How to fill the Application Documents【Attention】
・Use a writing utensil which is difficult to erase such as a black or blue ballpoint pen .
・If we found out that the application contents have been falsified, permission may be revoked even after
occupancy has been determined.

１ How to fill the front page of the application form

≪Example≫＜Profile of Liu Fei Yang ＞
He is a foreign student currently enrolled in a master's program on his own expense andhe lives with his wife and a child.
Form No. 2（Article 8(1)(i)）
Application Form for Single/Family RoomJanuary 4th, 2022
To the Chairperson of Yokohama Association for International Communications and Exchanges

Age onJanuary 1st,2022

I would like to request permission to use a lodging room at the YokohamaInternational Student House.
I certify that if I receive permission, I will not violate any regulations and otherrules, and will vacate the house upon returning the room to its original conditionat the termination of the tenaｎcy.
Signature： Liu Fei Yang
Name

Last nameFirst nameNationality

Ｎotification ofresults will bedispatched aroundFebruary 9th. Fillout this space,
if you want thenotification to bedispatched toaddress other thanthe present one.
As a rule, we donot send it
overseas. Inaddition, if you ask
your friend or
someone toreceive it, write
his/her address,
name, phone
number.

Write down
"From April 1st,
2022to March
28th, 2023
For those
applying for afamily room,
give usinformation
about yourfamily who will
live with you.

Japanesereading
Date of birth

中 国レ□Male □Female

Genderレ

1996年7月25日（25歳）□ Own expense □Government-sponsored □Foreign government-sponsored

Presentaddress（郵便番号231-0017)(電話番号045-123-4567)

Address toreceive thenotification（Zip code(Phone numberSchool,Department,
Field of Study,Course, etc.

（School enrolled in from April）)

同)

上 (E-mailアドレス ○×▼＠yish.or.jp )Enrollment(or transfer)

University・Graduate School・Junior College・Technical School April, 2021

修士
Department・Course
Field of Study・Graduate Course
経済学(School currently enrolled in）

Scheduled graduation

March, 2023

２nd year

University・Graduate School・Junior College・Technical School

修士
経済学

Department・Course
Field of Study・Graduate Course 1st year ・Research student

Permitted period From April 1st, 2022 to March 28th, 2023Name/s ofuser/sName

Gender
男女

Age25
25

女

3

Type of room □Single room レ□Family room
Status ofresidence

Relationship to applicant

留学Student

本人 self
配偶者spouse

家族滞在
Dependent
家族滞在
Dependent

子child子子

２ How to fill in the back page of the application form (Tuition, Income and Expenses (monthly), Current Residence)

Income and Expenses【Attention】Round down to the nearest hundred●Write your estimated average monthly income andexpenses for the 2021 year (April 2021 to March 2022).

(Example ¥7,690 →￥7,600)

Tuition●Write down the yearly school expenses actually paid for in section 【A】 in the 2021 school year. For those who have school expense
exemptions, write down the amount after exemption. School expenses include tuition fee, cost of equipment and training costs but they
do not include enrollment fees.
●For those applying for a family room and living with their spouse whose status of residence is "student," write down the total amount for the applicant
and the spouse of the applicant in section 【A】 .

TuitionYearly amount paid

【A】

\332,000［Tuition exemption □None □Total □Partial ］（Amount of 【A】 ÷ １２ months ≒ \27,600【B】（Monthly tuition））
IncomeScholarship
IncomeandName of scholoarship [Expenses(monthly) Allowance【B】Write down
the monthly
amount of tuition.

Expenses\70,000

Rent (applicant's share)¥55,000]￥０Tuition（Amount from 【B】）

\27,600

Income from part-time work

￥60,000

Food\26,000

Assistance from housemate or guarantor, etc.

\15,000

Utilities\7,000Transportation costs\8,000

Other expenses\31,400

Total\155,000

Other incomeTotal\10,000\155,000

Current □Private rental/apartment □Public lodging, university dormitory □Other dormitory Valid）
periodresidence □Living with others such as relatives, home stay □Other residence（２ rooms ６／4.5 tatami mat・㎡Until Marchof 2022

Transportation costs●Transportation costs required
to attend school(If theapplicant's
spouse hastransportation
costs required
to attend school,
add these to thetotal amount).

Income andexpense totals●The income andexpense totals
should be the same.

Kitchen ( Private・Shared・N/A ) Bath and shower ( Private・Shared・N/A )Toilet( Private・Shared)□1st time □2nd time □3rd time □4th time or more

No. of times applying

Reason for application (economic situation, housing circumstances, motivation for international exchange etc)

Other income ●Savings, etc.

Income from part-time work／Assistance from housemate or guarantor, etc.
●If the spouse living with the applicant for a family room has income from a part-time job, write down the total amount.

Scholarship●Write down the scholarship amount and namereceived at the time of application.

３ Important points about " Recommendation Letter (Form No. 3)"●Ask someone who knows you and your student life very well, such as supervising teacher of your seminars or classes or personnel incharge of foreign students, to fill out the recommendation letter. After that, receive the official seal of the university president (ordepartment head, Academic Affairs Section chief, principal, etc.). Recommendations without the official seal are not valid.
●For those planning on starting school from April, receive recommendations from those such as head teachers at your current school.

４ Important points about the "International Exchange Activity Questionnaire"●International students shall use the questionnaire for international students and resident assistants shall use thequestionnaire for resident assistants and submit it.
●Please take a look at the separate Introduction to International Exchange Projects ("International Exchange Activities,""Classes by International Students at Elementary and Junior High School s in Yokohama" and "Cooperation with Projects inYokohama"). You will be requested to take part in these projects while you live in our house.

５ Important points about copies of your "Residence Card" and"Student Identification Card"●Only international students shall submit these.
●Copy both sides of your Residence Card and your Student Identification Card, and adhere themto the designated sheets and submit them.