Application

Name *

First Name

Last Name

Phone Number

Country

(###)

###

####

Date of Birth *

MM

DD

YYYY

Preferred Start Date *

MM

DD

YYYY

Duration of Stay *

4 weeks

4 to 6 weeks

2 months

3 months

Do you have prior experience with ceramics? *

If yes, please answer the following questions

Yes

No

Have you previously visited Japan? *

If yes, please answer the following questions

Yes

No