Form Center

2. 2026 STUDENT APPLICATION/SISTER CITY TRIP TO SHIZUOKA CITY/KAMBARA, JAPAN

   The Shelby County International Relations Council (SCIRC) in partnership with the City of Shelbyville is once again planning to send a student delegation to our Sister City, Shizuoka City/Kambara, Japan in the summer of 2026. 

   Our Sister City program was established in 1988 to provide a cultural exchange of students and adults between our communities.

   SCIRC will assist with the planning and coordination for this trip along with the City. Although no specific dates have been chosen yet, the student trip is planned for mid-June 2026. The trip will be approximately one week and include a homestay experience in Shizuoka City/Kambara, as well as a few days in Tokyo.

   Travelers are expected to personally pay 100% of all costs associated with the trip, which generally includes roundtrip airfare, public transportation while in Japan, hotel costs in Tokyo, data/mobile phone costs while traveling abroad, gifts to their homestay host families, special group activities, sponsored meals, and any personal purchases. The cost of the trip is expected to range from $3,000 - $4,000 per traveler. Fundraising for this trip is acceptable.

   The travel group will include several students currently in grades 8-12 along with adult chaperones. 

   Students chosen for our delegation will be required to attend general orientation sessions prior to the trip on Japanese culture, language, customs, and trip details. Guardians will also be required to attend information sessions where additional forms and important information will be handled. 

   Students selected must be excellent representatives of Shelby County and will be expected to display good citizenship and community values. Upon completion of the trip, all students and adults are encouraged to share their experiences with community groups, service organizations, or school classes.

   Students in grades 8-12 from Shelby County who are interested in this homestay, cultural exchange may complete and submit the application below along with a $250.00 deposit by December 22, 2025. 

   Two references must also be obtained on the appropriate form and submitted by December 22, 2025.

   The applications will be reviewed by the SCIRC selection committee and a student delegation will be chosen by February 15th to represent Shelby County for the 2026 summer trip. Prior participation or enrollment in a Japanese program is not required.

   An information meeting will be held on November 30, 2025 at City Hall, 44 West Washington Street, in the Council Chambers at 6:30 p.m. for anyone who is interested in learning more about the Sister City program. Additional information on the history of our Sister City relationship can be found on the homepage of the City’s website at www.shelbyville.in.gov/sistercity.

   Questions may be directed to Linda Sanders at 317-753-4319, lsanders@cityofshelbyvillein.com or the Mayor’s Office at 317-398-6624.

4. Student's Full Legal Name*
5. Student's Preferred Name*
7. Student's Preferred Pronoun*
   -- Select One --He/Him/HisShe/Her/HerThey/Them/TheirZe/Hir/Hir
8. Student's Year In School*
   -- Select One --8th GradeFreshmanSophomoreJuniorSenior
9. Year in Japanese Class (If enrolled)*
   -- Select One --01234
11. Address*
13. City*
14. State*
15. Zip Code*
17. Phone Number*
18. Email Address*
20. List Any Medical Conditions or Restrictions*

    For example: allergies, food restrictions, etc. 
    
    If none, indicate so with N/A

22. List all current school activities

    Include office, if held.

24. List extra-curricular activities, outside of school, in which you are involved
28. Parent/Guardian #1 First Name:*
29. Parent/Guardian #1 Last Name*
31. Parent/Guardian #1 Mailing Address*
33. City*
34. State*
35. Zip Code*
37. Phone Number*
38. Email Address*
42. Parent/Guardian #2 First Name
43. Parent/Guardian #2 Last Name
45. Parent/Guardian #2 Mailing Address
47. City
48. State
49. Zip Code
51. Phone Number
52. Email Address
56. Application Materials
58. What would you share with the people in our sister city about Shelbyville and/or Shelby County?*
60. When you return, how would you share the experiences you had in Japan with your community?*
62. PLEASE PROVIDE AN ATTACHMENT OF A ONE-PAGE ESSAY EXPLAINING WHY YOU SHOULD BE SELECTED TO REPRESENT SHELBY COUNTY AS A STUDENT REPRESENTATIVE FOR OUR SISTER CITY TRIP.
66. LIST TWO (2) REFERENCES BELOW WHO YOU HAVE ASKED TO COMPLETE A RECOMMENDATION (SUCH AS A TEACHER, COACH, PASTOR, YOUTH SPONSOR, SCOUT LEADER, ETC.)
68. First and Last Name*

    Reference #1

69. Relationship to Applicant*
70. Email Address*
72. Letter of Reference #1*
74. First and Last Name*

    Reference #2

75. Relationship to Applicant*
76. Email Address*
78. Letter of Reference #2*
82. Next Steps

    Upon hitting "submit" you will be redirected to the "Student Acknowledgement Form" and then the "Parent/Guardian Permission Form" to be complete by your "Parent/Guardian." Applications will not be considered "complete" until

    1.  Completed student application submitted

    2. "Student Agreement Form" is submitted

    3. "Parent/Guardian Permission Form" is submitted

    4. $250 deposit mailed to  SCIRC RE: "Student First and Last Name" City Hall 44 W Washington Street, Shelbyville, IN 46176

Leave This Blank:


84. 1. Receive an email copy of this form.
85. Email address

    This field is not part of the form submission.

86. Submit

* indicates a required field