Venue* Tokyo Sunday, 10/21 Nagoya Saturday, 10/20

Relationship to students planning to study abroad* parent study abroad agency school friend, relative or graduate company

Company's name 

(If you are from the media or a study abroad agency, please write your company's name)

Title  Mr. Ms.

First Name*

Last Name*

E-mail*

TEL 

FAX 

Zip code*

Address*

How did you hear about the U.S. University Fairs?(multiple selections)* Poster Flyer In-train AD Billboard Asahi Shukan ST Ryugaku Journal ALC Catch a Wave Website of U.S. Commercial Service Website of Fulbright Japan (Japan-U.S. Educational Commission) E-mail Newsletter Other

What your purpose at the US University Fairs?(multiple selections)* Collect school information at booths Collect information at seminars Look for affiliated schools Meet with people from your old school Meet with your affiliated schools

＜N.B.＞*

The informaiton provided above is classified and is used for statistical purposes by U.S. Commercial Service and Fulbright Japan (Japan-U.S. Educational Commission). We ask for your permission to give some of the information to the participating schools.

I agree to give this information to the participating schools at the fairs. I do not agree to give this information to the participating schools at the fairs.