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¡ÚIPS ¾ðÊóÀ¸»º¥·¥¹¥Æ¥à¸¦µæ²Ê¡Û¡ÚOnly for IPS Applicants¡Ûºßα»ñ³ÊǧÄê¾ÚÌÀ½ñ¸òÉÕ¿½ÀÁ½ñ Application for certificate of eligibility

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ÆþÎϤ¬¤¹¤Ù¤Æ½ªÎ»¤·¤Þ¤·¤¿¤é¡¢º¸¾å¤Î¡Ö³Îǧ/confirmation¡×¥Ü¥¿¥ó¤ò²¡¤·¤Æ¤¯¤À¤µ¤¤¡£ÆþÎϳÎǧ¤Î¸å¡¢¡ÖÅÐÏ¿/Register¡×¥Ü¥¿¥ó¤ò²¡¤¹¤È½ªÎ»¤Ç¤¹¡£
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This is very important to apply for visa status to study in Japan. Please make sure to answer following questions by the deadline.
¢¨Please fill out in Alphabet except "Name in Chinese character" box. After filling out, please push a bottum of "³Îǧ/confirmation" on on the upper-left corner.
After making sure all of your filling out, please push a bottum of" ÅÐÏ¿/register". If you do that, it is completed to register.
If you make a mistake to fill out, you can re-register.
ɬ¿Ü²óÅú¹àÌܤ¬¶õÍó¤À¤ÈÀè¤Ø¿Ê¤á¤Þ¤»¤ó¡£
If a mandatory column is blank, you cannot apply.

­µ ´ðËܾðÊó About yourself

Q.1 ¼õ¸³ÈÖ¹æ Application number (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¼õ¸³ÈÖ¹æ¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡ÊȾ³Ñ¡Ë¡£
¡¡¡¡¡¡Please fill out your application number with One-byte character.
¼õ¸³ÈÖ¹æ Application number¡¡¡§

Q.2 ¹ñÀÒ Nationality (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¹ñÀÒ¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out your nationality.
¹ñÀÒ Nationality¡¡¡§

Q.3 À¸Ç¯·îÆü Date of Birth (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡À¸Ç¯·îÆü¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¼«Ê¬¤ÎÀ¸Ç¯¤¬É½¼¨¤µ¤ì¤Ê¤¤¾ì¹ç¤Ï¡¢¥Ö¥é¥ó¥¯¤Ë¤·¤Æ¤¯¤À¤µ¤¤¡£.
¡¡¡¡¡¡Please select your birthday and fill out. If you cannot find the year of your birthday in this box, you can leave it blank.
ǯ Year ·î Month Æü Day

Q.4 »á̾¡Ê´Á»ú¡Ë Name in Chinese character

¡¡¡¡¡¡´Á»ú»á̾¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¤¿¤À¤·¡¢´Á»ú»á̾¤Î¤Ê¤¤Êý¤Ï¡¢ÆþÎϤ¹¤ëɬÍפϤ¢¤ê¤Þ¤»¤ó¡£
¡¡¡¡¡¡If you have name in Chinese character, please fill out.
´Á»ú»á̾ Name in Chinese character¡¡¡§

Q.5 »á̾¡Ê±Ñ»ú¡ËName in English(Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡±Ñ»ú»á̾¤ò¥Ñ¥¹¥Ý¡¼¥È¤Ëµ­ºÜ¤µ¤ì¤Æ¤¤¤ëÄ̤ê¤ËÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out your name in English as your passport.
±Ñ»ú»á̾ Name in English¡¡¡§

Q.6 À­ÊÌ Sex (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¤É¤Á¤é¤«¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£Please select one.
ÃË Male ½÷ Female

Q.7 ½ÐÀ¸ÃÏ Place of birth (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡À¸¤Þ¤ì¤¿¹ñ¤ª¤è¤ÓÅÔ»Ô̾¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out the country name and city where you were born.
¡ÊÎã) Ãæ¹ñ¡¦Ë̵þ / (Example) Beijing, China¡¡¡§¡¡

Q.8 ÇÛ¶ö¼Ô¤Î̵ͭ Marital Status(Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¤É¤Á¤é¤«¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£Please select one.
ͭ Married ̵ Single

Q.9 ¿¦¶È Occupation (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡ÆüËÜ¤ØÆþ¹ñÁ°¤Î¿¦¶È¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£ºß³ØÃæ¤Î¾ì¹ç¤Ï¡¢"³ØÀ¸"¤ÈÆþÎϤ¹¤ë¤³¤È¡£
¡¡¡¡¡¡Please fill out your occupation before entering Japan, but if you are a student now, please fill out "Student".
¿¦¶È Occupation¡¡:

Q.10 Ëܹñ¤Ë¤ª¤±¤ëµï½»ÃÏ Home town/city (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¸½ºßµï½»¤Î¹ñ̾¤ª¤è¤ÓÅÔ»Ô̾¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤
¡¡¡¡¡¡Please enter the country and city name where you live now.
¡ÊÎã) Ãæ¹ñ¡¦¾å³¤ / (Example) Shanghai, China¡¡¡§¡¡

Q.11 ºÇ½ªºßÀÒ¹»Ì¾ Name of the last school (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡ºÇ½ªºßÀÒ¹»Ì¾¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out the name of last school.
ºÇ½ªºßÀÒ¹»Ì¾ Name of the last school¡§

Q.12 ºÇ½ª³ØÎò¤Î³Ø¹»¼ïÊÌ¡¡Type of Education of the last school or institution (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡Q.11¤ÇÅú¤¨¤¿¶µ°éµ¡´Ø¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Which one is your last institution filled in Q.11?
¶µ°éµ¡´Ø Institution

Q.13 Q.12¤Ç¡¢¤½¤Î¾¤òÁªÂò¤·¤¿¾ì¹ç¤Î¤ß²óÅú¡¡Please fill out in the followings if you selected "Others" in Q.12.

¡¡¡¡¡¡Q.12¤Ç¡¢¤½¤Î¾¤òÁªÂò¤·¤¿Êý¤Ï¡¢¶µ°éµ¡´ØÌ¾¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out the name of your last institution if you selected "Others" in Q.12.
¤½¤Î¾ Others¡¡¡§

Q.14 ºßÀÒ¾õ¶·¡¡Status of last school of present school(Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡Q.11¤ÇÅú¤¨¤¿³Ø¹»¤ÎºßÀÒ¾õ¶·¤ò°Ê²¼¤è¤êÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please select the status of last school or present school of Q.11. from below.
ºßÀÒ¾õ¶· Status of last school or present school

Q.15 ´¶È¤Þ¤¿¤Ï´¶È¸«¹þ¤ßǯ·îÆü Date of graduation or expected graduation (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡Q.11¤ÎºÇ½ªºßÀÒ¹»¤ò´¶È¤·¤¿Æü¤Þ¤¿¤Ï´¶ÈͽÄêÆü¤òÆþÎÏ¡ÊÆüÉÕ¤¬ÉÔÌÀ¤Ê¾ì¹ç¤ª¤è¤ÓÁªÂò»è¤Ë´¶Èǯ¤¬¤Ê¤¤¾ì¹ç¤Ï¡¢¶õÍó¤òÁªÂò¤¹¤ë¤³¤È¡Ë
¡¡¡¡¡¡Please fill out the date you graduated or will graduate from the last school in Q.11. If you don't know when you will be able to graduate from school or cannot find your graduated year, you can leave it blank.
ǯ Year ·î Month Æü Day

Q.16 ½¤³ØÇ¯¿ô Total period of education (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¾®³Ø¹»¤«¤éºÇ½ª³ØÎò¹»¤Þ¤Ç¤Î½¤³ØÇ¯¿ô¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please select total period of education from an elementary school to the last school.
½¤³ØÇ¯¿ô Total period of education is for¡¡ ǯ Years

Q.17 IPS½¤Î»¸å¤ÎͽÄê Plan after graduating from IPS (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡IPS½¤Î»¸å¤ÎͽÄê¤ò°Ê²¼¤«¤é1¤ÄÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please select your plan after graduating IPS from follows.
IPS½¤Î»¸å¤ÎͽÄê Please select your plan after graduating from IPS from follows.

Q.18 Q.17¤Ç¡¢¤½¤Î¾¤òÁªÂò¤·¤¿¾ì¹ç¤Î¤ß²óÅú¡¡Please fill out in the followings if your answer is "Others" in Q.17.

¡¡¡¡¡¡Q.17¤Ç¡¢¤½¤Î¾¤òÁªÂò¤·¤¿Êý¤Ï¡¢IPS¤ò½¤Î»¸å¤ÎͽÄê¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out your last institution if you selected Others at Q.17.¡ÊÎã/Example¡¡¹âÅùÀìÌç³Ø¹»)
IPS½¤Î»¸å¤ÎͽÄê Plan after graduating from IPS

Q.19 ¥Ñ¥¹¥Ý¡¼¥È¤Î¥³¥Ô¡¼ A copy of passport¡¡Ì¤Äó½Ð¼ÔÂÐ¾Ý If you have not submitted a copy of your passport, please attach here.

¡¡¡¡¡¡¥Ñ¥¹¥Ý¡¼¥È¤Î¥³¥Ô¡¼¡Ê¸«³«¤­1¥Ú¡¼¥¸ÌÜ¡§´é¼Ì¿¿¡¢»á̾¡¢À¸Ç¯·îÆü¡¢¥Ñ¥¹¥Ý¡¼¥ÈÈֹ椬µ­ºÜ¤µ¤ì¤Æ¤¤¤ë¥Ú¡¼¥¸¡Ë¤òźÉÕ¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please attach a copy of your passport of 1st page spread (A page which has your picture, name, birthday, passport number)
¡¡¡¡¡¡Please push the right side bottom¡Ö»²¾È¡× and select the file. Your file will be uploaded.
¥Ñ¥¹¥Ý¡¼¥È¥³¥Ô¡¼ A copy of your passport¡¡

Q.20 Ï¢ÍíÀè Your e-mail address(Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡µ­ºÜÆâÍÆ¤Ë¤Ä¤¤¤Æ¤ª¿Ò¤Í¤¹¤ë¤³¤È¤¬¤¢¤ê¤Þ¤¹¤Î¤Ç¡¢¥á¡¼¥ë¥¢¥É¥ì¥¹¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£ Please fill out your e-mail address so that there is a possibility to ask you about these information.

­¶ Æþ¹ñ¤Ë¤Ä¤¤¤Æ About your entry

Q.21 ι·ôÈÖ¹æ Passport number

¡¡¡¡¡¡¥Ñ¥¹¥Ý¡¼¥ÈÈÖ¹æ¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¥Ñ¥¹¥Ý¡¼¥È̤¼èÆÀ¤ÎÊý¤Ï¡¢»êµÞ¼èÆÀ¤·¡¢¥³¥Ô¡¼¤òIPS¤ØÄó½Ð¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please full out your passport number here.If you do not have your passport yet, please apply for it immediately and submit a copy of your passport to IPS Office as soon as you get it.
ι·ôÈÖ¹æ Passport number¡¡¡§

Q.22 ι·ôÍ­¸ú´ü¸Â Date of expiration of your passport

¡¡¡¡¡¡¥Ñ¥¹¥Ý¡¼¥È¤ÎÍ­¸ú´ü¸Â¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¥Ñ¥¹¥Ý¡¼¥È̤¼èÆÀ¤ÎÊý¤Ï¡¢»êµÞ¼èÆÀ¤·¡¢¥³¥Ô¡¼¤òIPS¤ØÄó½Ð¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out date of expiration of your passport.If you do not have your passport yet, please apply for it immediately and submit a copy of your passport as soon as you get it.
ι·ôÍ­¸ú´ü¸Â Date of expiration of your passport¡¡¡§ ǯ Year ·î Month Æü Day

Q.23 Æþ¹ñͽÄêǯ·îÆü Date of entry(Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡Æþ¹ñͽÄêÆü¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¤¿¤À¤·Æþ³Ø¼°¤Î£±¥«·î°Ê¾åÁ°¤ÎÆþ¹ñ¤ÏÈò¤±¤ë¤³¤È¡£
¡¡¡¡¡¡Please fill out the your planning date entering Japan.But please don't enter Japan more than 1 month before enrolling IPS.
Æþ¹ñͽÄêǯ·îÆü Date of entry¡¡¡§ ǯ Year ·î Month Æü Day

Q.24 ¾åΦͽÄê¹Á Port of entry (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¾åΦ¤¹¤ëͽÄê¤Î¶õ¹Á¤Þ¤¿¤Ï¹Á̾¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please select an airport or a port where you will enter Japan.
¡¡¡¡¡¡¾åΦͽÄê¹Á Port of entry¡¡¡§

Q.25 Ʊȼ¼Ô¤Î̵ͭ Accompanying persons, if any (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡ÆüËܹñÆâ¤ÇƱµï¤¹¤ë²È²¤òÂÓÆ±¤¹¤ë¾ì¹ç¡¢¡ÖÍ­¡×¤òÁªÂò¡£
¡¡¡¡¡¡If you will enter Japan with your family who will live in Japan with you, please select 'Yes'. If not, please select 'No'.
ͭ Yes ̵ No

Q.26 ºº¾Ú¿½ÀÁͽÄêÃÏ Intended place to apply for visa (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡±¦µ­¤ÎURL¤è¤ê¡¢¤´¼«¿È¤Î¿½ÀÁÃϤò³Îǧ¤·¡¢ÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡You can know the place you should apply for visa if you see the following website.¡¡¡¡³°Ì³¾Ê¥Û¡¼¥à¥Ú¡¼¥¸ Japanese Embassies, Consulates
ºº¾Ú¿½ÀÁͽÄêÃÏ̾ Intended place to apply for visa¡¡¡§

Q.27 ²áµî¤Î½ÐÆþ¹ñÎò Past entry into/departure from Japan (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡²áµî¤Î½ÐÆþ¹ñÎò Have you ever entered Japan?
ͭ Yes ̵ No

Q.28 Æþ¹ñ²ó¿ô How many times you entered Japan before

¡¡¡¡¡¡Q.26¤Ç¡ØÍ­¡Ù¤òÁªÂò¤·¤¿¾ì¹ç¤Ë²óÅú¡¡Please fill out in the followings when the answer is "Yes" in Q.26.
ÆüËÜ¤ËÆþ¹ñ¤·¤¿²ó¿ô¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£Please select how many times you entered Japan from follows.¡¡¡§

Q.29 ľ¶á¤Î½ÐÆþ¹ñÎò The latest date you entered and left Japan

¡¡¡¡¡¡Q.26¤Ç¡ØÍ­¡Ù¤òÁªÂò¤·¤¿¾ì¹ç¤Ë²óÅú¡¡Please fill out in the followings when the answer is "Yes" in Q.26.
The latest entry from ǯ Year ·î Month Æü Day ¤«¤é To ǯ Year ·î Month Æü Day

Q.30 ÈȺáÎò¤Î̵ͭ Criminal record(in Japan/ overseas) (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡ÆüËܹñÆâ³°¤òÌä¤ï¤º¡¢ÈȺá¤òÍýͳ¤È¤¹¤ë½èʬ¤ò¼õ¤±¤¿¤³¤È¤¬¤¢¤ì¤Ð¡¢¡ÖÍ­¡×¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡If you have criminal records in Japan or abroad, please select 'Yes'.
ͭ Yes ̵ No

Q.31 ÈȺáÎò¤ÎÆâÍÆ Details of criminal record

¡¡¡¡¡¡Q.29¤Ç¡ØÍ­¡Ù¤òÁªÂò¤·¤¿¾ì¹ç¤Ë²óÅú¡¡Please fill out in the followings when the answer is "Yes" in Q.29.¡¡¡¡¡¡
ÈȺáÎò¤ÎÆâÍÆ Detail about criminal record¡¡¡§

Q.32 Âàµî¶¯À©¤Þ¤¿¤Ï½Ð¹ñÌ¿Îá¤Ë¤è¤ë½Ð¹ñ¤Î̵ͭ Departure by deportation/departure order(Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡¡ÖÍ­¡×¤òÁªÂò¤·¤¿¾ì¹ç¡¢²ó¿ô¤Èľ¶á¤ÎÁ÷´ÔÎò¤òÊÌÅÓ¤ªÊ¹¤­¤·¤Þ¤¹¡£
¡¡¡¡¡¡If you select 'Yes',we will ask how many times you have and when the latest departure by deportation is.
ͭ Yes ̵ No

­· ÆüËÜÂÚºßÈñ¤Î»ÙÊÛÊýË¡Åù Method support to pay for expenses while in Japan

¡¡¡¡·ÐÈñ»ÙÊۼԤϡ¢½Ð´ê»þ¤ËÄó½Ð¤·¤¿Í¶â»Ä¹â¾ÚÌÀ½ñ¤Î̾µÁ¤ÈƱ°ì¿Íʪ¤Ë¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡Supporter should be the same person on the certificate of bank balance which has submitted to the admission office.

Q.33 ÂÚºßÈñ»ÙÊÛÊýË¡ Method of support to pay for expenses while in Japan (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡ÂÚºßÈñ¤Î¹©ÌÌÊýË¡¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£Ê£¿ôÁªÂò²Ä
¡¡¡¡¡¡Please select the column of how to make your living cost in Japan. You can make multiple selections.
(1)ËÜ¿ÍÉéô In case Applicant uses own saving
(2)ºß³°·ÐÈñ»ÙÊÛ¼ÔÉéô In case Supporter lives abroad
(3)ºßÆü·ÐÈñ»ÙÊÛ¼ÔÉéô In case Supporter lives in Japan
(4)¾©³Ø¶â Scholarship
(5)¤½¤Î¾ Others

Q.34 ·îÊ¿¶Ñ»ÙÊÛ³Û An amount of support per month (average) (Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡Q.33¤ÇÁªÂò¤·¤¿¹àÌܤˤĤ¤¤Æ¡¢¤½¤ì¤¾¤ì1¥ö·îÅö¤¿¤ê¤Î¶â³Û¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¡Êñ°Ì unit¡§±ß Yen)
¡¡¡¡¡¡Please fill out amount(in Japanese yen) you will receive each month in each field.
(1)ËÜ¿ÍÉéô Amount(per month) that Applicant can contribute.
(2)ºß³°·ÐÈñ»ÙÊÛ¼ÔÉéô Amount(per month) that Supporter living abroad contributes
(3)ºßÆü·ÐÈñ»ÙÊÛ¼ÔÉéô Amount(per month) that Supporter in Japan contributes
(4)¾©³Ø¶â Scholarship
¡¡¢¨·î¡¹¤Î¼õµë¶â³Û Amount(per month) of scholarship
(5)¤½¤Î¾ Others

Q.35 ÂÚºßÈñ¤òÆüËܤ˻ý¤Á¹þ¤àÊýË¡ Method of carrying money to Japan (Mandatory)

¡¡¡¡¡¡ÂÚºßÈñ¤òÆüËܤػý¤Á¹þ¤àÊýË¡¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£Ê£¿ôÁªÂò²Ä
¡¡¡¡¡¡Please select how to carry your living cost in Japan. You can make multiple selections.
(1)³°¹ñ¤«¤é¤Î·È¹Ô Carrying from abroad
(2)³°¹ñ¤«¤é¤ÎÁ÷¶â Remittance from abroad
(3)¤½¤Î¾ Others

Q.36 Á÷¶â¡¦·È¹ÔÅù¤Î¶â³Û Amount of remittance from abroad or carrying cash to Japan

¡¡¡¡¡¡Q.35¤ÇÁªÂò¤·¤¿¹àÌܤˤĤ¤¤Æ¡¢¤½¤ì¤¾¤ì¤Î¶â³Û¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¡Êñ°Ì unit¡§±ß Yen)
¡¡¡¡¡¡¤Þ¤¿¡¢(1)³°¹ñ¤«¤é¤Î·È¹Ô¤òÁªÂò¤·¤¿¾ì¹ç¤Ï¡¢¡Ø·È¹Ô¼Ô¡Ù¤È¡Ø·È¹Ô»þ´ü¡Ù¤âÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out the amount(in Japanese yen) in each field. In case of "Carring from abroad", plesae fill in "Name of the person carrying cash" and "When carrying cash to Japan" in each field.
(1)³°¹ñ¤«¤é¤Î·È¹Ô¶â³Û Amount of carrying from abroad
¡¡¢¨(1)·È¹Ô¼Ô¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£Who carrying cash?
¡¡¢¨(1)·È¹Ô»þ´ü¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£When carrying cash to Japan
(2)³°¹ñ¤«¤é¤ÎÁ÷¶â¶â³Û Amount of remittance from abroad
(3)¤½¤Î¾ Others

Q.37 ·ÐÈñ»ÙÊÛ¼Ô Supporter

¡¡¡¡¡¡Q.33¤Ç(2)ºß³°·ÐÈñ»ÙÊÛ¼ÔÉéô¡¢(3)ºßÆü·ÐÈñ»ÙÊÛ¼ÔÉéô¡¢(5)¤½¤Î¾¤òÁªÂò¤·¤¿¾ì¹ç¡¢·ÐÈñ»ÙÊۼԤˤĤ¤¤ÆÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¢¨·ÐÈñ»ÙÊۼԤϡ¢Äó½Ð¤Î¶ä¹Ô»Ä¹â¾ÚÌÀ½ñ¤Î̾µÁ¤È°ìÃפµ¤»¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡If you select (2)In case Supporter living abroad or (3)In case Supporter living in Japan or (4)Others in Q.33, please fill out follows.
¡¡¡¡¡¡*"Supporter" means here the person on the certificate of bank balance you have already submitted to the admittion office.
»á̾ Supporter's name
½»½ê Supporter's address
ÅÅÏÃÈÖ¹æ Supporter's Phone number
¿¦¶È¡Ê¶Ð̳Àè¤Î̾¾Î¡ËSupporter's Occupation(place of employment)
¶Ð̳ÀèÅÅÏÃÈÖ¹æ Supporter's Work phone number
ǯ¼ý Supporter's annual income¡Êñ°Ì unit¡§±ß Yen)

Q.38 ¿½ÀÁ¼Ô¤È¤Î´Ø·¸ Relationship with the applicant

¡¡¡¡¡¡Q.37¤Î·ÐÈñ»ÙÊۼԤȤδط¸¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡¡¡¡¡please select the relationship with the applicant from below.

Q.39 Q.38¤Ç¤½¤Î¾¤òÁªÂò¤·¤¿¾ì¹ç¤Î¤ß²óÅú Please fill out a relationship in the following field if you select "Others" in Q.38.

¡¡¡¡¡¡·ÐÈñ»ÙÊۼԤȤδط¸¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡Please fill out the relationship with the applicant.

Q.40 Q.34¤Ç(4)¾©³Ø¶â¤òÁªÂò¤·¤¿¾ì¹ç¡¢¾©³Ø¶â¤Î»Ùµëµ¡´Ø¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£Ê£¿ô²óÅú²Ä¡£
If you select (4)Scholarship at Q.34, please select an organization which provide scholarship from follows. You can make multiple selections.

¡¡¡¡¡¡Âç³Ø¤«¤é¤Î¾©³Ø¶â¼õµë¤¬·èÄꤷ¤Æ¤¤¤ë¾ì¹ç¡¢¤½¤Î¾¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡If you will receive a scholarship from Waseda University, please select "Others".
¾©³Ø¶â»Ùµëµ¡´Ø Organization of the scholarship

Q.41 ¾©³Ø¶â»Ùµëµ¡´ØÌ¾ The name of the organization of scholarship

Q.40¤Ç¡Ö¸ø±×¼ÒÃÄË¡¿Í¤Þ¤¿¤Ï¸ø±×ºâÃÄË¡¿Í¡×¤â¤·¤¯¤Ï¡Ö¤½¤Î¾¡×¤òÁªÂò¤·¤¿¾ì¹ç¤Î¤ß²óÅú Please fill out a relationship in the followings if the answer is "Public interest incorporated association or public interest incorporated foundation " or "Others" in Q.40.
¸ø±×¼ÒÃÄË¡¿Í¤Þ¤¿¤Ï¸ø±×ºâÃÄË¡¿Í̾
The name of Public interest incorporated association or public interest incorporated foundation
¤½¤Î¾¾©³Ø¶â»Ùµëµ¡´ØÌ¾
The name of the scholarship foundation of "Others" you selected in Q.40

­¸ ºßÆü¿ÆÂ²¤ª¤è¤ÓƱµï¼Ô Family in Japan or co-residents

¡¡¡¡ÆüËܤ˽»¤à¿ÆÂ²¤äƱµï²È²¤¬¤¤¤ë¾ì¹ç¡¢°Ê²¼¤ËÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¤¤¤Ê¤¤¾ì¹ç¤Ï¡¢ÆþÎϤ¹¤ëɬÍפϤ¢¤ê¤Þ¤»¤ó¡£
¡¡¡¡If you have a family or co-residents staying with you in Japan,please fill out follows. If you do not have, please leave follows blank.

Q.42 1¿ÍÌÜ¤ÎºßÆü¿ÆÂ²¤Ë¤Ä¤¤¤ÆÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£ Please fill out about the 1st person.

¡¡­¡»á̾ The 1st person's name :
¡¡Â³ÊÁ The 1st person's relationship with you :
¡¡À¸Ç¯·îÆü The 1st person's birthday (Îã/Example) 1990/1/15 :
¡¡¹ñÀÒ The 1st person's nationality :
¡¡¶Ð̳À衦Ä̳ØÀè The 1st person's place of employment/school :
¡¡ºßᥫ¡¼¥ÉÈÖ¹æ The 1st person's residence card number
¡¡¡¡¡¡¡¡¡¡Æ±µïͽÄê Intended to reside with the 1st person or not
ͭ Yes ̵ No

Q.43 2¿ÍÌÜ¤ÎºßÆü¿ÆÂ²¤Ë¤Ä¤¤¤ÆÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£ Please fill out about the 2nd person.

¡¡­¢»á̾ The 2nd person's name :
¡¡Â³ÊÁ The 2nd person's relationship with you :
¡¡À¸Ç¯·îÆü The 2nd person's birthday (Îã/Example) 1990/1/15 :
¡¡¹ñÀÒ The 2nd person's nationality :
¡¡¶Ð̳À衦Ä̳ØÀè The 2nd person's place of employment/school :
¡¡ºßᥫ¡¼¥ÉÈÖ¹æ The 2nd person's residence card number
¡¡¡¡¡¡¡¡¡¡Æ±µïͽÄê Intended to reside with the 2nd person or not
ͭ Yes ̵ No

Q.44 3¿ÍÌÜ¤ÎºßÆü¿ÆÂ²¤Ë¤Ä¤¤¤ÆÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£ Please fill out about the 3rd person.

¡¡­£»á̾ The 3rd person's name :
¡¡Â³ÊÁ The 3rd person's relationship with you :
¡¡À¸Ç¯·îÆü The 3rd person's birthday (Îã/Example) 1990/1/15 :
¡¡¹ñÀÒ The 3rd person's nationality :
¡¡¶Ð̳À衦Ä̳ØÀè The 3rd person's place of employment/school :
¡¡ºßᥫ¡¼¥ÉÈÖ¹æ The 3rd person's residence card number
¡¡¡¡¡¡¡¡¡¡Æ±µïͽÄê Intended to reside with the 3rd person or not
ͭ Yes ̵ No

Q.45 4¿ÍÌÜ¤ÎºßÆü¿ÆÂ²¤Ë¤Ä¤¤¤ÆÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£ Please fill out about the 4th person.

­¤»á̾ The 4th person's name :
¡¡Â³ÊÁ The 4th person's relationship with you :
¡¡À¸Ç¯·îÆü The 4th person's birthday (Îã/Example) 1990/1/15 :
¡¡¹ñÀÒ The 4th person's nationality :
¡¡¶Ð̳À衦Ä̳ØÀè The 4th person's place of employment/school :
¡¡ºßᥫ¡¼¥ÉÈÖ¹æ The 4th person's residence card number
¡¡¡¡¡¡¡¡¡¡Æ±µïͽÄê Intended to reside with the 4th person or not
ͭ Yes ̵ No

­¹ ºßα»ñ³ÊǧÄê¾ÚÌÀ½ñÁ÷ÉÕÀè The address for delivery of your certificate of eligibility

¡¡¡¡ÆþÎϤµ¤ì¤¿½»½ê¤Øºßα»ñ³ÊǧÄê¾ÚÌÀ½ñ¤ò͹Á÷¤·¤Þ¤¹¡£Your certificate of eligibility will be sent to the entered address by EMS.

Q.46 ¡¡°Ê²¼¤Î»þ´ü¤ËEMS¤ò¼õ¤±¼è¤ì¤ë°¸Àè¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£¡¡Please fill out the address you can receive EMS in the following time.(Mandatory) (ɬ¿Ü²óÅú¹àÌÜ)

¡¡¡¡¡¡4·îÆþ³Ø¼Ô¤Ø¤Ï2·î²¼½Üº¢¤Ë͹Á÷¤µ¤ì¤Þ¤¹¡£ The certificate of eligibility of those who enroll in April is sent at the end of February.
¡¡¡¡¡¡9·îÆþ³Ø¼Ô¤Ø¤Ï7·î²¼½Üº¢¤Ë͹Á÷¤µ¤ì¤Þ¤¹¡£ The certificate of eligibility of those who enroll in September is sent at the end of July.
Í¹ÊØÈÖ¹æ Postal code
¹ñ Country
½»½ê Address
¼õ¼è¿Í»á̾ Name of Addressee
ÅÅÏÃÈÖ¹æ Phone number
¡¡¡¡¡¡¡¡¼õ¼è¿Í·É¾Î honorific title for the addressee
Mr. Mrs. Miss