ボランティア登録申込書（英語）

R 元年 6 月版

Calling All Interpreters& Other Volunteers!
The Kagawa International Exchange Association (I-PAL) operates a volunteer dispatch system todispatch interpreters and other volunteers to aid international residents with limited Japanese skills, andto promote mutual international understanding among prefectural residents. Volunteers are now being
recruited so hurry and apply!

昨日の夜から頭が痛いそうです。

かぜですね。

ＡＢＣＤＥＦＧＨ

くすりをのんだらＩＧＫＬＭＮＯＰ

よくなりますよ。

ＱＲＳ？？？？？

1.What are the volunteer activities?
Type of Volunteer

Explanation of Duties
Support international residents with limited Japanese ability when

1. Interpreter

they go to the doctor’s, to a health or welfare facility, or in otheractivities in which they will need language assistance byinterpreting for them.
Support international residents with limited Japanese language

2. Japanese Instructor

abilities by teaching them Japanese language skills necessary ineveryday life.
Support international residents by conducting activities that

3. Japanese Cultural Instructor

promote mutual understanding, such as Japanese cooking, tea
ceremony, traditional folk dance, sports, etc.
International residents, or those with international cooperation or

4. International Speakerstudyabroad

experience,

promotemutualinternational

understanding by offering their personal international experiences
or foreign language instruction at educational facilities.

ボランティア登録申込書（英語）

R 元年 6 月版

2. Flow Chart of Volunteer Activities: (In the case of a volunteer interpreter)
Medical, Health,or Welfare Facilities

Kagawa’s International Residents
with Limited Language Abilities

1. Dispatch
6. Report Results

Request5. Preliminary

4. Volunteer Chosen

Kagawa PrefectureInternational Exchange
Association

6. Interpretation, etc.
Volunteer Activities

Talks
2. Dispatch Request

Registered Volunteers
3. Regulation of Contact

3. Specific Conditions of Volunteer Activities:
１．Volunteers may not engage in any activities that require the knowledge of a specialist, activities that pose athreat of contagion or other harm to their well-being, commercial activities, and other activities that are
inappropriate for volunteers to partake in.
２．The individual or organization requesting the dispatch of a volunteer will be responsible for paying thevolunteer fee, transportation stipend, and printed materials stipend*.
３．The volunteer fee is 1,000 yen per hour, and the transportation stipend will equal the actual transportation fees
paid in principle. In the case in which a volunteer drives to his/her location, the actual fees paid amount to 37
yen for every 1 kilometers traveled. The printed materials stipend* is limited to a 2,000 yen maximum.
４．In the case that a volunteer is involved in an accident while carrying out volunteer duties, he or she will becovered by I-PAL’s insurance policy.
５．The individual or organization requesting the dispatch of a volunteer will be held responsible for the cost of
medical treatment and/or legal fees incurred as a result of the volunteer activity.
６．In the event of a disaster or other emergency in the prefecture, registered information will be shared with theprefectural, city, and town authorities, so there these authorities may directly request a volunteer to interpret ortranslate if an international resident is injured or requires additional assistance.
(*The printed materials fee is limited to situations in which materials are needed by Japanese Instructors,
International Speakers, or Japanese Cultural Instructors.)

4. How can I participate in these volunteer activities?
To participate in volunteer activities, prior registration is required!!! Please register by filling out the separate
Volunteer Application Form and send it via e-mail, fax, or post to Kagawa Prefecture International Exchange
Association.
Volunteer certification will be mailed to your residence at a later date. Please be sure to bring this certification
with you whenever you are called to participate in volunteer activities.

5. Where can I learn about Volunteering？
We will send out information concerning skill enhancement training opportunities and things to keep in mind
about volunteer activities and supporting foreign residents during times of disaster. Please be sure to participate inthese events. We also lend out books with useful information about volunteering, so please bring your volunteer
certification in order to borrow them.
Applications/Contact〒760-0017 1-11,63, Bancho,Takamatsu, I-PAL Kagawa
Kagawa Prefecture International Exchange Association “Volunteer Dispatch Project”(Closed on Mondays)

URL:
EMAIL：

http://www.i-pal.or.jp/tsuyaku/

toroku@i-pal.or.jp TEL：087-837-5908

FAX：087-837-5903

ボランティア登録申込書（英語）

R 元年 6 月版（Form１）REGISTRATION APPLICATION FOR VOLUNTEERS (New or Continuing)
ID：YearMonthDay

To The Director of the Kagawa Prefecture International Exchange Association (I-PAL)●Before applying for registration, I agree to the following conditions.

1.Information recorded on the volunteer certification <Form 1> (excluding name, sex, age, address, and contact information) will become
public information for general use.
2. Volunteers will fulfill their interpretation duties if capable when I-PAL requests their services.
3. When volunteers are dispatched, they will follow the instructions given to them by the organization requesting their services, and carryout their duties. Also, they will refrain from engaging in any activities that require the knowledge of a specialist, activities that pose athreat of contagion or other harm to their well-being, commercial activities, and other activities that are inappropriate for volunteers topartake in.
4. Volunteers will not, for any reason or with any unjustified intent, share personal information from the individual/organization for whomthey are volunteering with any third party. Volunteers will continue to maintain confidentiality of such information even after they stop
serving as volunteers.
5. In the event of a disaster or other emergency in the prefecture, or if such an emergency seems imminent, the volunteer’s registeredinformation will be shared with the prefectural, city, and town authorities, so there these authorities may directly request volunteers tointerpret or translate if an international resident is injured or requires additional assistance.

KatakanaNationality（Last）

Contact Info.
（Please provide us witheither your home ormobile phone #）(If possible, pleaseprovide a PC e-mailaddress)

Preferred
Day and Time

Birth Date

□M（Given）

Full NameAddress

Sex□F
Closest Station〒Phone：（home）
FAX：（（mobile））E-mail（computer)E-mail（cell）
MondayTuesday

WednesdayThursdayFridaySaturday□morning□afternoon□evening□morning□afternoon□evening□morning□afternoon□evening□morning□afternoon□evening□morning□afternoon□evening□morning□afternoon□evening（Condition other than the above）

Holiday□morning□afternoon□evening

Occupation□□□□□ Interpreter

Sunday/Language(s)：（）・（Full time
Part time
No occupation
Student）
・（）（→Please fill out Form 1- ①as well）□ Japanese Instructor
Volunteer Activity（Check one or more）（→Please fill out From 1- ②as well）□ Japanesee Cultural Instructor（→Please fill our Form 1- ③as well）□ International Speaker（→Please fill out Form 1- ③as well）
登録時処理

抹消時処理

＊For I-PALｱｸｾｽ

□

年月日

□年月日

use onlyﾒｰﾙ

□年月日

□年月日

ﾌｧｲﾙ

有効期限：

ﾌｧｲﾙ移動

□来館時対応者：

年 12 月ボランティア登録申込書（英語）

R 元年 6 月版

YearMonthDay(Form1－①)

REGISTRATION APPLICATION QUESTIONNAIRE
FOR VOLUNTEER INTERPRETERS＊ Dispatches will be requested, after the necessary volunteer conditions and requirements have been met, based onthe answers to this questionnaire, so please complete this form with as much detail as possible.
＊In the event of a change in any of the following information, please notify I-PAL promptly.
KatakanaNationality（Last）

SexBirth Date□M（Given）

Full Name□F□Yes（Is this your native language？

1. Spoken Language□No）（Language qualifications, certification, etc.）＊For English speakers, please provide your TOEIC or English Proficiency Test Scores (if applicable)＊If your native language is not Japanese, please provide your Japanese language qualifications（Number of years lived in foreign countries, interpretation experience, etc.）

1.Interpretation
VolunteerLanguage□Yes（Is this your native language？

2. Spoken Language□No）（Language qualifications, certification, etc.）＊For English speakers, please provide your TOEIC or English Proficiency Test Scores (if applicable)＊If your native language is not Japanese, please provide your Japanese language qualifications（Number of years lived in foreign countries, interpretation experience, etc.）（Medical, Academic, well-being training, or other qualifications or experience）

2. IndividualExperience
・Are you able to volunteer as an interpreter at a medical organization? □Yes□No・Are you able to translate in the case of an emergency (e.g., providing support information to disastervictims, etc.)?

3. OtherQuestions□Yes□No・Are you able to translate announcements, etc. for educational organizations? □Yes

□No・Are you able to volunteer at elementary schools, middle schools, and community centers in the prefecture
for the purpose of instructing foreign resident children (Japanese language and regular school subjects)?
□Yes□Noボランティア登録申込書（英語）

R 元年 6 月版

YearMonthDay(Form1－②)

REGISTRATION APPLICATION QUESTIONNAIRE
FOR VOLUNTEER JAPANESE INSTRUCTORS＊Dispatches will be requested, after the necessary volunteer conditions and requirements have been met, based on
the answers to this questionnaire, so please complete this form with as much detail as possible.

＊In the event of a change in any of the following information, please notify I-PAL promptly.

KatakanaNationality（Last）

Education
Experience

Birth Date

□M（Given）

Full Name
1. JapaneseSex□F
Where did you study Japanese or Japanese Language Education? (Circle all that apply)
1. I-PAL volunteer Japanese language course

4. University

2. Private volunteer Japanese raining course

5. Government-sponsored training course

3. Correspondence courses

6. Other（）Do you have any Japanese teaching experience? (Including private experience)（□Yes□No）

If yes, please explain briefly.
Where（location・organization

Target group・number of people

Dates of experience

name・country, etc.）

2. Japanese
TeachingExperience

Teaching materials that you used.

・・・・・・

・Can you participate as a volunteer if your only compensation is the transportation stipend? （□Yes

3. OtherQuestions□No）・Are you able to volunteer at elementary schools, middle schools, and community centers in the prefecture for thepurpose of instructing foreign resident children (Japanese language and regular school subjects)?

□Yes □No＊Did you also apply or are you currently applying to be a Volunteer Interpreter? （□Yes□No）

If not, please fill out the following.

4. Foreign

Spoken Language（Is this your native language？

□Yes□No）

Language（Language qualifications, certification, etc.）

Ability＊For English speakers, please provide your TOEIC or English Proficiency Test Scores (if applicable) .

＊Languages other＊If your native language is not Japanese, please provide your Japanese language qualifications.

than Japanese（Number of years lived in foreign countries, interpretation experience, etc.）

ボランティア登録申込書（英語）

R 元年 6 月版

YearMonthDay(Form1－③)

REGISTRATION APPLICATION QUESTIONNAIRE
FOR JAPANESE CULTURAL INSTRUCTORS& INTERNATIONAL SPEAKERS＊

Dispatches will be requested, after the necessary volunteer conditions and requirements have been met, based on
the answers to this questionnaire, so please complete this form with as much detail as possible.

＊In the event of a change in any of the following information, please notify I-PAL promptly.

Katakana（Last）（Given）Full Name
Course Subject＊What class(es) can you offer? Provide a summary of the activities involved.

1. Japanese
CulturalContents

Understanding
Volunteer

Qualifications,＊Please describe in detail.

instructing
experience, etc.
Course Subject
Subject Country＊What class(es) can you give? Provide a summary of the activities involved.

2. International
Understanding
VolunteerContents

Qualifications,＊Please describe in detail.

instructing
experience, etc.
＊Did you also apply or are you currently applying to be a Volunteer Interpreter? （□Yes□No）

If not, please fill out the following.

Spoken Language
3. Foreign（Is this your native language？

□Yes□No）（Language qualifications, certification, etc.）

Language＊For English speakers, please provide your TOEIC or English Proficiency Test Scores (if applicable) .

Ability＊If your native language is not Japanese, please provide your Japanese language qualifications.

＊Languages otherthan Japanese（Number of years lived in foreign countries, interpretation experience, etc.）