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AEON 1% CLUB FOUNDATION
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APPLICATION FORM
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Please fill in this form neatly in BLOCK Letters! Tick (☑)the box that applies.
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Fields in BOLD LETTERS are essential.
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Name in full (in fist language)GenderPhoto (4×3）
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□male □female
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LastFirst
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Name in full (in English)Nickname
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LastFirst
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Current Address
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Tel/Fax (Optional)Tel:Mobile:Fax:
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Social MediaFacebook:Instagram:
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Twitter:Others:
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E-mail(PC) Size of
T-Shirts		S ・ M ・ L ・ XL
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Date of birth / /AgeNationalityBlood Type
(Optional)
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Day /Month /Year
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Passport Number Expiry date / /
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Day /Month/Year
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Emergency Contact
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Full name:
Relationship with applicant:
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Tel:Mobile:
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School nameSchool
year
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Personal and Family circumstances (optional)
(Khó khăn của bản thân & gia đình (nếu có))		Future dream
(Mục tiêu nghề nghiệp/ ước mơ sau khi ra trường)
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Language skillsHobbies and interests (Optional)
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English score:TOEIC:_____________TOEFL:________________
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IELTS:_____________
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Other languages (optional) (please specify languages and your levels.)
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_______________________________________
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I, the undersigned, by signing this form, guarantee that I shall fully comply with the rules of this program, and the law and regulations of the host country during the course of the program.
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Signature
_________________________
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PART 2: ESSAY
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Topic:Là thế hệ trẻ, các em nhận thấy mình cần làm gì để chung tay giảm thiểu khí thải nhà kính?
As the young generations, what should you do to reduce the greenhouse gas emissions?
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Your essay (can be written in EN/ VN):
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I, the undersigned, by signing this form, guarantee that I shall fully comply with the rules of this program, and the law and regulations of the host country during the course of the program.
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