Application for Placement Test in Japanese

Date:
Name:   
Email address:    Home/Dorm Phone:    Cell Phone:
Home Address (street, town, state, zip code):

Major (s):

Which Japanese course are you planning to take?

For which year or semester?

Check the date you are planning to take the test:

12/02/09 (Wed)
01/20/2010 (Wed)

History of your Japanese Language Study

1. How many years have you studied Japanese?

2. How many credits did you earn? credits.

3. What institution did you study at?

4. Names of textbooks you have used:

5. Do you have experience living in Japan? yes no (If yes, how long?) Jobs you had or schools you attended in Japan:

6. How many kanji do you read and write?

Reading:
< 200
200-400
400-600
600-1000
1000-1500
more than 1500

Writing:
< 200
200-400
400-600
600-1000
1000-1500
more than 1500

Other pertinent information regarding your study of Japanese:

Type the characters you see in the picture below: