APPLICATIONFOR CERTIFICATE OF ELIGIBILITY

Transcription

1 For applicant, part 1 Ministry of Justice, Government of Japan APPLICATIONFOR CERTIFICATE OF ELIGIBILITY To the Director General of Regional Immigration Bureau Pursuant to the provisions of Article 7-2 of the Immigration Control and Refugee Recognition Act, I hereby apply for the certificate showing eligibility for the conditions provided for in 7, Paragraph 1, Item2 of the said Act. Nationality/Region Family name Given name Date of birth Year Month Sex Male / Female Place of birth Marital status Married / Single Occupation Home town/city in Japan Cellular phone No. Passport Number Date of expiration Year Month Purpose of entry: check one of the followings "Professor" "Instructor" "Artist" "Cultural Activities" "Religious Activities" "Journalist" "Intra-company Transferee" "Business Manager "Researcher (Transferee)" "Researcher" "Engineer / Specialist in Humanities / International Services" "Skilled Labor" "Designated Activities ( Researcher or IT engineer of a designated org)" "Entertainer" "Student" "Trainee" "Technical Intern Training "Dependent" "Designated Activities (Dependent of Researcher or IT engineer of a designated org)" "Designated Activities(Dependent of EPA)" "Spouse or Child of Japanese National" "Spouse or Child of Permanent Resident" "Long TermResident" "Highly Skilled Professional(i)(a)" "Highly Skilled Professional(i)(b)" "Highly Skilled Professional(i)(c)" Date of entry Year Month Port of entry Intended length of stay Accompanying persons, if any Intended place to apply for visa Past entry into / departure from Japan (Fill in the followings when the answer is "Yes") time(s) The latest entry from Year Month to Year Month Criminal record (in Japan / overseas) Yes ( Detail: ) / No Departure by deportation /departure order (Fill in the followings when the answer is "Yes") time(s) The latest departure by deportation Year Month Family in Japan (Father, Mother, Spouse, Son, Daughter, Brother, Sister or others) or co-residents Relationship Date of birth Nationality/Region Intended to reside with applicant or not Place of employment/school Residence card number Special Permanent Resident Certificate number Regarding item20, if there is not enough space in the given columns to write in all of your family in Japan, fill in and attach a separate sheet. In addition, take note that you are not required to fill in item20 for applications pertaining to Trainee / Technical Intern Training. Note : Please fill in forms required for application. (See notes on reverse side.)

2 For applicant, part 2 P ("Student") Place of study For certificate of eligibility of school Total period of education (from elementary school to last institution of education) Education (last school or institution) or present school Years Registered enrollment Graduated In school Temporary absence Withdrawal Doctor Master Bachelor Junior college College of technology Senior high school Junior high school Elementary school of the school Date of graduation or expected graduation Year Month Japanese language ability (Fill in the followings when the applicant plans to study at advanced vocational school or vocational school (except Japanese language)) Proof based on a Japanese language test of the test Attained level or score Organization Organization and period to have received Japanese language education Period from Year Month to Year Month Japanese education history (Fill in the followings when the applicant plans to study in high school) Organization and period to have received Japanese language education / received education by Japanese language Organization Period from Year Month to Year Month Method of support to pay for expenses while in Japan Method of support and an amount of support per month (average) Self Yen Supporter living abroad Yen Supporter in Japan Yen Scholarship Yen Yen Remittances from abroad or carrying cash Carrying from abroad Yen Remittances from abroad Yen of the individual Date and time of Yen carrying cash carrying cash Supporter Occupation (place of employment) Annual income Yen

3 For applicant, part 3 P ("Student") For certificate of eligibility Relationship with the applicant (Check one of the followings when your answer to the question 26(1) is supporter living abroad or Japan) Husband Wife Father Mother Grandfather Grandmother Foster father Foster mother Brother / Sister Uncle / Aunt Educational institution Friend / Acquaintance Relative of friend / acquaintance Business connection / Personnel of local enterprise Relative of business connection / personnel of local enterprise Organization which provide scholarship (Check one of the following when the answer to the question 26(1) is scholarship) Foreign government Japanese government Local government Public interest incorporated association / Public interest incorporated foundation Plans after graduation Return to home country Enter school of higher education in Japan Find work in Japan Actual guardian in Japan ( Fill in the following if the applicant is to study at a junior high school or elementary school ) Relationship with the applicant Cellular Phone No. Applicant, legal representative or the authorized representative, prescribed in Paragraph 2 of Article 7-2. Relationship with the applicant Cellular Phone No. I hereby declare that the statement given above is true and correct. Signature of the applicant (representative) / Date of filling in this form Year Month Attention In cases where descriptions have changed after filling in this application form up until submission of this application, the applicant (representative) must correct the part concerned and sign their name. Agent or other authorized person Organization to which the agent belongs

4 For organization, part 1 P ("Student") For certificate of eligibility of the foreigner to enter school Place of Study of School Classification of school Graduate school University Junior college Advanced vocational school (except Japanese language school) Vocational school (except Japanese language school) Japanese language institution Senior high school Junior high school Elementary school Type of class classes -Evening classes Evening classes Satellite program (fill in this box when attending remote classes that use two-way communication) Correspondence course (including cases receiving credits for education via video or internet) of the school where the applicant will be educated of the resident adviser in Japan (in case that the place of study is an advanced vocational school,vocational school, junior high school or elementary school) Is the applicant participating in a student exchange program? Which organization is in charge of that program? (when the place of study is senior high school,junior high school or elementary school) National or local government Incorporated administrative agency National university corporation Educational foundation Public interest incorporated association or public interest incorporated foundation Date of entrance Year Month Lesson hours per week Registration Doctor Master Graduate school (Research student) Undergraduate student University (Auditor elective course student) University (Research student) University (Japanese language course student) Junior college (Traditional student) Junior college (Auditor elective course student) Junior college (Japanese language course student) Higher advanced professional school Advanced vocational school (Specialized course) Advanced vocational school (Higher course) Advanced vocational school (General course) Vocational school Japanese language institution (Advanced vocational school of specialized course) Japanese language institution (Preparatory courses) Japanese language institution () Senior high school Junior high school Elementary school

5 For organization, part 2 P ("Student") For certificate of eligibility Faculty / Course (Check one of the followings when the answer to the question 5 is doctor college(auditor elective course student).) university (research student), junior college (Traditional student), junior Law Economics Politics Commercial science Business administration Literature Linguistics Sociology History Psychology Education Science of art (cultural science/ social science) Science Chemistry Engineer Agriculture Fisheries Pharmacy Medicine Dentistry (natural science) Sports science of specialized course (Check of the followings when the answer to the question 5 is higher advanced professional school vocational school) Engineering Agriculture Medical services / Hygienics Education / Social welfare Law Practical commercial business Dress design / Home economics Culture / Education Period of education until graduation Year(s) I hereby declare that the statement given above is true and correct. of the place of study or organization and representative, and official seal of the organization Date of filling in this form Seal Year Month Attention In cases where descriptions have changed after filling in this application form up until submission of this application, the organization must correct the part concerned and press its seal on the correction.