Ikeda Center Youth Committee (ICYC) Application Form

First Name

Last Name

Email Address

Phone Number

Year of birth

If you are a student, please fill out the following three sections below:

Degree or Field of Study

University

Expected Graduation Year

If you are a young professional, please tell us the following:

Profession

Purpose Statement

In a brief summary above, please share why you are interested in joining ICYC.

By submitting my application, I consent to the use of my personal data as permitted in the Privacy Policy: https://www.ikedacenter.org/privacy-policy