¡®InterCulture Korea¡¯

 

 Champs Elysees Center B-dong 311

#889-5, Daechi-dong, Kangnam-gu

Seoul, Korea

Telephone (82)2-566-4050,  Fax (82)2-566-4058

e-mail : ickorea4051@hanmail.net

 

Membership Application

 

Please PRINT in ENGLISH                                                                                          Date:

Family name:              First name (Nick name):    Age:   Sex:

___________________   _____________________    ____   (F/ M )

 

Family members, if any:    Spouse:                        Child:                           Child:

first name:                     ___________________________________________________

                                    ___________________________________________________

sex (F/M):                     ___________________________________________________

age:                              ___________________________________________________ occupation/education: ___________________________________________________

other:                            ___________________________________________________

 

Telephone:                     Fax:                               E-mail:

home:            _________________            home:            _________________            home:            _______________

office:            _________________            office:            _________________            office:            _______________

mobile:            _________________

beeper:            _________________            Name of company: _________________________

 

Mailing address:                                           

house/apt.bldg.& no.:             ___________________________________________________

dong & dong number:            ________________________            ku:            _______________

city & postal code:            ___________________________________________________

  

Country of birth:          _____________________           Nationality: _____________         

Occupation:            _____________________           Religion:          _______________

 

Previous overseas postings, if any (Year & place)______________________________

How many years have you lived in Korea?_______ Expected departure:________

 

 ¡®InterCulture Korea¡¯

Member¡¯s name:_________________________________________                                                            

Which hobbies and interests would you like to share with other members of IC Korea? (Please prioritize three topics)

customs and ethics of Korea            _____    Korea¡¯s ancient history and culture  _____

modern Korean society  _____    Korean language                                   _____

getting to know Seoul                _____    language (Which?)                                   _____

shopping in Seoul                _____    newcomer¡¯s issues                           _____

antiques                                    _____    food                                                     _____    religion(s)                                 _____    Korean folk beliefs                           _____

health & oriental medicine            _____   fine arts                                                _____

literature                                   _____    performing arts (music, dance, etc.)_____      

freelance writing              _____               science                                         _____    architecture                               _____    flower arrangement                              _____ 

media                                       _____   fashion & design                           _____

photography                             _____   film & movies                           _____

sports                                       _____    excursions                                            _____

volunteer work             _____   mountain hiking                         _____

other            _______________________   other_____________________________      Specifications:            _______________________________________________

_________________________________________________________________

_________________________________________________________________

Spoken languages (Please indicate  level: O for nil, A for low, B for good, C for excellent):

Korean____  Japanese____  English_____  French_____  German_____ Other______

 

Preferred language(s) of communication: ___________________________

 

Is it OK, if your¡°InterCulture Korea¡±partner shares the same intereste as you, but is unable to communicate fluently?(yes/no)        ________

 

If No:Which level of language ability is acceptable? _____________-

 

How did you learn about ¡°InterCulture Korea¡±?___________

 

Are you member of other organisations and assocoations?

SIWA____  FOCUS ______   AMCHAM_______  EU Chamber______

AWC____  Lions Club_____  Rotary________     Other______  

Signature:_________________________________      Date:__________________