莠ャ驛ス豌鷹圀譌・譛ャ隱槫ュヲ譬。蜈・蟄ヲ鬘俶嶌

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1 京都民際日本語学校入学願書 ENROLMENT FORM KYOTO MINSAI JAPANESE LANGUAGE SCHOOL この欄は記入しないでください Please do not fill in. 入学希望度入学希望時期コース 申請番号 4 月 7 月 10 月 1 月 進学 一般 本人記載 To be filled in by Applicant 学籍番号 注 : 願書は日本語または英語で記入すること ( タイプ又は楷書で記入のこと ) Note: In Japanese or English (Please type or print with ball-point pen) ふりがな氏名 ( 漢字名 ) : Full name (as stated in passport) 国籍 : Nationality 出生地 : Place of birth Male 男 Female 女 生月日 : 月日 Date of Birth Year Month Day 写真貼付欄. 最近 3 ヶ月以内に写した 上半身正面脱帽のもの Photo 4cm 3cm Taken within 3 months half-length, without hat, full from face. 齢 : Age 電話 (Phone number) : メール ( ) : 現住所 Present address 本籍地 Permanent address 婚姻 : Single 未 Married 既 使用言語 Language 学校で履修した外国語 What foreign language did you study in your school? 旅券 Passport 旅券番号 Passport No. 発行機関 Issuing Authority 発行月日 Date of Issue 有効期限 Valid Until ビザ 入国予定 Visa 查証申請予定地 Site for Visa Application 上陸予定地 Port of Entry 在日の経費支弁者又は連絡先 Sponsor or contact person residing IN JAPAN (not your country) ( 在日の経費支弁者又は日本国内の連絡先がある時は記入してください ) 氏名 Name 住所 Address 勤務先名 Name of office Tel Tel

2 本科課程修了後の進路 Desired course [After completion of your course] 日本語習得後の進学希望 Do you intend to enter universities or other institutions for higher education after completion of this course? いずれかに〇を記入し 志望学科を書いてください ( Circle your answer and write desired major.) 大学院 Graduate School 志望学科 (Desired Major) 大学 ( 学部 ) University (Department) 短期大学 専門学校 その他 Junior College Vocational School Others 学歴 Educational background 注 : 小学校から最終学歴まで代順で記入すること 保育所 幼稚園は省く Note: Entry should be made in chronological order, starting from the elementary to final school you graduated from. Nursery or kindergarten can be omitted. 学校名 Name 所在地 Location 修業限 Duration 入学月 卒業 ( 修了 ) 月 Start date graduation/complete date (month/) 小学校 Elementary School 中学校 Junior High School 高等学校 High School 大学 University or College その他 Others その他 Others

3 日本語学習歴注 : 個人教授も記入して下さい Previous study of Japanese: including private lessons 学校 ( 教師名 ) Institution (Name of Teacher) 所在地 Location 期間 Period 日本語学習に使用した教科書を記入すること Please state any book you used to study Japanese. 職歴 その他 W o r k / Vocational experience 代順に書いてください If yes, list them below in chronological order. 勤務先名 Name of Employer 所在地 Location 地位 職務内容 Position Description of Work 期間 Period ~ ~ ~ ~ (month) () ~ (month) () 兵役 Military service 期間 Period 来日歴注 : 過去の来日歴を代順に全て記入すること Previous Stay (s) in Japan: If yes, list of any prior visits to Japan below in chronological order. 入出国月日 Date of entry and departure 在留期間 Length of stay 在留資格 Visa status 入国目的 Purpose of visit.. (day) (month) () (day) (month) ().. (day) (month) () (day) (month) ().. (day) (month) () (day) (month) ().. (day) (month) () (day) (month) ().. (day) (month) () (day) (month) ()

4 申請歴 Application history 過去に在留資格認定証明書の交付申請をしたことがありますか Have you ever applied for a entry visa (not a regular tourist visa) at the Japanese Immigration? 家族 : 在日家族も含み 全ての家族を記入すること Family : All the members of your family, including those who live in Japan. 氏名 Full name 続柄 Relationship 齢 Age 職業 Occupation 現住所 Home address 上記の通り相違ありません I hereby declare upon my honor the above to be a true and correct. 日付 月 日 Date month day 本人署名 Signature 備考 この欄は記入しないでください Please do not fill in.

5 (Specific reason for studying Japanese) (Name) (Minister of Justice Japan) TAIJI MATSUNO (Nationality) INDONESIA My name is Taiji Matsuno from Indonesia. Sice I was child I loved Japanese Manga as Naruto and One piece. At that time I was reading Indonesian translated Manga not original in Japanese. When I was high school students we had a cultural exchange program with a Japanese high school and some Japanese students joined our class. I got a Jpanese friend by this program and one of my Japanese firend gave me a original Manga of Naruto from Japan. It was my first time to raed manga in Japanese language and I was so excited to read. But I couldn't read a word and really upset. Then I started leraning Japanese in OHAYOU Japanese Language Center in Jakarta. As I studied Japanese language I became more interested in all about Japan specially culture and history. I began to think one day I visit in Japan and see and feel real Japan. Last my dream come true. My parents gave me a ticket to Japan for a week. I visited many place in Japan, Tokyo, Osaka, Kyoto, and Hiroshima. When I visited in Kyoto I felt this is real Japan. I could see many beautiful traditional culture and buildings. It was so amazing. I saw also very high IT technology in every where.it was so interesting becasue my subject in high school was IT and now my dream is living in Japan and study IT. At first I will study Japanese in Kyoto Minsai for 2 s, then enter Kyoto university to study most advanced IT technology in the world. After completing all my study I want to get a job as IT engineer in Japan. Name TAIJI MATSUNO I, the underlined, hereby certify the information given above is correct and complete ( Date ) : ( Signature ) :

6 Letter of agreement regarding payment To Minister of Justice Japan Nationality Name of applicant Date of birth day/month/ male female I shall explain the reason for acting as the above named applicant expenses of applicant {when he(she) enters Japan / during his or her stay in Japan} as his or her sponsor as written below. 1 Reason for acting as sponsor (Please explain in detail the reasons for acting as sponsor and your relation to the applicant). 2 Details of payment I,, accept responsibility for the payment of the above-mentioned described below, during an extension of his or her period of stay, the applicant must show proof of having paid past expenses, either by receipt verifying the money transfer, or a hat funds have been wired from abroad. ( 1 ) Tuition fees Month / Half / Year Yen ( 2 ) Living expenses Monthly Yen ( 3 ) Method of payment (Please describe how you will make payment, money transfer, payment into bank account, etc.) Date: day month Name of Sponsor: Address: Relationship to applicant: (Signature / Seal) Tel:

7 Year Month Day PLEDGE To Director of Kyoto Minsai Japanese Language School I herby pledge the following, upon entrance to the school. I will, while a student at Kyoto Minsai Japanese Language School, dedicate myself to my studies and obey all laws and rules of Japan and the school, respectively. I, being responsible for the financial obligations of the herein mentioned student, jointly guarantee with the said student to pay any and all school fees and charges that may become due from time to time in the course of the student Student Date of Birth Nationality Male Female Head of household (Next of kin if parents are deceased) Relationship to student Address TEL Signature of Guraantor(Defrayer) Registered Seal Address TEL Name of Company or Occupation (Type of business, Position in detail) Work Address TEL Relationship to student:

8 We also need 1. Certificate of Bank account deposit (or CSN-certificate for Swedish students) 2.Diploma from last school graduated (copy) 3.Transcripts (copy) 4.Certificate of Japanese study 5.passport copy 6.National ID (copy)

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