K-kurodasa.starcat.ne.jp,写真（笑顔！） 判断,手書極力避邦文申請書参考記入,写真：笑顔（見栄！受入相手判断,氏名（同）,氏大文字、名第1文字大文字。入力、 手書体（活字体）。 氏名順番先 書類（名+氏）統一。 黒田Katsumoto KURODA,呼,E-Mail派遣先
6、使今取得携帯、多量資料添付場合、NG）,電話番号+81-（0）52-722-5530+81-（0）90-2186-7408書。 +国際番号表。81日本国番号。局番（0）不要、日本国内掛場合必要入,住所英語表記,自分情報記入,保護者（両親）情報記入,保護者場合記入,+81-(0)90-2186-7408,住所日本郵便屋迷配達表記心。 新町1丁目32、Shinmachi 1Chome、32親切。 132Shinmachi、番地順序逆丁目 判。,Shinmachi 1home ,3-2,二者択一、該当選四角（）中、大文字 小文字X入。 点、文字化場合注意。,X,Nagoya,Aichi,464-00
7、42,JAPAN,国籍欄Nationality、Japanese Citizen of続 Japan,市県国順Nagoya,Aichi,JAPAN,Japanese,e.g.for example略。例、意味,日付普通日/月/年順数字。順番指定特場合、日/英語月/年間違避。年5月10日10/05/201710/May/2017,10/May/2017,地区入力,緊急連絡先優先順位 X両親離婚別居状況 X,RC情報入力推薦地区状況確認、入力（自分調）,以降同一項目 （名前、住所、項目） 、 最初留意点同 記入、,学生本人情報記述,自動的表示, X,食事制限正直記入,食事制限内容具体的記入,X X
8、 X,必！ NO学生留学不可二者択一、該当選四角（）中、大文字小文字X入。点、文字化場合注意。,X,家族情報,理解言語学校評価記入（正直）,語学程度評価学校先生確認上位評価、後苦労!,兄弟姉妹情報。幼稚園preschooler小中高校生Student表記,X,電話FAX,住所,学年数日本高校3学年制3学年3grades 中学、学校名判断可能、中33grades,在籍学年、中33、高11、高22（学校名判断可能）卒業年度、高校卒業記入（作成時点）,学校英文成績書出名履修科目申請者学校表記確認。一般例普通科General course理数Science and Math Major course芸
9、術Art and Music course商業科Business and Commerce course工業科Engineering and Technology course,全校生徒数,申請者属学年全生徒数,成績順位分母学年生徒数。【組】生徒数。,担任IchirouSUZUKI、Homeroomteacher 校長Jiro FUJI、Principal,学生本人家族状況言語学校情報記述,応募者本人質問応自分考、英訳各項目対応A423枚（10）使用枚1.5枚短。苦手、物、動物等明示手書基本的,保護者質問応（保護者自身作成）（相手、向）（参照：本人点強調）留意点上記同様最長A4,自動的表示,自
10、己紹介家族推薦状英文,Students Letter1.2.3. 12.,A4231010.5,申請者名前,氏大文字、名第1文字大文字。入力、手書体（活字体）氏名順番先（名+氏統一）秋山Akiko AKIYAMA書式使用、自己紹介等作成SectionB1StudentsLetterSectionB2Parents Letter使用自己紹介文右上必氏名入力。万一時、誰。,自己紹介家族推薦状英文,申請者名前,自己紹介家族推薦状英文,氏大文字、名第1文字大文字。入力、手書体（活字体）氏名順番先（名+氏統一）秋山Akiko AKIYAMA書式使用、自己紹介等作成SectionB1StudentsLet
11、terSectionB2Parents Letter使用自己紹介文右上必氏名入力。万一時、誰。,A4121010.5,Parents Letter1.2.7.,文書申請書後,写真（）必要短撮影、該当欄挿入印刷、両面糊付貼付写真判断。見栄写真使用,自動的表示,自己紹介家族紹介写真（）,情報自動的表示,自分記入医師提出記入,主治医年数記入,X,二者択一、該当選四角（）中、大文字小文字X入。点、文字化場合注意。,右上申請者名前記入（ACROBAT作成者、自動的表示）。別紙足時、同様別紙右上必氏名書。万一時、誰次頁以降、追加場合、準。,X,X,注）2b、2f、2h、2i、2q、3cYES場合、医師【診
12、断書】必要,X,X,確実記入。虚偽場合、重大引起,該当場合確実情報記入,病気、既往症（医師記入）,X,X,持病薬持参場合、必記入,母子手帳、等記入,署名必（）！,Katsumoto KURODA,医者医院押印,異常場合別紙詳細情報書。正直記入。留学後発覚途中帰国。,6.疾病対予防注射（接種）受留学条件、空欄得7.反応結果同様（6,7共）次SectionCAppendixA使用,1月間薬5mg1日3回、服用 5/3 times/day for a month,1992年罹、Measles(rubeola)横Had in 1992罹、None N/A5.上病名横他含、埋。,右上申請者名前記入。別紙
13、足時、同様別紙右上必氏名書。万一時、誰。,医師提出記入自分記入！,二者択一、該当選四角（）中、大文字小文字X入。点、文字化場合注意。,医師氏名入力、手書体（活字体）。,既往症接種（医師記入）,氏名,追加必要場合記入用紙申請書後,病気、既往症接種（医師記入）,申請者名前記入,限、接種行【病院】専用使（接種項目合、Form問）推奨、渡航前、3月以内証明書発行（有効期限3月、渡航12月前取得）記載接種、埋接種関留意点読、対応,接種回数勝負,接種関、日本後進国！（特USA交換、 非常厳場合）,Katsumoto KURODA,医者医院押印,署名必（）！,氏大文字、名第1文字大文字。 入力、手書体（活字
14、体） 氏名順番先（名+氏統一） 秋山Akiko AKIYAMA,二者択一、該当選四角（）中、 大文字小文字X入。 点、文字化場合注意。,追加記入。（別紙必要、同様別紙右上必氏名書。万一時、誰。,歯状況（医師記入）歯必、出発前日本治療完了,自動的表示,追加必要場合記入用紙申請書後,自動的表示,Katsumoto KURODA,Katsuko KURODA,Kurobei KURODA,Rotarou ROTARY,署名必（）！,iinchou CHIKU,Kaicho KURABU,YechouRCCLUB,派遣地区委員長情報,派遣（RC）情報会長青少年交換委員長,Guarantee Form
15、派遣学生派遣元（）保証書式,署名、作成時該当役職方注）実際交換年度役職違場合多,自動的表示（表示場合、入力）,受入地区、情報（留学先情報）記入！派遣先（渡航先）記入Guarantee届、 正式派遣生、候補生,Guarantee Form 来日学生来日先（）受入保証書式,毎月小遣,通学学校情報,第情報Guarantee届、早急連絡取,来日学生用記入空港https:/www.k- KURODA,会長名、President例、Saburo SATO、President,宣言医療関許可、病歴通知免責,氏大文字、名第1文字大文字。入力、手書体（活字体）氏名順番先（名+氏統一）秋山Akiko AKIYAM
16、A,署名、作成時該当役職方注）実際交換年度役職違場合多,自動的表示,Katsumoto KURODA,署名必（）！,二者択一、該当選四角（）中、 大文字小文字X入。 点、文字化場合注意。,校長名、Principal例、Jiro FUJI、Principa,学校報告及推薦状封印、持参（開封）,学校成績証明書先生推薦状英語能力証明書次。,学校報告成績証明書封印、持参（開封）,自動的表示,成績証明書、直近3年分必要。高校1年生、中学卒業時必要英文（4部）、邦文（2部）封印、開封,学校正規書式提出構,学校担任先生推薦状封印、持参（開封）,自動的表示,学校正規書式提出構,学校推薦状担任先生推薦記述書式、
17、学校正規書式構,学校英語能力証明書 封印、持参（開封）,自動的表示,英語能力証明書米国派遣学生Format（類似可）従英文記入学校認定受,学校使用作成提出,1.写真笑顔添付2.（署名）3.英文4部、邦文2部作学校成績証添付英文（）【英文部交換先、部地区委員会、部RC】 邦文（）【邦文部地区委員会、部RC】4.等確認用（）留事, 英文部邦文部提出,申請者名前記入,医療関係追記事項、書式記入,病気、既往症接種（医師記入）追記、用紙使用,医療（医師記入）,申請者名前記入,歯科治療等追記事項、書式記入,歯状況（医師記入）歯科関追記、使用,追記事項、書式使用,申請者名前記入,追記事項各名称入力,Sect
18、ion A :Personal InformationSection B:Letter and PhotosSection C:Medical History and ExaminationSection D:Dental Health and ExaminationSection E:Student,Parent,& Sponsor EndorsementsSection F:Host Club, District,& School EndorsementsSection G:Rules and Conditions of ExchangeSection H:Secondary School
19、 Personal ReferenceOther,医療（医師記入）,申請者名前記入,自己紹介家族推薦状（保護者）英文,両親書簡文例以下質問答子受入宛書簡作成。作成外国人親子観考慮文面、文例参考。子病気記入。出来上文章、方。Dear Host RC and Family【共通自己紹介文例】Im （親名前）, （子供名前）s father(or mother). Its my great pleasure to have an opportunity to introduce my daughter to you in this letter by answering the following
20、questions. 1. How is your childs relationship with you and your family? with his/her friends? （子両親家族関係子友人関係。）1)She has a good relationship with us and with her sister. When we have spare time, we play various board games, watch movies and TV. She also enjoys taking care of her little cousins and pla
21、ying with them. She has many friends at school, so she has a good time there.2)She has a younger brother aged 14 years old. She is kind to him but sometimes they quarrel as most brothers and sisters do.She loves her family members. We travel to famous places during long vacations. We go skiing in wi
22、nter and swimming in summer. She is kind to everyone and nobody speaks ill of her. She goes to school with her friend every morning. Many of her friends want to go amusement parks and concerts with her. She works hard at extracurricular activities (afterschool club at school).3) Excellent. My daught
23、er often asks me for homework advice. She often gives me advice on my fashion styles. She enjoys talking a lot with family members every day, typically about her new favorite music and artists, about her friends and about events at school. She goes shopping with other family members pretty often to
24、have fun.2. How does your child react to disagreement, discipline, and frustration? （子意見相違規律不満対反応。）1)If she has any complaints about the discipline, she tells us about it. Then she explains her thoughts on the matter so we can understand how she feels. Even if she doesnt get her wish, shell respect
25、the discussion.2) My daughter is moderately assertive that in most cases she can deal with disagreements in a decent way. She is very good at explaining her opinion logically, which sometimes clarifies misunderstandings. Also, she understands it is usually better to come to a reasonable compromise i
26、n real life. Her character would be nearly ideal if she learned a way to handle unavoidable frustration.3. How does your child handle challenging or difficult situations? （努力必要、困難状況子対応。）1) She is optimistic about everything. With that she will work hard with a positive mindset.2)We believe that she
27、understands what she should do.3) My daughter usually makes every effort to find the best approach when facing confrontation. She is also good at asking experts for assistance. For instance, when she became in charge of costumes for the group dance event at school, she organized a special team to st
28、udy how to design and sew costumes on the internet, then sketched her costume design, and made the pattern. Finally, she sewed several sets of costumes using her mothers sewing machine for hours and hours, day and night.4. What amount of independence do you give to your child? What is your childs le
29、vel of maturity?（子程度主体性子成熟度程度。）1) We do not force her do anything. Once she became a high school student, she mostly decides for herself what she does.2) She has her own room and cell phone, but is not permitted to use social network services. As already mentioned in answering other questions, she m
30、ay ask somebody to do everything for her. She seldom cooks or does house chores. She may act like an immature child at times.She often relies on others when she should be more independent.3) As her parents, wed like to see what she is going to do in her future, but we think she acts her age.4) My da
31、ughter seems much more mentally mature than typical girls her age. When she was young, I strictly regulated her lifestyle; the way she uses her money, for example, but now I encourage her to make decisions for herself. At age 16 she traveled all the way to Osaka (170 miles away) for sightseeing with
32、 a friend of hers. Recently she took a long distance overnight bus to visit Tokyo Disneyland with a few friends of hers. Both started as a proposal from her and I allowed her to do them.5. What makes you proud of your child? （子誇思何。）1) We love her smile. She always has a smile on her face, so we feel
33、 happy when she is. We are proud of her cheerful personality.2) She is honest and kind to everyone. She always thinks about family members, not only us but also her grandparents. She has long talks with them by phone.3)We are proud of her cheerful character.4) Im proud of my daughter s creativity an
34、d ability to absorb many new things. She has been creative since her infancy. I still remember her amazing woodblock buildings and artworks. At age 9 she wanted to talk to a close friend of hers at any time so she made an FM transmitter, doing soldering by herself. She has learned a lot of things wi
35、th passion: swimming, Japanese calligraphy, piano, clarinet, singing, and English conversation in addition to the normal school education. Furthermore, she has taught herself to ride a unicycle, play the guitar and sewing. No wonder she is now interested in fashion design - a collection of various s
36、kills, plus creativity. 6. Why do you want your child to be an exchange student? （子交換参加思理由何。）1) First of all, because she wanted to be an exchange student. We would like to support what she wants to do. And we want her to know the wide world, we think she has grown enough mentally to do that.2) She
37、is good at speaking English and wants to get a job where she can work all over the world. We want her to experience other cultures and languages while she is young. This is what I had dreamed of when I was young.3) We understand that customs are different in every culture. Wed like to make her exper
38、ience a country we dont know and become more conscious of her own cultural identity.4) Because the experience of being an exchange student will widen my daughter s way of thinking and will prepare her for a working career in future. It was almost three years ago that my daughter said for the first t
39、ime that someday she would go to the U.S. alone to work there. I was not surprised, I was just so happy to hear that because it was a clear sign that she was already mature and independent and that she had the extraordinary bravery necessary to stay abroad alone at her age. I was so proud of her. Si
40、nce then she has been keeping that desire in mind.Being an exchange student is therefore her ideal first step in realizing her dream. Im convinced that her stay will establish a solid basis for her entire life, not to mention her working career. 7. Are there any other comments you would like to shar
41、e with the host families? （伝他。）1) I appreciate your kindness in becoming host families for her. She likes to chat, so please talk to her a lot. This way she will enjoy her life with you.2) She has been raised as a princess until now. She may not be patient at first. But we hope she will overcome the
42、se difficulties with your help. Please speak to her frankly. We would like you to feel as if you were her second family. Thank you very much.3) I just cant thank you enough for hosting my daughter as an exchange student. I hope the days with her will be interesting, exciting and productive for everybody. Thank you so much.,
