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アユサ・ジャパンのスタッフより追ってご連絡いたします。
毎週、金曜日に最新の求人情報をお送りします。
Please complete the following form for the Independent Placement Service.
(All fields marked
*
are required for submission)
Please choose a program
*
Internship
Training
Volunteer
Please select one of the above options.
Please enter the following information as it appears in the applicant's passport.
First Name
*
Last Name
*
Birth Date (mm/dd/yyyy)
*
Country of Citizenship
*
Country of Legal Residence
*
Gender
*
Male
Female
Country of Birth
*
City of Birth
*
Email Adress
*
Phone Number
*
Address
*
City
*
State/Province
*
Postal Code
*
Country
*
Emergency Contact Information
Name
*
Relationship
*
Phone Number
*
Educational History
Post-Secondary Institution (Outside of U.S.)
*
Field of Study
*
Is the applicant currently enrolled in university?
*
Yes
No
Please select one of the above options.
If no, month and year of graduation?
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2000
2001
2002
2003
2004
2005
2006
2007
2008
Career History
Please list information on employment that directly relates to the applicant's chosen field. Employment must be outside of US.
Job #1
Company
Supervisor's First Name
Last Name
Supervisor's Title
Job Start Date (mm/dd/yyyy)
Job End Date (mm/dd/yyyy)
Applicant's Job Title
Applicant's Job Description
Job #2
Company
Supervisor's First Name
Last Name
Supervisor's Title
Job Start Date (mm/dd/yyyy)
Job End Date (mm/dd/yyyy)
Applicant's Job Title
Applicant's Job Description
Job #3
Company
Supervisor's First Name
Last Name
Supervisor's Title
Job Start Date (mm/dd/yyyy)
Job End Date (mm/dd/yyyy)
Applicant's Job Title
Applicant's Job Description
Please check the information provided in this application carefully before clicking on the "Submit" button below.
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