23wsj Study visit application form

Bulletin 2 – Appendix 5

23WSJ Study Visit Application Form

National Scout Organization Country

1) Please provide contact details for 23WSJ Study Visit Delegation Leader (First Name)

(Family Name)

(Date of Birth)

(Gender)

(Position in NSO) (E-mail)

(Telephone)

(Address) (City)

(Region/State)

(Postcode)

(Country)

2) How many people do you estimate might be in your 23WSJ Study Visit Delegation?

Estimated Number in Delegation

3) Which accommodation option does your delegation intend to use? <Package Option> Option

Fee

No. of

Subtotal

Participants Option 1: Jamhotel Basic Package

JPY 10,000

JPY

Option 2: Dormitory Package

JPY 15,000

JPY

Option 3: Basic Package

JPY 5,000

JPY

Extra Stay on 7th August 2013

JPY 2,000

JPY Total Fee

<Own Arrangement>

Number of Participants Dates that you intend to visit

4) What is your preferred language for communications relating to the 23WSJ Study Visit?

English

French

5) Will you or members of your delegation require a visa?

Yes

No

6) Do any of your members have any special needs?

Yes

No

If yes, please provide details:

7) What topics do you hope to cover during your visit?

8) Please give details of members of your delegation (First Name)

(Family Name)

(Date of Birth)

(Gender)

(Position in NSO) (E-mail)

(Telephone)

(Address) (City)

(Region/State)

(Postcode)

(Country) *Make a copy of this page if necessary

9) Approval of NSO (Name of NSO) (Name of Approver) (Title) (E-mail) (Date)

(Signature)

This form should be completed by each National Scout Organization (only one per country), and returned to the Jamboree Office by the end of June 2013