Thank you for your interest in JINA language exchange program. We prepared this form for those that wish to meet a language exchange partner so that they may improve their English or Japanese. Please fill out at least your name (nickname is okay) and e-mail address. All other fields are optional. Your information will be added to our system, and you will be able to view other members who registered with our system. You can then contact them via email. If you want your name to be deleted from the system in the future, please contact info@jinaonline.org.

* - required

	ABOUT YOURSELF
	*You are a	Japanese speaker looking for a English speaker English speaker looking for a Japanese speaker
	*E-Mail Address:
	*Password
	*Re-enter password
	*Choose a handlename/nickname
	*gender:	male female
	*Worker/Student:	Student Non-student
	*Age Group:	18 - 24 25 - 30 30 - 40 45 - 50 50+
	*Native language
	*Practicing language:Language Level	Basic Conversational Business Level Fluent Native
	Hobbies/Interests:
	*Desired Location to Meet	SF /Bay Area  SF Downtown  Peninsula  South Bay  East Bay  North Bay  Other SF /Bay Area Los Angeles Area  Downtown LA  South LA  West LA  Orange County  San Diego  Other LA Area New York / New Jersey  Manhattan  Queens  Brooklyn  Bronx  Long Island  New Jersey  Other NY/NJ area US other cities  Atlanta, GA  Austin, TX  Baltimore, MD  Boston, MA  Chicago, IL  Cleveland, OH  Dallas, TX  Denver, CO  Detroit, MI  Hartford, CT  Houston, TX  Kansas City, MO  Las Vegas, NV  Miami, FL  Milwaukee, WI  Minneapolis, MN  Philadelphia, PA  Phoenix, AZ  Pittsburgh, PA  Portland, OR  Sacramento, CA  Salt Lake City, UT  San Antonio, TX  Seattle, WA  St. Louis, MO  Washington, DC CANADA  Calgary, Alberta  Halifax, Nova Scotia  Montreal, Quebec  Ottawa, Ontario  Toronto, Ontario  Vancouver, British Columbia JAPAN  Tokyo  Chiba  Kanagawa  Aichi  Osaka  Kyoto

	ABOUT YOUR DESIRED PARTER
	*Worker/Student:	Student Non-student
	*gender:	male female
	*Age Group:	18 - 24 25 - 30 30 - 40 45 - 50 50+
	*Practicing language:Language Level	Basic Conversational Business Level Fluent Native
	*Desired Location to Meet	SF /Bay Area  SF Downtown  Peninsula  South Bay  East Bay  North Bay  Other SF /Bay Area Los Angeles Area  Downtown LA  South LA  West LA  Orange County  San Diego  Other LA Area New York / New Jersey  Manhattan  Queens  Brooklyn  Bronx  Long Island  New Jersey  Other NY/NJ area US other cities  Atlanta, GA  Austin, TX  Baltimore, MD  Boston, MA  Chicago, IL  Cleveland, OH  Dallas, TX  Denver, CO  Detroit, MI  Hartford, CT  Houston, TX  Kansas City, MO  Las Vegas, NV  Miami, FL  Milwaukee, WI  Minneapolis, MN  Philadelphia, PA  Phoenix, AZ  Pittsburgh, PA  Portland, OR  Sacramento, CA  Salt Lake City, UT  San Antonio, TX  Seattle, WA  St. Louis, MO  Washington, DC CANADA  Calgary, Alberta  Halifax, Nova Scotia  Montreal, Quebec  Ottawa, Ontario  Toronto, Ontario  Vancouver, British Columbia JAPAN  Tokyo  Chiba  Kanagawa  Aichi  Osaka  Kyoto
	Hobbies/Interests:

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