20 th Annual Japanese Language Speech Contest in Texas

San Antonio Regional

Entry Form

Last Name_____________________ First Name_______________________________

Name in Katakana ____________________________________________

Address________________________________________________________________

City__________________________________State______ZIP____________________

Telephone_______________________ E-mail _________________________________

Age___________

Division (Please circle one) Div. I, Div. II, Div. III, Div. IV, Div. V

Have you traveled to Japan before? Yes No

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 teachers name and contact information:

Name___________________________________________________

Tel______________________________ E-mail _______________________________

Please indicate your agreement with the following statement by signing the line below

“I will present my speech in the 20 th Annual Japanese Language Speech Contest at San Antonio College on Saturday, February 7, 2009. I understand the regulation and time limits specified by the Japan-American Society of Texas and will abide by the judges’ final decisions.”

_________________________________________________ ________________________

Applicant’s Signature Date

_________________________________________________ ________________________

Parent or Guardian’s Signature Date

(If contestant is under 18 years of age)

Application must be postmarked E-mailed by Saturday, January 24. No exceptions will be made. Please complete and submit this form to: Japan-America Society of San Antonio, 847 E. Hildebrand, San Antonio, TX 78212 or E-mail: tamaki@jas-sa.org