Mẫu đơn đăng ký cho các khóa học ngôn ngữ Nhật bản trường đại học Sojo Số lượng của thí sinh Bạn muốn nhập học ngày: ___ Năm: tháng: ___ nhập học vào trường đại học và Nhật bản sẽ được hủy bỏ trong trường hợp lỗi hoặc thông tin sai lệch. 1. Name: ________________ ( ______________________________ ) ________________ Given Name Middle Name Family Name 2. Sex: ___________ Photo 3. Nationality: __________________ 4. Native Language: 5. Date of birth: Year:__________ Month:_____ Day:_____ ( years of age) 6. Place of Birth: ______________________ 7. Present Address: Phone No._______________________ Fax______________________ E-mail_______________________ If you wish to be contacted at a place other than the above address, write so below. Place of Contact: Phone No._______________________ Fax______________________ E-mail_______________________ 8. Family: (Include family members living apart) Name Relationship Age Occupation Address 9. Languages Proficiency: (Fill in any languages other than Japanese or English that you can use and rate your ability in each as elementary, intermediate or advanced) Language Japanese English Self-Evaluation 10. Application Reasons, Study Plan, Career after Course Completion: ______________________________________________________________________________________________ ______________________________________________________________________________________________ ______________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ _________________________________________________ __________________________________________________ 11. Family Members and Acquaintances already in Japan: ( If applicable) Name: ( ) Address: ( ) Phone No._______________________ Fax______________________ E-mail___________________________ 12. Previous Entry to Japan ( If applicable) : Yes ( times) No The latest entry(Year Month Date to Year _ Month Date ) 13. Previous Application for “Certificate of Eligibility for a Status of Residence" : (If Applicable) Yes: ( Year _____Month ) ( Year _____Month ) No 14. Criminal Record: ( in Japan or overseas) Yes: (Details: __________________________________ ) No 15. Educational Background : (Beginning with elementary school and including Japanese Language School(s) attended) School Name Location (City) Period of Study Phone number of the final graduated school( ) The last homeroom teacher at the final graduated school( ) 16. Employment Background: ( If applicable) Name of Employer Location Type of Work Period of Employment 17. Marital Status: (1) Single (2) Married 18. Passport: (For Holders Only) (1) Number (2) Date of Issue Year Month Date (3) Expiry Date Year Month Date (4) Issuer 19. Expected Entry Date to Japan: Year Month Date 20. Expected Place of Disembarkation: (e.g. Fukuoka) 21. Be Accompanied: (1) Yes (2) Alone 22. Place of Visa Application: 23. Years of Study: (Primary School to Final Year. Exclude Japanese Language School) ____Years 24. Japanese Language Proficiency: Level (For Relevant Persons) 25. Examination for Japanese University Admission for International Students (EJU) Results: Japanese Physics Chemistry Biology General Subject Mathematics I Mathematics 2 I hereby attest that, to the best of my knowledge, the above information is correct. Also, after admission, I promise to obey the school rules and to study in earnest. Year:_____________ Month :______Day:______
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