Why not enroll your child in the Summer School Japanese Lessons held at TOPIA? Teachers are on hand to help
your child out with their homework, and they can learn Japanese through lots of fun activities, like games andquizzes!! Let’s do our best together!

 I want to learn kanji andJapanese words!
 I want to do homework!
 I want to make some friends!
What to Bring:For:

Writing tools, homework, school textbook, and things your child wants to study.
Elementary, junior, and senior high school students whose first language is not Japanese.

Where:TOPIA, Tokushima Station Clement Building 6F

When:July 21 (Thur.), 22 (Fri.), 23 (Sat.), 26 (Tue.),
27 (Wed.), 28 (Thur.), 29 (Fri.), 30 (Sat)10:30 a.m. to 12:00 p.m.

Cost
Free ofCharge

Instructor:

JTM Tokushima Nihongo Network

Deadline:

Applications must be received by Monday, July 11th.

How to Apply:

Please fill out the application form and questionnaire send it to TOPIA via post, fax, e-mail orin person.

⚫

You may still be allowed to participate in this lesson even if you miss the deadline, so if you are interested,
please contact us.

Applications & Inquiries:TOPIA, attn. Nomizu〒770-0831 Tokushima-shi, Terashima Honcho Nishi 1-61, Clement Plaza 6F
Tel: 088-656-3303
Fax: 088-652-0616
E-mail: coordinator2@topia.ne.jp★ We will be implementing measures to prevent the spread of the novel
coronavirus (COVID-19). We ask that you please wear a mask.
★ If you are going to be absent from class, please call 088-656-3303.
★ Classes may be cancelled due to inclement weather such as typhoons, heavy rain.
※This Summer School is sponsored by the Tokushima Prefectural Government in conjunction with TOPIA.

１

Summer School Japanese Lessons
Questionnaire Regarding Your Japanese Level
Send this application to TOPIA by FAX (088-652-0616)
or E-mail (coordinator2@topia.ne.jp)

Application
Katakana

Gender: M・F

Name

AgeSchool

GradeNationality

Languages Spoken

Guardian Name
AddressTEL (Please provide a number
we can call during class hours)

Thank you for applying to the Children’s Japanese Summer School Program. Starting on July 21, you’ll be studying
Japanese with some Japanese teachers for eight days. Before you start, please tell us about your Japanese language
skills. We’re going to use your answers to prepare lessons that are just right for you. If you don’t know what to write,
ask someone at home to help you out.
1.

When did you come to Japan? Year: _____________ Month: ______________________

2.

What language do you speak when you are with your family?
With father: ________________________

With mother: ________________________

3.

Can you read hiragana? □ Yes□ A little bit

□ No

4.

Can you write hiragana? □ Yes□ A little bit

□ No

5.

Can you read katakana? □ Yes□ A little bit

□ No

6.

Can you write katakana?

7.

Can you read the kanji you are studying in school?

□ Yes□ A little bit

□ No

8.

Can you write the kanji you are studying in school?

□ Yes□ A little bit

□ No

□ Yes

□ A little bit□ No

9. Can you understand when your friends speak Japanese?
□ Yes, very well.

□ Yes, mostly.

□ Not really.

□ Not at all

10. Can you understand when your teachers speak Japanese?
□ Yes, very well.

□ Yes, mostly.

□ Not really.

□ Not at all

11. Please write a circle if you understand well, a triangle if you understand a little and an X if you don’t understand thefollowing school subjects:＊Elementary: Literature ()Math ()Social Studies (Other:(＊Jr./Sr. High (Literature Classes): Classic Literature (Composition () Kanji ()Science ())) Modern Literature () Other:)()

12. What do you want to study at the Japanese Summer School? Please choose two.
□ Language Study□ Homework□ School Subjects□ Other: _____________________________
２

13. If you chose “Language Study”, what exactly do you want to study?
□ Speaking□ Reading □ Writing□ Kanji for up to Elementary/Junior/Senior High School (circle one), Grade ___________□ Other: _______________________
14. If you chose “Homework”, what exactly do you want to study?
□ Literature □ Math

□ Composition □ Other: __________________________

15. If you chose “School Subjects”, what subjects do you want to study?
______________________________________________________________________
16. The Japanese Summer School will take place over eight days. Please mark an X in the brackets next to the days thatyou are NOT able to attend.
Thursday, July 21 (Wednesday, July 27()

Friday, July 22 ())

Thursday, July 28 ()Saturday, July 23()

Tuesday, July 26(

Friday, July 29() Saturday, July 30())

17. If you have any questions, please write them in the box below:

Permission to Take Photographs
We will be taking photos of the lesson and will be using them in TOPIA’s and JTM’s newsletters and on our websites.
Do you give permission to TOPIA and JTM to take and publish photos of your children for our newsletters and websites?
Please check the box that applies.
□ Yes, you may take photos and publish pictures of my children in your newsletters and website.
□ No, you may not take photos and publish them.

We will not use the information gathered through this questionnaire for anything other than for preparing lessons for you.
Thank you for your cooperation.
--------------------------------------------------------------------------------------------------------------------------Dear Parents/Guardians,
Please send this completed questionnaire to the following address by Monday, July 11th via mail or fax.とくしま し てらしまほんちょうにし〒770-0831 徳 島市寺 島 本 町 西1-61 クレメントプラザ６Ｆ
こうざい とくしまけんこくさいこうりゅうきょうかい（公 財）徳島県 国際 交 流 協 会 TOPIATEL 088-656-3303〒770-0831

FAX 088-652-0616

Clement Plaza 6F, 1-61 Terashima Honcho Nishi, Tokushima City

Tokushima Prefectural International Exchange Association