2018 AGU SUMMER PROGRAM APPLICATION FORM

*Mandatory fields
PERSONAL DETAILS
LAST NAME,  FIRST NAME,   MIDDLE NAME (if any)
N
*As of July 9, 2018
*Sex
*Do you have Japanese Citizenship?

EDUCATION DETAILS
Please indicate in "years" or "months"

ACCOMMODATION
*Please select all that applies.

DIETARY REQUIREMENTS AND OTHER INFORMATION If you have any dietary requirements for health or religious reasons, please let us know in advance. Please check all that applies to you.
I cannot eat:
*Do you smoke?

*DECLARATION