OIST School-Aged Program (The Afterschool program is at full capacity and operating with a waiting list)

External Teacher Registration

First and Last name / 氏名 *

Mailing address / 住所 *

E-mail address / メールアドレス *

Phone number / 電話番号 *

Briefly explain what you will be teaching. / 教える内容を説明する *

E-mail address of your OIST liason / OIST担当者のメールアドレス *

If you are a family member of an OIST employee, please list their first and last name. | OIST職員の家族の場合は、姓名を記載してください。 *

What section at OIST will you work with? | OISTのどのセクションで働くことになりますか？ *

SAP: School Age Program | OIST小学校プログラム（SAP）

Name of the club or group you are working with. / 関係しているOISTのクラブ名もしくはグループ名をお教え下さい。 *

What days and times do you plan on utilizing OIST facilities? / OISTの施設のご利用希望日（クラスの日時） *

What specific location on OIST campus will you be using? / クラスの希望場所 *

Do you have insurance? yes or no? / 保険にご加入されておりますか？ *

This question is primarily for the sports classes. If your class is not sport related, please mark NA

What type of insurance do you have? / どのような保険にご加入されておりますか？ *

This question is primarily for the sports classes. If your class is not sport related, please mark NA

Approximately how many OIST members will be participating with you? / OISTからは何名参加予定ですか？ *

Will you be working with people under 20 years of age? / 20才以下の子供の参加予定はありますか？ *

YES

If you are working with children, what will be the age range? / 参加予定の子供の年齢層をお聞かせください。 *

If you are working with children, do you agree to assume responsibility during the time you are working with the children? / もし子供が参加する場合、預かり中責任を負うことにご了承頂けますか？ *

YES

First and last name of your OIST liason (person you are working directly with) / OISTの担当氏名 *

First and last name of your emergency contact / 緊急連絡先　氏名 *

Phone number of your emergency contact / 緊急連絡先　電話番号 *

Do you have the Covid-19 vaccinations/ワクチン接種状況の確認 *

Yes - I have all three as of June 2022 /２０２２年６月までに３回ワクチンを接種しています。

No, I am not vaccinated / まだ接種したことがありません

I have less than 2 vaccinations /　２回はワクチンを接種しています。

Weekly PCR testing will be required for the time being.

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