Japan on the Road - Reservation Form

School Name
School District
Address
City
State
Zip
Teacher's Name
School Phone
Home Phone
Email
Best time to contact you at school
Principal's Name
Grade Level
Class Size

Preferred month of visit. (Please be as flexible as possible)

1. 2. 3.

Direction to your school.
Please be specific! Remember to include the names of highways. Include a school map if available. Some of our volunteers are new to this area.

Approximate travel time to your school from downtown Portland

Have your students studied anything about Japan?
Yes No

If your students have studied about Japan, please describe below.
This information will be very useful to our team in planning their visit.