HiSciLab Application Form

Workshop date: , 2021

Application deadline: _, 2021

Cost to Student: 2,000 Yen

Accommodation, food and transportation provided by OIST.

1 Start 2 Complete

Student Information

Student Birthdate *

Year

Month

Day

Last Name *

First Name *

High School Name *

High School Grade *

1 Grade 10

2 Grade 11

3 Grade 12

Gender *

Male

Female

Home Address

Postal Code *

Prefecture *

City/Town/Village *

subarea #/ block#/house# *

Phone Number *

Email address *

Parent/Guardian Information

Last Name *

First Name *

Home Address (only if different from the student)

Postal Code

Prefecture

City/Town/Village

subarea #/ block#/house#

Phone Number *

Email address *

Relation to the student *

Please type in English explaining your purpose for choosing the HiSciLab workshop. (minimum 200 words) *

Please type in Japanese explaining your purpose for choosing the HiSciLab workshop. (minimum 200 words) *

Please contact us at science.outreach@oist.jp if you have any questions.

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