<p> Japan-U.S. Cherry Blossom Centennial Application Form </p><p>For official use only. No. of receipt: No. of recognition: </p><p>/ / (dd/mm/year) Name of Event English:</p><p>Japanese (optional):</p><p>Name of Organizer English:</p><p>Japanese (optional):</p><p>Category of Organizer Circle as appropriate:</p><p>Non-Profit Organization / Corporation / School / Public Service / Local Government/Affiliated Institution / Government / Other ( ) Name and Title of English: Group Representative(s)</p><p>Japanese(optional):</p><p>Name and Title of English: Individual in Charge of Event</p><p>Japanese (optional):</p><p>Contact Information Address:</p><p>Tel. No. ( ) - Fax No. ( ) - E-mail: URL: Description of Event(s) Dates/Times of Event</p><p>Venue English:</p><p>Japanese (optional):</p><p>Co-host (if any) Name: Contact: Subject of Event Circle all that apply: Politics / Economics / Science & Technology / Tourism / Japanese Food / Movies / Drama / Dance / Music / Photography / Lifestyle / Health & Exercise / Arts / Education / Academic & Intellectual / Sports / Youth /Grassroots Exchange / Other ( )</p><p>Format Circle all that apply: Festival / Concert / Exhibition / Performance / Conference / Seminar-Lecture / Workshop / Contest / People-to-People Exchange / Training / Volunteer Activities / Program / Screening / Internet / Book / Other ( ) Circle as appropriate: A. This will be a stand-alone event. B. This event is part of a larger event. [Specify the name of the larger event: ] Sources of Funding Circle all that apply: Public Support / Corporate Contributions/ Donations / Entrance Fee / Membership Fees / Own Funds / Other ( ) Status of Preparation Circle all that apply: Event Confirmed / Planning Stage / Conceptual Stage/ Other( ) Use of logo Circle as appropriate: I wish/ do not wish to apply for permission to use the Japan-U.S. Cherry Blossom Centennial logo If you wish to make use of the logo, in what media would you like it to appear? Posters/ Website/ Pamphlets/ Other ( )</p><p>Notes</p>