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¡äIPS ¾ðÊóÀ¸»º¥·¥¹¥Æ¥à¸¦µæ²Ê ¡ÚOnly for IPS Applicants¡Ûºßα»ñ³ÊǧÄê¾ÚÌÀ½ñ¸òÉÕ¿½ÀÁ½ñ Application for certificate of eligibility
¡ÚIPS ¾ðÊóÀ¸»º¥·¥¹¥Æ¥à¸¦µæ²Ê¡Û¡ÚOnly for IPS Applicants¡Ûºßα»ñ³ÊǧÄê¾ÚÌÀ½ñ¸òÉÕ¿½ÀÁ½ñ Application for certificate of eligibility
ºº¾Ú¤ò¿½ÀÁ¤¹¤ë¤¿¤á¤ËɬÍפʽñÎà¤ÎºîÀ®¤ËɬÍפʾðÊó¤Ç¤¹¡£É¬¤º´ü¸Â¤Þ¤Ç¤Ë¤ªÅú¤¨¤¯¤À¤µ¤¤¡£¢¨´Á»ú»á̾°Ê³°¤Ï¡¢¤¹¤Ù¤Æ¥¢¥ë¥Õ¥¡¥Ù¥Ã¥È¤ÇÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£
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¡£
ÆþÎϤ˴ְ㤤¤¬¤¢¤ì¤Ð¡¢¤â¤¦°ìÅÙ½é¤á¤«¤éÆþÎϤò¹Ô¤Ã¤Æ¤¯¤À¤µ¤¤¡£²¿Å٤ǤâÆþÎϤǤ¤Þ¤¹¡£
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.
1960
1961
1962
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1966
1967
1968
1969
1970
1971
1972
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2013
ǯ Year
1 (Jan.)
2 (Feb.)
3 (Mar.)
4 (Apr.)
5 (May)
6 (Jun.)
7 (Jul.)
8 (Aug.)
9 (Sept.)
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12 (Dec.)
·î Month
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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¤ÎÍ̵ Marital Status
(Mandatory)
(ɬ¿Ü²óÅú¹àÌÜ)
¡¡¡¡¡¡¤É¤Á¤é¤«¤òÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£Please select one.
Í 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
Âç³Ø±¡¡ÊÇî»Î¡Ë Doctor
Âç³Ø±¡¡Ê½¤»Î¡Ë Master
Âç³Ø Bachelor
û´üÂç³Ø Junior college
ÀìÌç³Ø¹» College of technology
¹âÅù³Ø¹» Senior high school
Ãæ³Ø¹» Junior high school
¤½¤Î¾ Others
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
´¶È Graduated
ºß³ØÃæ In school
µÙ³ØÃæ Temporary absence
ÃæÂà Withdrawal
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.
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
ǯ Year
1 (Jan.)
2 (Feb.)
3 (Mar.)
4 (Apr.)
5 (May)
6 (Jun.)
7 (Jul.)
8 (Aug.)
9 (Sept.)
10 (Oct.)
11 (Nov.)
12 (Dec.)
·î Month
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2
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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¡¡
14
15
16
17
18
19
20
21
22
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.
µ¢¹ñ Return to home country
ÆüËÜ¤Ç¤Î¿Ê³Ø Enter school of higher education in Japan
ÆüËܤǤν¢¿¦ Find work in Japan
¤½¤Î¾ Others
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¡¡
̤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·ô͸ú´ü¸Â Date of expiration of your passport
¡¡¡¡¡¡¥Ñ¥¹¥Ý¡¼¥È¤Î͸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·ô͸ú´ü¸Â Date of expiration of your passport¡¡¡§
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
2030
ǯ Year
1 (Jan.)
2 (Feb.)
3 (Mar.)
4 (Apr.)
5 (May)
6 (Jun.)
7 (Jul.)
8 (Aug.)
9 (Sept.)
10 (Oct.)
11 (Nov.)
12 (Dec.)
·î Month
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2
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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¡¡¡§
2012
2013
ǯ Year
2 (Feb.)
3 (Mar.)
8 (Aug.)
9 (Sept.)
·î Month
1
2
3
4
5
6
7
8
9
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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¡¡¡§
Ê¡²¬¹ñºÝ¶õ¹Á Fukuoka Airport
ÇÁ Hakata port
´ØÀ¾¹ñºÝ¶õ¹Á Kansai International Airport
À®ÅĹñºÝ¶õ¹Á Narita International Airport
±©ÅĹñºÝ¶õ¹Á Haneda Airport
¤½¤Î¾ Other
Q.25 Ʊȼ¼Ô¤ÎÍ̵ Accompanying persons, if any
(ɬ¿Ü²óÅú¹àÌÜ)
¡¡¡¡¡¡ÆüËܹñÆâ¤ÇƱµï¤¹¤ë²È²¤òÂÓÆ±¤¹¤ë¾ì¹ç¡¢¡Ö͡פòÁªÂò¡£
¡¡¡¡¡¡If you will enter Japan with your family who will live in Japan with you, please select 'Yes'. If not, please select 'No'.
Í 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?
Í 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.¡¡¡§
1²ó once
2²ó twice
3²ó 3 times
4²ó 4 times
5²ó 5 times
6²ó 6 times
7²ó 7 times
8²ó 8 times
9²ó 9 times
10²ó°Ê¾å more than 10 times
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
1980
1981
1982
1983
1984
1985
1986
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
ǯ Year
1 (Jan.)
2 (Feb.)
3 (Mar.)
4 (Apr.)
5 (May)
6 (Jun.)
7 (Jul.)
8 (Aug.)
9 (Sept.)
10 (Oct.)
11 (Nov.)
12 (Dec.)
·î Month
1
2
3
4
5
6
7
8
9
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11
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30
31
Æü Day ¤«¤é To
1980
1981
1982
1983
1984
1985
1986
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
ǯ Year
1 (Jan.)
2 (Feb.)
3 (Mar.)
4 (Apr.)
5 (May)
6 (Jun.)
7 (Jul.)
8 (Aug.)
9 (Sept.)
10 (Oct.)
11 (Nov.)
12 (Dec.)
·î Month
1
2
3
4
5
6
7
8
9
10
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21
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30
31
Æü Day
Q.30 ÈȺáÎò¤ÎÍ̵ Criminal record(in Japan/ overseas)
(Mandatory)
(ɬ¿Ü²óÅú¹àÌÜ)
¡¡¡¡¡¡ÆüËܹñÆâ³°¤òÌä¤ï¤º¡¢ÈȺá¤òÍýͳ¤È¤¹¤ë½èʬ¤ò¼õ¤±¤¿¤³¤È¤¬¤¢¤ì¤Ð¡¢¡Ö͡פòÁªÂò¤·¤Æ¤¯¤À¤µ¤¤¡£
¡¡¡¡¡¡If you have criminal records in Japan or abroad, please select 'Yes'.
Í 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¤ÎÍ̵ Departure by deportation/departure order
(Mandatory)
(ɬ¿Ü²óÅú¹àÌÜ)
¡¡¡¡¡¡¡Ö͡פòÁªÂò¤·¤¿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.
Í 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.
É× Husband
ºÊ Wife
Éã Father
Êì Mother
ÁÄÉã Grand father
ÁÄÊì Grand mother
ÍÜÉã Foster father
ÍÜÊì Foster mother
·»Äï»ÐËå Brother/Sister
½ÇÉã¡ÊÇìÉã¡Ë¡¦½ÇÊì¡ÊÇìÊì¡Ë Uncle/Aunt
¼õÆþ¶µ°éµ¡´Ø Educational institution
ͧ¿Í¡¦ÃÎ¿Í Friend/Acquaintance
ͧ¿Í¡¦ÃοͤοÆÂ² Relative of friend/acquaintance
¼è°ú´Ø·¸¼Ô¡¦¸½ÃÏ´ë¶ÈÅù¿¦°÷ Business connection/Personnel of local enterprise
¼è°ú´Ø·¸¼Ô¡¦¸½ÃÏ´ë¶ÈÅù¿¦°÷¤Î¿ÆÂ² Relative of business connection/Personnel of local enterprise
¤½¤Î¾ Others
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
³°¹ñÀ¯ÉÜ Foreign government
ÆüËܹñÀ¯ÉÜ Japanese government
ÃÏÊý¼«¼£ÂÎ Local government
¸ø±×¼ÒÃÄË¡¿Í¤Þ¤¿¤Ï¸ø±×ºâÃÄË¡¿Í Public interest incorporated association or public interest incorporated foundation
¤½¤Î¾ Others
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
Í 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
Í 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
Í 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
Í 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