2017 ASIJ Summer Passport Program


1.  Complete online application.

2. 7-10 days after submitting your application an invoice for the ¥10,000 application fee will be emailed to you with your personal summer bank account number.

3. Pay the application fee by bank transfer or Internet banking (ASIJ will NOT confirm receipt, please contact your bank); company billing is not available.

4. From the time the application fee has been received through the end of April, you will  ONLY  be contacted if changes to your requested program are needed; if you are NOT contacted, your program remains as requested.

5. In early May an invoice for tuition, class fees and bus, if applicable, will be emailed; payment due no later than May 26th.

6. The week of May 29th program details for K-10 and the daily schedule for students in grades 5-10 will be emailed.
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Student's Last Name *
Student's First Name *
Gender *
Date of Birth (mm/dd/yyyy) *
Current School *
Current Grade, academic year 2016-2017 *
Contact Number *
Emergency Phone 1 *
Emergency Phone 2 *
Parent Email Address 1 *
Parent Email Address 2 *
Medical Release Form : Allergies (Please also include any food allergies):
Routine / Other Medication:
Parents of students in K thru Grade  10: I give permission for ASIJ Summer Passport Program personnel to treat my child for minor abrasions and to administer Tylenol if necessary. I understand I will be notified of any medical aid given. *
Parents of Students in K and Grade 1,2,3,4 : I give permission for my child to go on a field trip with his/her class and teacher during the school day.
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If your child will be riding the bus, please indicate below. The bus schedule and bus registration will be sent to you. *
I want my Grade K/1/2/3/4 child to participate in: *
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