Application Form - Student Ambassador

The Heart of America Japan-America Society 2025 Application for the Student Ambassador Program to Kurashiki, Japan

Application Deadline - February 15, 2025
----- QUALIFICATIONS TO BECOME AN HAJAS STUDENT AMBASSADOR -----

Minimum qualifications to be considered as a candidate for the

Heart of America Japan-America Society Student Ambassador Program

1. Student status: Candidates must be a U.S. citizen who is a full-time high school student with good moral character, maturity, and a sincere desire to serve as a Heart of America Japan-America Society Student Ambassador. Students should be residents of the Kansas City, Missouri metro area (approximately one hour from downtown KCMO). Students must also hold or acquire a current U.S. passport.

2.     HAJAS membership: The student’s family must maintain HAJAS membership for the year of the trip.

3.     Age: A candidate must be at least 16 years of age by June 1, 2025.

4.     Health: The student must be in good health and have health insurance.

5.     Agreement: Each Student Ambassador will be required to sign a contract stating that travel is limited to the (approximately) three-week duration of the trip to Kurashiki only, and to agree to conduct him/herself as a mature representative of HAJAS. HAJAS will provide orientation sessions for the Student Ambassadors prior to departure for Kurashiki. The HAJAS also asks Student Ambassadors to volunteer at the Ethnic Enrichment Festival (August) and Greater Kansas City Japan Festival (October).

6.     Japanese study: The candidate must possess some formal knowledge of Japanese language and culture. A letter of recommendation from the Japanese instructor is required along with the application.

7.     Pre-trip essay: Candidates will be required to submit an essay (500 to 1000 words) with their application indicating why they would like to be a Student Ambassador to Kurashiki, Japan.

8.     Post-trip report: Student Ambassadors will be required to submit a report of approximately 1,500 words describing the highlights of the trip and to make a presentation about their trip at the September 23, 2025 regular meeting of the HAJAS membership.

9.     Transcripts: The student will provide a copy of his or her high school transcripts through the end of 1st semester, 2024-25 school year. Each applicant will undergo an interview with the HAJAS Student Ambassador Committee. A SEALED, official transcript from the high school must be sent by mail to Patty Woods (see #11 below).

10.   Expenses: HAJAS will purchase the airline tickets for the Student Ambassadors’ trip to Kurashiki and will also send funds to Kurashiki to cover incidental expenses needed for the trip. All other expenses, including travel insurance and personal spending money, are to be covered by Student Ambassadors or their parents. The HAJAS asks that each Student Ambassador take a small gift to each family member for the host families. Each Student Ambassador will contribute $2,000.00 to HAJAS to partially defray expenses of HAJAS on behalf of the Student Ambassador Program.

11.   Application Mailing: Please fill out the fields below, sign and send a printed copy of this form, along with items #6, #7, & #9, to Patty Woods, HAJAS, P.O. Box 22487, Kansas City, MO 64113. This application and all additional documentation must be received by February 15, 2025.
I. Personal Data:

Tell us about yourself.
Full Name*

PrefixFirst NameMiddle NameLast NameSuffix
Birth date*

MonthDayYear
Student mobile phone number*

Area CodePhone Number
Student email address*

Confirmation EmailWhere the confirmation will be send to
Gender*

MaleFemaleNon-binary
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / guardian name(s)*

0/100
Parent(s) email address
example@example.com
Parents’ address(es) if different from above (street, city, state and zip code)

0/200
Parent phone number (primary contact)

Area CodePhone Number
II. Education Information:
Name of school where you are a full-time student*
Year in school (e.g., junior, senior)*
G.P.A./Hours included in G.P.A.*
How you've received formal Japanese language study (school or tutor, online program)*
Please provide all ways in which you've learned Japanese (e.g., school, tutor, online class).
Name of the school(s) / programs and how long you studied Japanese at these school(s)*
Please list school and/or tutor and number of years at each school where Japanese was studied.
III. Applicant's E-Signature:
By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the SUBMIT button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
E-Signature:*
Should be Empty:

The Heart of America Japan-America Society 2025 Application for the Student Ambassador Program to Kurashiki, Japan

I. Personal Data:

II. Education Information:

III. Applicant's E-Signature: