20th Annual
Japanese language Speech Contest
Entry Form
Last Name ________________________ First Name __________________________
Name in Katakana _______________________________ Grade :_____________
Home Address __________________________________________________________
City _______________________ State __________________ ZIP _______________
Telephone ___________________________ E-mail _____________________________
Division
Division I (夢見たものは) Division
II (ゆずり葉) Division
III Division IV Division
V
(Please circle one)
Have you traveled to
If yes, please indicate the dates and duration of the stay :
__________________________________________________________________________
If you attend school, please indicate the name of the school and the grade or level
School __________________________________ Grade or Level ____________________
If you are taking Japanese at school, please list your teacher’s name and contact information
Name
______________________________________________________________
Tel : ____________________________
Email :___________________________
Please indicate your agreement with the following statement by signing the line below.
“ I
will present my speech in the 20th Annual Japanese Language Speech Contest on
Saturday
February 7, 2009. I
understand the regulation and time limits specified by Japan-America
Societies of Houston and
will abide by the judges’ final decisions.”
_____________________________________
Date _________________________________
Applicant’s
Signature
_____________________________________
Date _________________________________
Parent or guardian’s Signature
(If contestant is under 18 years of
age)
Applications must be postmarked, faxed or e-mailed by Friday,
January 23, 2009.
No exceptions will be made. Please complete and submit this form to:
Japan-America Society of Texas at Houston, 4801 Woodway,
Suite 230W, Houston, Texas
Tel:
(713)963-0121
Fax :
(713)963-8270 e-mail
: yoko@jashouston.