IC INTERN APP FORM

Before filling out this application, please read all the information pages at Internship Information.

Also, please read the Privacy policy regarding data collection.

*We are now accepting applications for the April 2019 - January 2020 academic year.

I confirm that I have read all the Internship Information pages and accept the terms of the Privacy Policy. *

Yes No

CONTACT INFORMATION

Given Name(s) *

Family Name *

Date of Birth *

YYYY/MM/DD

Gender *

Male Female

Nationality *

Passport Issuing Country

Home Address *

Email Address (please enter your address twice to confirm) *

example@example.com

Skype Name

We conduct interviews through Skype. Please create an account if you do not have one.

ACADEMIC INFORMATION

What educational institution are you currently enrolled in? *

Please write the name of the school you are attending. You must currently be a student to apply.

Year in School *

Major Field of Study *

Minor Field of Study

if applicable

Anticipated Date of Graduation *

YYYY/MM/DD

INTERNSHIP DATES AND LENGTH

When is it possible for you to do this internship? Please check all that apply. *

Spring Term (Late March - Early August) Fall Term (Mid September - Late December) Winter Term (Late November - Late January)

Preferred Internship Length *

How many weeks/months?

Preferred Start Date *

YYYY/MM/DD

Preferred End Date *

YYYY/MM/DD

BACKGROUND AND INTERESTS

How did you hear about this internship? *

Why are you applying for an internship? *

Intercultural Experience *

Experience Abroad *

Language Experience *

Please note that Japanese language skills are not a requirement.

Teaching, Coaching or Leadership Experience *

Work Experience *

What are your goals in coming to Japan? *

Imagine that you are planning a fun two-hour event for our students. What kind of event would you plan? *

Please remember that the students are learning English as a foreign language.

Additional Information *

Things you want to tell us about yourself and why interning would be beneficial for you and for IC.

Health and Medical Issues *

Allergies, physical health issues, mental health issues, etc. Please include anything that may affect your housing situation, our students, the work environment or your own safety. This information will be kept confidential. Please note that we do not discriminate. Refer to the Medical Issues section of the Internship Information located at the webpage indicated above for more details.

REFERENCES

Please enter three references including at least one academic reference (i.e., a Japanese teacher, an instructor, an academic advisor), and a professional reference (i.e., a boss or supervisor). Please note that relatives and friends will not be accepted as referees. We will be contacting the references by email so please provide us with references who will speak on your behalf. Also, please provide us with references who speak English.

Reference #1

Given Name(s) *

Family Name *

Relation to you *

Phone Number *

Email Address *

example@example.com

Skype Name

Reference #2

Given Name(s) *

Family Name *

Relation to you *

Phone Number *

Email Address *

example@example.com

Skype Name

Reference #3

Given Name(s) *

Family Name *

Relation to you *

Phone Number *

Email Address

example@example.com

Skype Name

PARENT OR GUARDIAN CONTACT INFORMATION

We would like the contact information for your parent or guardian and your permission to be in touch with them concerning your application.

I give Ibaraki Christian University permission to contact the following parent or guardian. *

Yes No

Given Name(s)

Family Name

Relation to you

Phone Number

Email Address

example@example.com

Skype Name

I confirm that the information in this application is true and contains no omissions or misrepresentations. If erroneous information is discovered at a later date, I will voluntarily withdraw from the program upon request at my own cost with Ibaraki Christian University bearing no responsibility. *

Yes No

I agree to the use and storage of the data above for the internship application process. *

Yes No

*Please check the data above prior to pressing submit*

Pressing submit does not complete the application process. After you press submit, you will receive a confirmation email. Please download and save the pdf of your data (change the file name to include your name), and attach that with your resume in an email to english_internATicc.ac.jp. This will complete the initial application process.

After we have received that email with the attached application pdf and resume, we will contact you.

Please note that email can be treated as spam or lost somewhere along the way. If you do not receive any confirmation or email concerning your application, we suggest you email to confirm that we have received everything. You can reach us at english_internATicc.ac.jp. Please change the AT to an @ mark.

Enter the message as it's shown *

IBARAKI CHRISTIAN UNIVERSITY