JF Japanese Language Course at the NIPPON CLUB Culture Courses

REGISTRATION FORM–Spring 2016

JF Japanese Language Course at The NIPPON CLUB Culture Courses

Last Name (Please print or type.) First Name (Please print or type.)

Address Apt. City State Zip

Home Phone Cell Phone Email

I would like to register for: A1-1 Introductory Japanese(4/27–6/29, WED. 6:15– 7:15 pm)$200

A1-1 Introductory Japanese(4/21–6/23, THU. 6:15 – 7:15 pm)$200

A1-2 Introductory Japanese(4/27–6/29, WED. 6:30– 8:00 pm)$300

A1-3 Introductory Japanese(4/21–6/23, THU.7:40 – 9:10 pm)$300

A2-1 Elementary Japanese (4/26–6/28, TUE.6:30 –8:00 pm)$300

A2-3 Elementary Japanese (4/21–6/23, THU. 6:00 –7:30 pm)$300

A2/B1Pre-Intermediate Japanese

(4/27–6/29, WED. 7:30 –9:00 pm)$300

B1Intermediate Japanese(4/18–6/27, MON. 6:30 – 8:00 pm)$300

Registration Fee: Nippon Club member $25

*first time only Employee of Nippon Club/JCCI member company $30

 Non-member $50

* If you are not sure about your membership type, call (212) 581-2223.

To register, please complete this form and submit by mail or in person to:

The Nippon Club Culture Courses

145 West 57th St., 6Fl, New York, NY 10019

(Please make your check payable to “The Nippon Club”).

*The office is open Mon - Fri: 10am - 5pm.

*Payment by cash or check only. (No credit card).

*IMPORTANT!Registration deadline isthree (3) business days prior to the first class meeting.

Notice:- Full payment for tuition and fees must accompany your registration.

- Class may be cancelled due to insufficient enrollment by the registration deadline.

- Refunds are not available after the first class starts.

First survey

Your name: ______

What is your first language?

Do you know any language(s) other than your first language? If yes, please name all of them and rate your proficiency level of each language (i.e. beginner, intermediate-low, intermediate-high, advanced-low, advanced-high, near-native level etc.).

Have you ever been to Japan?

□Yes

□No

When:

How long:

Where:

Purpose:

Have you studied Japanese before?

□No ⇒Please skip Question No. 5 and No. 6and proceed to Question No.7

□Yes

When:

How long:

How :

(Please specify the names of institution(s), textbook(s) and chapters covered, and/or websites you used)

Please provide your self-evaluation of your Japanese language ability.

How well do you think you are able to perform the following tasks using Japanese?

Mark the box that applies to you with X.

Scale

1: Can’t do it 2: Can do it but not at a satisfactory level

3: Can do it fairly well enough 4: Can do it without any difficulty

1
can’t / 2
poor / 3
fair / 4
well
1. / Can read words written in hiragana.
2. / Can read words written in katakana.
3. / Can make basic greetings such as hello, good-bye, thank you, sorry etc.
4. / Can talk about yourself, what you do and where you live using simple words and structure.
5. / Can talk about what food you like.
6. / Can talk about what you do daily.
7. / Can talk about what you have in your house.

Have you ever taken any official Japanese language proficiency tests (ex JLPT, ACTFL OPI, AP Japanese etc.)? If yes, please elaborate in detail (when you tried what, and the result of each exam).

What are your purposes/goals in studying Japanese? Please check all that apply.

□to learn what Japanese language/cultures are like.

□to travel in Japan somewhat comfortably.

□to communicate with your friends/family on simple daily topics.

□to communicate with your friends/family on social/academic topics.

□to have business communication.

□to understand TV dramas/movies.

□to read newspaper/watch TV news.

□Other(s)

What aspects of Japanese culture are you interested in?

(Check all of the boxes that apply and provide examples)

□Arts (ex.)

□Literature (ex.)

□Food (ex. )

□Anime/manga (ex.)

□Music (ex.)

□Fashion (ex.)

□Movie (ex.)

□Other (Please specify.)

How did you find out about the JF Japanese language course?

□Chopsticks New York

□Time Out New York

□Email from Japan Foundation, NY

□Japan Foundation, NY website

□Email or pamphlet from Nippon Club

□Facebook

□Newsletter from the Japan Foundation, NY

□Newsletter from the Nippon Club

□Word of Mouth

□Web search

□Poster (where: )

□Other ( )

Please indicate the reason(s) you got interested in JF Japanese Language Course at The Nippon Club Culture Courses. Check all that apply.

□Location

□Schedule

□Class level

□Class contents

□Cost

□Instructors

□Related cultural events

□Other: Please specify below. ______

______

Is there anything that motivated you to sign up at this particular time? If yes, please provide more detail.

Example 1: I’ve been interested in Japanese language for a long time, and I finally have time to manage it.

Example 2: I’m traveling to Japan soon.

Example 3: It’s a good season for me to start something new!

______

(Optional) What is your age group?

□Under 18 □18-29□30-44□45-59□60 or older

(Optional) What is your current occupation?

Any comments or message?

Thank you very much for your time!