□Form 1 －1

Admission Application
Kawahara E-Business College Japanese language department
Place of Birth
Family in Japan【 Yes ・ No 】

Highest degree【 Doctor・Master・Bachelor・Junior college・Technical college・High school 】
Total period of educationYears

Accompanying persons, if any【 Yes ・ No 】

Family Name

Given Name

Nationality

Sex【 Male ・ Female

Date of birthYearMonthPhoto(Bust up)】

3x4cm

Day

Marital status【Married ・Single】Occupation【Yes() ・No】

Home address

TELAddress in Japan〒TEL
Applying dormitory

Applying course□ 1 - year course□ 1.5 - year course□ 2 - year course□ Yes□ NoPassport
NumberDate of expiration

Past History of Applying for Entering Japan 【 YesYear

Month・ No】

Day ～YearDay

Result 【Approval ・Disapproval】
Period of entry into Japan

Year

MonthMonthDay

Plans after graduation（１） □ Enter a school in Japan 【 Technical college / Junior college / College / Graduatecollege】(２)□ Return to home country(３)□ Others

Form □
1 －２

Experience in studying Japanese language
□ No
□ Yes
Name of school

Date of admission

Date of graduation

Year

MonthYear

MonthYear

MonthYear

MonthYear

MonthYearMonthFamily
Name

Relationship

AgeOccupation

Nationality

Address

Financial supporter
Name

Occupation

Address
TEL
Relationship to the applicant□ Husband□ Wife □ Father□ Grandfather□ Mother□ Grandmother□ Friend ・Acquaintance□ Others（）

I hereby declare that the statement given above is true and correct.
YearMonth

Signature of applicant

Day

Form

Health Certificate
Name（ Male ・ Female ）Nationality

Date of BirthYear

MonthDay

Present Address

Applicant’s description
CheckedYear

MonthDay

Heightｃｍ

WeightChestｃｍ

VisionHearingｋｇ
rightleft(())

rightgoodleft

observation required

PastChestillness

X-raymedical treatment required
CheckedYear

MonthRemarks

Presenttreatment

Diagnosis of applicant results as follows□Excellent □Good □Pass □Bad

Health condition of applicant is adequate to purse studies in Japan
Yes No
I certify that the above record is true and correct.

Certified byNameAddress

Day2□

Form □
3 －１

Resume1. Nationality

2. Name3. Sex4. Date of birth
YearMonthDay
5. Marital status
Single / Married[Spouse’s name
6. Present address

M・F]

7. Academic background (from elementary school to the last institution of education)
Name of school

Address

Date of admission

Date of graduation

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

8. Japanese education history
Name of school

Address

Date of admission

Date of graduation

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

9. Occupation history
Name of company

Address

Date of employment

Date of resignation

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

10. Records in entering and leaving JapanDate of entry

Date of leaving

YearMonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Year

MonthDay

Status of stay in Japan

Purpose of entry

様式□
3 －２

11. Purpose of studying

12.Plans after graduation【 Enter school
Find work

Start business

Others】（1） Desired school:
Desired major:
Details:（2） Company you plan to work:
Address:
Description of business:
Reasons and details:（3） Start business:
Address:
Description of business:
Fundraising plan:
Reasons and details:（4） Others:Year
Signature of applicant

MonthDay

Form □
3 －３Purpose of studying and plans after graduation
Japanese translation 日本語訳
年

⚫

修学理由

月日

⚫

修学後の予定[進学希望（1） 進学希望学校名：
希望科目：
進学希望説明：（2） 就職予定先名称：
就職予定先住所：
事業内容：
就職希望説明：（3） 自営：
事業先住所：
事業内容：
資金調達計画・方法：
自営希望説明：（4） その他：

就職希望

事業経営希望

その他

]

Form

Certificate of Graduation
Japanese translation 日本語訳
年

月日

4
□

Form5□

Grade ReportJapanese translation 日本語訳
年

月日

Form

6
□

Certificate of Sponsorship
YearMonthDay

To Principal, Kawahara E-Business CollegeName (Applicant)Date of birthNationalityYearMonthDay

Present Address
I hereby agree to guarantee that the above student will observe the articles asmentioned below, after he /she has been admitted to your Institution.
1. He / she will obey Japanese laws and rules, and will not act beyond her / his visa
status.
2. He / she will take all financial responsibility such as tuition, petty expense, living
expense and travel expense.
3.

He / she will obey the rules of your institution, and I will make sure that he / shewill study hard for his/her major.

I hereby explain as follows, the reason why I bear the responsibility as a Guarantor forthe above-mentioned student:

Japanese translation 日本語訳 : attach a separate sheet

Guarantor
NamePresent address
Place of employment
Relationship with applicant

Signature

TELForm7□

Letter of Commitment
YearMonthDay

To Principal, Kawahara E-Business CollegeI hereby pledge that I will obey the articles as follows upon being permitted toyour institution.
1. I will observe the rules of your institution and study hard.
2. I will observe the laws and rules of Japan.
3. All the cost I need while staying in Japan, such as tuition while studying at
your institution, petty expenses, living expenses and travel expenses aretotally my responsible and I shall not trouble you with my financial matters.

Signature of the Applicant

Form8□Agreement

1. On Admission Procedure
Application for Certificate of eligibility will be sent by proxy to the Immigration
Bureau by KBC. However, issuance of the above certificate totally depends on theImmigration Bureau. Therefore, KBC assume no responsibility concerning this matter.
2. On Payment of Tuition and other fees•

Please be aware that once Tuition and other fees are paid, they are nonrefundable under any circumstances.

•However, in case a Certificate of Eligibility was not granted, or in case JapaneseEmbassies / Consulates refused to issue a visa after issuance of Certificate ofEligibility, Admission, Tuition, Insurance, Accommodation fees will be refunded.
Screening fee is non-refundable.

•If an applicant wishes to discontinue admission procedure due to a personalreason, after issuance of a Certificate of Eligibility, all the fees already paid
(Screening, Admission, Tuition, Insurance) are not refunded.

3. In case of refund (see above 2)
Name of the bankAccount no.

BranchAccount name

Address of the account holder
TELFAX

I hereby agree to the statement above on article 1 and 2, and also declare that thestatement above on article 3 is true and correct.

YearMonthSignatureDayForm □9

Certificate of current employment (for applicant)Japanese translation 日本語訳年月日□Form 10

Letter of Paying Expenses
To: Minister of Justice of JapanName

Nationality

Date of birthSex ( M・F )I became a financial supporter to pay expenses for the above-mentioned person
during his / her stay / enter in Japan. I hereby pledge that I will bear the expenses in
the following manner, with explanation of reason for being financial supporter.
Note:
1. Reason for being financial supporter to pay expenses (please write concretely, about
the details to take on the role of financial supporter to applicant, and about yourrelationship with the applicant.)

Japanese translation 日本語訳 : attach a separate sheet
2. Contents to pay expenses
I hereby pledge that I will bear expenses of the above-mentioned person during his / herstay in Japan in the following manner. Moreover, when applying for extension of period ofstay, documents to prove the ability of covering the living expenses and others such as copyof the Certificate of Remittance of Bankbook in the name of the applicant himself / herself
will be submitted.
(1) Tuition every 6 months
Currency for the chart [Yen ¥]All courses

1.5 Year course

2 Year course only

(including admission fee)

only

first due

2nd Year

2nd year 1st due

2nd year 2nd due

700,000

300,000

300,000

300,000(2) Living expenses
Per monthYen(3) How will you pay for the course? (please write concretely for. ex. remittance, transfer)

Japanese translation 日本語訳 : attach a separate sheet

YearMonthFinancial Supporter
Name
Present address
Relationship with the applicant)signature
TELDay