Japanese Speech Contest Entry Form


Name:   ____________________________   _________________________    Grade: __________

                                 English                                           in Katakana


Home Address: ___________________________________________________________________


Telephone Number:  _______________________ (The number we can reach you on the day of the speech contest.)


School Name:  ________________________ Japanese Teacherfs Name: _____________________



Entry Category: Circle your entry category.     #1     #2     #3     #4    #5


 Free Speech Title __________________________                                         T-shirt size ____________



Studentsf levels

Division I

Poetry Recitation #1

High school Level 1 or II

Division II

Poetry  Recitation #2

High school Level  II or III

Division III

Free Speech

All level

Division IV

Free Speech

All level


Division V

Free Speech

College students and adults






I will participate in the Japanese Speech Contest.


________________________________________________    _______________________

                       Participantfs signature                                                        Date


I approve the studentfs level.


________________________________________________    _______________________

                           Teacherfs signature                                                        Date




I give my son/daughter _____________________________ permission to participate in the Japanese Speech Contest to be held on February 14, 2009 at Ted Polk Middle School.  I understand that the final contestants will be recorded in videotape.  I hereby release his/her Japanese teacher, his/her school, Dallas Japanese Association and Japanese School of Dallas from any liabilities should any accidents occur during the contest.


________________________________________________    _______________________

Parent/Guardian signature    (not necessary if you are over 18 years old.)    Date






You must turn in this application by Friday, January 30, 2009.  No exceptions will be made.  Please print or type this form.