(Summer/Winter) Emergency Contact Information


APU asks all program participants to provide contact information so that we can get in touch with them in the event of an emergency. Please provide emergency contact information for yourself and a guardian (parent, relative, etc.) using the survey below. 

If you have any questions related to this survey, please contact us by email. 

Academic Office
Overseas Short-Term Summer / Winter Program Team
outbound@apu.ac.jp

There are 11 questions in this survey.

Student Information

Please provide emergency contact information for yourself. 
Student ID

Your Name

Private Email
Phone Number 
 Please include the country code and the area code.
Passport Number

Guardian Information

Please provide emergency contact information for your guardian (parent, relative, etc.)
Guardian Name
Relationship with the Student
 e.g. mother, father, grandmother
Zip Code
Postal Address 
Phone Number
 
Home
Work
Mobile
 Please include the country code and the area code. 
Email Address