2627 Roxas Boulevard, Pasay City
Tel. No. (02) 551-5710 loc 2313
Fax No. (02) 551-5784
To schedule a session at your school or at the Embassy of
Name of School/Organization: ______________________________________________
School Address: _________________________________________________________
Name of Coordinator: ____________________________________________________
Position at School: _______________________________________________________
School Phone No: (†††† ) ______________________ Fax: (†††† ) ____________________
Other Contact Number (††††††† ) ______________________________
Email Address: ______________________________
I. School and Class Information
a. Grade or Year Level: _______________________________________
b. Type:†††††† Public††† or††††† Private†† (Please encircle one.)
Date and Time you would like to schedule Hello!
†††††††† Preferred Choice: Date:_______________† Time: _______________
†††††††† 2nd Choice:†††††††††††Date: ______________†† Time: _______________
†††††††† 3rd Choice:†††††††††††Date:† ______________†† Time: _______________
d. Class or Group Size (Please limit group size to 45 or less) _____________
Studentsí background knowledge regarding
For School Visits only:
A/V Equipment Available for Use (Please check all that apply.)
†TV with VCR†††††††††† †VCD or DVD Player †††††††††† ††PA system††
††Large Screen †††††††††LCD Projector††††††††††††† ††††† Others: _____________________
I. Content of Presentation:
(Please state your preferences regarding the content of the Hello! Japan so that we can design a program to meet the interests of your students.)
Topics of Interest about
Specific Topic for Hello!
To facilitate scheduling, all requests should be made at least two weeks to one month in advance of presentations.
Please complete and fax this form to: (02) 551-5784. We will call you as soon as we received the accomplished request form. Thank you.