302018

Admissions Guide to Japanese Languageand Culture Course (for Entrance in 2018)

2018

入試広報課

The Mission of Asahi University

About Personal Information Protection

■ Definition of Personal InformationPersonal Information is defined in Article 2 of the Japanese Act on the Protection of Personal Information.

■ Contact LocationIf you have any question concerning this, please contact us at the following division:

Admission and Public Section,Asahi University

1851, Hozumi, Mizuho City, Gifu Prefecture 501-0296TEL 058-329-1088 FAX 058-329-1089

■ About SocialityThe idea of co-existence of human beings faces many problems to be solved, such as a problem of global resource and environment, a labor problem in the aging society, a problem of international economy in advanced countries, and problem of social economy in developing countries. To deal with such problems and to promote prosperity and happiness of human being, Asahi University aims to foster such individuals who have international sense and sociality, and respect harmony.

■ About CreativityThanks to the dramatic development of science and technology, the human being has obtained material wealth, but this development of science and technology must contribute to the formation of well-round character as well. To harmonize the progress of advanced science and the formation of well-round character, the human being needs to use the creative wisdom.To attain this goal, Asahi University promotes specialized and comprehensive education and researches with the interdisci-plinary cooperation of natural science, human and social science, and other arts.

■ About Human IntelligenceAs we face the age of highly advanced industrial and information society, our style of living and values has been drastically changing. While we enjoy the sound development of science and technology, we must also control the runaway of such development. In this respect, Asahi University strives to foster new human intelligence to boost humanity as universal ideal to all mankind, to establish individuality, and to construct a harmonious international future society in which human rights and freedom are respected.

■ OutlineWe fully realize the importance of personal information in the highly telecommunication society. We will follow the laws and norms applicable to protect relevant personal information, and we will handle such information duly and appropriately.

■ Using Personal InformationWe will use personal information that you submit according to the applicant requirements only for the purposes of: conducting the entrance examination, admission decision, admission procedure, preparatory study, trend analysis in the entrance examination in our university and the learning guide after entrance.But we sometimes provide personal information of applicants, accepted students and enrolled students to their respective former school officials, such as teachers in their former high schools, vocational schools or Japanese-language schools by their request for counseling on the choice of college. If there is any objection to this, please contact us at the location below.

■ Disclosure of Results of Entrance ExaminationsWe cannot disclose personal information involved in results of entrance examinations in principle. If do so, it will not be beneficial to our university operations.

The mission of Asahi University is foster individuals who are rich in sociality and creativity, which are two important elements to open up the international society in the future, and rich in universal human intelligence common to all people.

The Mission of Asahi University

Asahi University’s Mission and Goal

Asahi University respects the meanings of the Basic Act of Education and the School Education Act, and aims at the following targets in accordance with the provisions of the Laws.1) Doing educational research on the theory and application of general education, special arts, and sciences, and fostering human resources with intellectual and moral culture.2) In quest of knowledge widely all over the world, aiming at international exchanges of education and scientific research and attaining the purpose of advanced education, thus making improvement in arts, sciences, and culture and contributing to the development of society.

１

The Mission of Asahi University

About Personal Information Protection

■ Definition of Personal InformationPersonal Information is defined in Article 2 of the Japanese Act on the Protection of Personal Information.

■ Contact LocationIf you have any question concerning this, please contact us at the following division:

Admission and Public Section,Asahi University

1851, Hozumi, Mizuho City, Gifu Prefecture 501-0296TEL 058-329-1088 FAX 058-329-1089

■ About SocialityThe idea of co-existence of human beings faces many problems to be solved, such as a problem of global resource and environment, a labor problem in the aging society, a problem of international economy in advanced countries, and problem of social economy in developing countries. To deal with such problems and to promote prosperity and happiness of human being, Asahi University aims to foster such individuals who have international sense and sociality, and respect harmony.

■ About CreativityThanks to the dramatic development of science and technology, the human being has obtained material wealth, but this development of science and technology must contribute to the formation of well-round character as well. To harmonize the progress of advanced science and the formation of well-round character, the human being needs to use the creative wisdom.To attain this goal, Asahi University promotes specialized and comprehensive education and researches with the interdisci-plinary cooperation of natural science, human and social science, and other arts.

■ About Human IntelligenceAs we face the age of highly advanced industrial and information society, our style of living and values has been drastically changing. While we enjoy the sound development of science and technology, we must also control the runaway of such development. In this respect, Asahi University strives to foster new human intelligence to boost humanity as universal ideal to all mankind, to establish individuality, and to construct a harmonious international future society in which human rights and freedom are respected.

■ OutlineWe fully realize the importance of personal information in the highly telecommunication society. We will follow the laws and norms applicable to protect relevant personal information, and we will handle such information duly and appropriately.

■ Using Personal InformationWe will use personal information that you submit according to the applicant requirements only for the purposes of: conducting the entrance examination, admission decision, admission procedure, preparatory study, trend analysis in the entrance examination in our university and the learning guide after entrance.But we sometimes provide personal information of applicants, accepted students and enrolled students to their respective former school officials, such as teachers in their former high schools, vocational schools or Japanese-language schools by their request for counseling on the choice of college. If there is any objection to this, please contact us at the location below.

■ Disclosure of Results of Entrance ExaminationsWe cannot disclose personal information involved in results of entrance examinations in principle. If do so, it will not be beneficial to our university operations.

The mission of Asahi University is foster individuals who are rich in sociality and creativity, which are two important elements to open up the international society in the future, and rich in universal human intelligence common to all people.

The Mission of Asahi University

Asahi University’s Mission and Goal

Asahi University respects the meanings of the Basic Act of Education and the School Education Act, and aims at the following targets in accordance with the provisions of the Laws.1) Doing educational research on the theory and application of general education, special arts, and sciences, and fostering human resources with intellectual and moral culture.2) In quest of knowledge widely all over the world, aiming at international exchanges of education and scientific research and attaining the purpose of advanced education, thus making improvement in arts, sciences, and culture and contributing to the development of society.

１

32

Purpose of Japanese Language and Culture Course

Number of student enrollment and schedule from application to enrollment

Term April Enrollment

Period of Application September 29, 2017 (Fri.) ～October 27, 2017 (Fri.)

Screening [Applicants in Japan] Documents, Interview <November 5, 2017(Sun.)>[Applicants from abroad] Documents

Announcement ofSuccessful Applicants November 17, 2017 (Fri.)

Enrollment Deadline December 5, 2017 (Tues.)

Entrance Ceremony April 2, 2018 (Mon.)

Term September Enrollment

Period of Application April 5, 2018 (Thu.) ～April 20, 2018 (Fri.)

Screening [Applicants in Japan] Documents, Interview <May 12, 2018(Sat.)>[Applicants from abroad] Documents

Announcement ofSuccessful Applicants May 25, 2018 (Fri.)

Enrollment Deadline June 13, 2018 (Wed.)

Entrance Ceremony Middle September, 2018

1

2

Admissions Process

Founded in 2001, the Asahi University Japanese Language and Culture Course aims to teach enough Japanese language to international students who desire to study at undergraduate course of our university and graduate schools in Japan.This course offers a variety of selective courses such as “Japanese Studies” and “Basic Education” as well as a compulsory course “Japanese Language.” Through these courses, international students can improve under-standing of Japanese culture and society to have a fulfilling life in Japan.Asahi University has the institution of recommending JCLP students rising to undergraduate, aiming at passing the entrance examination of spring and autumn.

The number of student enrollment is 60 ※ However, give priority to admitting students entering school in April.

Application ProceduresApplicant Requirements

（1）

（2）Those who have entered Japan having their passports, or a certification issued by their government’sdiplomatic offices and can acquire College Student status.

（3）We expect you to have a Japanese capability of at least JLPT N5.(But as to students who have reserved totake the JLPT（Japanese-Language Proficiency Test）while not yet able to submit test result materials, please submit the certification of 150 hours Japanese learning time.)

Application Documents

（1）Documents to be prepared by the applicant

Please be sure to fill in it with black ink pen or blue ink pen (you must not use pencil or ball-point pen whose words areeliminable to fill in). And the application form can't be copied double-sided, it can only be copied single-sided.

[Note]: ･Applicants who study in specialist school, community college, university, graduate school and who work in enterprises please submit your school attendance certificate or certificate of employment. ･Applicants who come to Japan for experience, please attach specific purpose of coming to Japan. ･The students who have graduated for more than 5 years please attach the study abroad reasons book written on another piece of paper.

Document Remarks

1 Application for admission (university-specified form)

Please fill out in the applicant’s own handwriting.Japanese translation must be accompanied when the document is not filled in Japanese. Be sure to attach your photo.

2 Japanese Learning Background (university-specified form)

Please submit the Japanese learning certification issued by Japanese learning institution. Please must attach the examination result or admission card for entrance examinationwhich can certify your Japanese ability (equivalent to JLPT N5 and above).

3

Final school of graduate (high school or higher educational institution, etc.) Diploma or Graduation Certificate (original), or High School Graduation Letter

Please submit the authentic act copied from original copy and Japanese translation file.For Chinese applicants, certificated document issued by a Chinese notary office is required.● Note: Please submit the copy of graduation certificate in time after graduation when you are expected to graduate.(certification issued within past 3 months)

4

Please submit the authentic act and Japanese translation file of attainment certificateoriginal copy recording grades in each academic year.For Chinese applicants, a certificated document issued by a Chinese notary office is required. ● Note: Please submit the copy of attainment certificate in time after graduation when you are expected to graduate.(certification issued within past 3 months)

Final school of graduate (high school or higher educational institution, etc.) Transcript

5 Health Certificate (university-specified form)

6

Declaration Note for Authorization of Resident Eligibility Grant Application (university-specified form)

Please fill out in the applicant’s own handwriting.Please fill out in Japanese.Please fill out without any errors; the University will make application on behalf of you according to the documents you submit. If you have a passport, submit a copy of it.

7 Photos of Applicant (five)They must be taken within 3 months before the application date (4 cm by 3 cm)Upper front body, without hat, against plain backgroundWrite your name and nationality on the back.

1

3

Other Important Information（1）Applicants must inform us about your application record of the past for Certificate of Eligibility to Immigration Bureau.（2）（3

）We do not accept any applications except during the application period.

（4））We cannot accept any applications with uncompleted documents.

（5）

（8）

When any fraud or false is found in your application documents at a later date, your admission ofentrance will be cancelled.

（6The submitted application documents will not be returned for whatever reason.

（7））Applicants may be requested to submit additional documents if necessary.You cannot apply to our courses if you were enrolled in another institution of Japanese languageeducation within Japan for more than one year. Graduates who learn JCLP (Japanese culture and language program) in Japan can't apply it.

2

Applicants must meet the following requirements (1) , (2) , (3) .Those who are 18 years of age or more and have completed a 12-year school education course outside Japan (including those who are near completion by March 31, 2018 for April enrollment and by August 31, 2018 for September enrollment) or equivalent, as recognized by the Minister of Education, Culture, Sports, Science and Technology, Japan.

32

Purpose of Japanese Language and Culture Course

Number of student enrollment and schedule from application to enrollment

Term April Enrollment

Period of Application September 29, 2017 (Fri.) ～October 27, 2017 (Fri.)

Screening [Applicants in Japan] Documents, Interview <November 5, 2017(Sun.)>[Applicants from abroad] Documents

Announcement ofSuccessful Applicants November 17, 2017 (Fri.)

Enrollment Deadline December 5, 2017 (Tues.)

Entrance Ceremony April 2, 2018 (Mon.)

Term September Enrollment

Period of Application April 5, 2018 (Thu.) ～April 20, 2018 (Fri.)

Screening [Applicants in Japan] Documents, Interview <May 12, 2018(Sat.)>[Applicants from abroad] Documents

Announcement ofSuccessful Applicants May 25, 2018 (Fri.)

Enrollment Deadline June 13, 2018 (Wed.)

Entrance Ceremony Middle September, 2018

1

2

Admissions Process

Founded in 2001, the Asahi University Japanese Language and Culture Course aims to teach enough Japanese language to international students who desire to study at undergraduate course of our university and graduate schools in Japan.This course offers a variety of selective courses such as “Japanese Studies” and “Basic Education” as well as a compulsory course “Japanese Language.” Through these courses, international students can improve under-standing of Japanese culture and society to have a fulfilling life in Japan.Asahi University has the institution of recommending JCLP students rising to undergraduate, aiming at passing the entrance examination of spring and autumn.

The number of student enrollment is 60 ※ However, give priority to admitting students entering school in April.

Application ProceduresApplicant Requirements

（1）

（2）Those who have entered Japan having their passports, or a certification issued by their government’sdiplomatic offices and can acquire College Student status.

（3）We expect you to have a Japanese capability of at least JLPT N5.(But as to students who have reserved totake the JLPT（Japanese-Language Proficiency Test）while not yet able to submit test result materials, please submit the certification of 150 hours Japanese learning time.)

Application Documents

（1）Documents to be prepared by the applicant

Please be sure to fill in it with black ink pen or blue ink pen (you must not use pencil or ball-point pen whose words areeliminable to fill in). And the application form can't be copied double-sided, it can only be copied single-sided.

[Note]: ･Applicants who study in specialist school, community college, university, graduate school and who work in enterprises please submit your school attendance certificate or certificate of employment. ･Applicants who come to Japan for experience, please attach specific purpose of coming to Japan. ･The students who have graduated for more than 5 years please attach the study abroad reasons book written on another piece of paper.

Document Remarks

1 Application for admission (university-specified form)

Please fill out in the applicant’s own handwriting.Japanese translation must be accompanied when the document is not filled in Japanese. Be sure to attach your photo.

2 Japanese Learning Background (university-specified form)

Please submit the Japanese learning certification issued by Japanese learning institution. Please must attach the examination result or admission card for entrance examinationwhich can certify your Japanese ability (equivalent to JLPT N5 and above).

3

Final school of graduate (high school or higher educational institution, etc.) Diploma or Graduation Certificate (original), or High School Graduation Letter

Please submit the authentic act copied from original copy and Japanese translation file.For Chinese applicants, certificated document issued by a Chinese notary office is required.● Note: Please submit the copy of graduation certificate in time after graduation when you are expected to graduate.(certification issued within past 3 months)

4

Please submit the authentic act and Japanese translation file of attainment certificateoriginal copy recording grades in each academic year.For Chinese applicants, a certificated document issued by a Chinese notary office is required. ● Note: Please submit the copy of attainment certificate in time after graduation when you are expected to graduate.(certification issued within past 3 months)

Final school of graduate (high school or higher educational institution, etc.) Transcript

5 Health Certificate (university-specified form)

6

Declaration Note for Authorization of Resident Eligibility Grant Application (university-specified form)

Please fill out in the applicant’s own handwriting.Please fill out in Japanese.Please fill out without any errors; the University will make application on behalf of you according to the documents you submit. If you have a passport, submit a copy of it.

7 Photos of Applicant (five)They must be taken within 3 months before the application date (4 cm by 3 cm)Upper front body, without hat, against plain backgroundWrite your name and nationality on the back.

1

3

Other Important Information（1）Applicants must inform us about your application record of the past for Certificate of Eligibility to Immigration Bureau.（2）（3

）We do not accept any applications except during the application period.

（4））We cannot accept any applications with uncompleted documents.

（5）

（8）

When any fraud or false is found in your application documents at a later date, your admission ofentrance will be cancelled.

（6The submitted application documents will not be returned for whatever reason.

（7））Applicants may be requested to submit additional documents if necessary.You cannot apply to our courses if you were enrolled in another institution of Japanese languageeducation within Japan for more than one year. Graduates who learn JCLP (Japanese culture and language program) in Japan can't apply it.

2

Applicants must meet the following requirements (1) , (2) , (3) .Those who are 18 years of age or more and have completed a 12-year school education course outside Japan (including those who are near completion by March 31, 2018 for April enrollment and by August 31, 2018 for September enrollment) or equivalent, as recognized by the Minister of Education, Culture, Sports, Science and Technology, Japan.

５４

（2）Documents to be prepared by Guarantor

Document Remarks

1Pledge and Letter of Guarantee (Letter of Guarantee of student registration) (university-specified form)

Please sign and seal the letter after filling out in the guarantor’s own handwriting.

2

Proof of residence Submit documentary evidence supporting the guarantor’s residence.Submit either one of the following documents which is applicable for the guarantor:

①For a guarantor who is Japanese and lives in Japan Certificate of residence (certification issued within past 3 months)

②For a guarantor who is non-Japanese and lives in Japan

Certificate of residence and Copy of Residence Card (two sides) (certificationissued within past 3 months)

③For a guarantor who does NOT live in Japan

Copy of Family Registration with the address (certification issued within past 6 months)For Chinese applicants, copy and submit all the pages of Family Registration andJapanese translation file.

（3）Documents to be prepared by bearer of expenses ① When the applicant’s parents or family members will send money for school and living expenses from outside Japan

Document Remarks

1 Pledge Written by the Sponsor (University-specified form)

Please make out in sponsor’s (payer’s) own handwriting.Japanese translation must be accompanied when the document is not filled in Japanese.

2 Certificate of Bank Balance

3 Certificate of Employment or Vocational Certificate

Submit an Employment Certificate indicating the location of the company and the name of the representative.If you are a company owner or proprietor, please submit a certificate indicating the sponsor (payer) and company names, for example “a copy of the registration.”(certification issued within past 3 months)

4 Salary Certificate Submit documentary evidence supporting sponsor’s (payer’s) personal income.(certification issued within past 3 months)

5 Certificate of tax payment Please submit the personal certification materials of tax payment which cancertify the payer (remitter) himself.(certification issued within past 3 months)

6Documentary evidence supporting a parent-child relationship or kinship

Please submit the authentic act copied from Birth Certificate and FamilyRegistration and Japanese translation file.(certification issued within past 3 months)

② When a Japan resident will pay the school and living expenses for the studentDocument Remarks

1 Pledge Written by the Sponsor (university-specified form)

Please sign and seal after filling out in sponsor’s own handwriting.Japanese translation must be accompanied when the document is not filled in Japanese.

2

Documentary Evidence Supporting Annual Income of the Sponsor for Expenses

Submit one of following documents:(certification issued within past 3 months)

① Certificate of Municipal & Prefectural Inhabitants Tax Must state the amount of income and the number of dependent relatives

② Tax Payment Certificate issued by the tax authorities (No.1) and (No.2)

③ If the applicant will pay the school and living expenses by him or herselfDocument Remarks

1 Certificate of Bank Balance Submit a certificate of bank balance in applicant’s own name, with the amount of available in school and living expenses. (certification issued within past 3 months)

2 Salary Certificate or Tax payment Certificate

Submit documentary evidence supporting the applicant’s personal income.(certification issued within past 3 months)

3 Certificate related Scholarship Benefits

When you receive a scholarship, submit documentary evidence supporting the amount of money and the period of payment.

Application Fee:20,000yen (Please send money after all application documents have been prepared.) （1）Remittances within Japan

With our specified transfer form filled out completely, transfer the application fee from your convenient financial

institution no later than the application deadline. And the transfer certification of fee which can certify the moneyhas been remitted is stamped by on the reverse of the application.The fee charged for cash transfer should be borne by each applicant.

4

（4）OthersThe university will apply "Certificate of Eligibility for a Status of Residence" to Nagoya Regional Immigration Bureau on behalf of successful applicants. Please be informed that we will submit some of your application documents for the above application if necessary.We have no responsibility if your "Certificate of Eligibility for a Status of Residence" is not issued by the Ministry of Justice, which is the responsible authorities.

（2）Remittances from outside of Japan① Transfer the application fee of 20,000 yen (Japanese Yen) to a designated account under the name of the

applicant. The fee charged for the cash transfer should be borne by each applicant. We will pay the fee charged at a bank in Japan for the cash transfer from each applicant.

② Paste a copy of the transfer certification of application fee stamped by on the reverse of the application.③ Keep the receipt for application fee as your proof. (No need to submit)

（3）Application Fee transfer accountTransfer to : The Ogaki Kyoritsu Bank, Hozumi Branch(Address : 632-2 Beppu, Mizuho, Gifu. 501-0222 JAPAN)Deposit Item : Ordinary depositAccount-number : 86596The Recipient's Account Name

: Asahi University educational foundation

SWIFT code : OGAKJPJT

（4）The application fee of 20,000yen is non-refundable.

・The Ministry of Justice abolished the guarantor system in April 1997, however, we request a guarantor for each applicant same as before.

・The requirements for a guarantor are as below:① A guarantor should be a father or a mother in principle. A guarantor must be a person who can assume all

responsibilities for the personal conducts and financial obligations of a student while enrolled at Asahi UniversityJapanese Language and Culture Course.

② A guarantor can be an adult relative or a friend who supports himself/herself when he or she can pursue theresponsibilities mentioned above.

③ It does not matter whether the guarantor lives in Japan or not. And it is acceptable that a person doubles as a guarantor and a sponsor.

Submit a bank certificate balance in sponsor’s (payer’s) own name, with the amount available in school and living expenses. (The original of certificate of deposit and duplicate of the receipt need to be submitted for China’s admission application.)(certification issued within past 3 months)

５４

（2）Documents to be prepared by Guarantor

Document Remarks

1Pledge and Letter of Guarantee (Letter of Guarantee of student registration) (university-specified form)

Please sign and seal the letter after filling out in the guarantor’s own handwriting.

2

Proof of residence Submit documentary evidence supporting the guarantor’s residence.Submit either one of the following documents which is applicable for the guarantor:

①For a guarantor who is Japanese and lives in Japan Certificate of residence (certification issued within past 3 months)

②For a guarantor who is non-Japanese and lives in Japan

Certificate of residence and Copy of Residence Card (two sides) (certificationissued within past 3 months)

③For a guarantor who does NOT live in Japan

Copy of Family Registration with the address (certification issued within past 6 months)For Chinese applicants, copy and submit all the pages of Family Registration andJapanese translation file.

（3）Documents to be prepared by bearer of expenses ① When the applicant’s parents or family members will send money for school and living expenses from outside Japan

Document Remarks

1 Pledge Written by the Sponsor (University-specified form)

Please make out in sponsor’s (payer’s) own handwriting.Japanese translation must be accompanied when the document is not filled in Japanese.

2 Certificate of Bank Balance

3 Certificate of Employment or Vocational Certificate

Submit an Employment Certificate indicating the location of the company and the name of the representative.If you are a company owner or proprietor, please submit a certificate indicating the sponsor (payer) and company names, for example “a copy of the registration.”(certification issued within past 3 months)

4 Salary Certificate Submit documentary evidence supporting sponsor’s (payer’s) personal income.(certification issued within past 3 months)

5 Certificate of tax payment Please submit the personal certification materials of tax payment which cancertify the payer (remitter) himself.(certification issued within past 3 months)

6Documentary evidence supporting a parent-child relationship or kinship

Please submit the authentic act copied from Birth Certificate and FamilyRegistration and Japanese translation file.(certification issued within past 3 months)

② When a Japan resident will pay the school and living expenses for the studentDocument Remarks

1 Pledge Written by the Sponsor (university-specified form)

Please sign and seal after filling out in sponsor’s own handwriting.Japanese translation must be accompanied when the document is not filled in Japanese.

2

Documentary Evidence Supporting Annual Income of the Sponsor for Expenses

Submit one of following documents:(certification issued within past 3 months)

① Certificate of Municipal & Prefectural Inhabitants Tax Must state the amount of income and the number of dependent relatives

② Tax Payment Certificate issued by the tax authorities (No.1) and (No.2)

③ If the applicant will pay the school and living expenses by him or herselfDocument Remarks

1 Certificate of Bank Balance Submit a certificate of bank balance in applicant’s own name, with the amount of available in school and living expenses. (certification issued within past 3 months)

2 Salary Certificate or Tax payment Certificate

Submit documentary evidence supporting the applicant’s personal income.(certification issued within past 3 months)

3 Certificate related Scholarship Benefits

When you receive a scholarship, submit documentary evidence supporting the amount of money and the period of payment.

Application Fee:20,000yen (Please send money after all application documents have been prepared.) （1）Remittances within Japan

With our specified transfer form filled out completely, transfer the application fee from your convenient financial

institution no later than the application deadline. And the transfer certification of fee which can certify the moneyhas been remitted is stamped by on the reverse of the application.The fee charged for cash transfer should be borne by each applicant.

4

（4）OthersThe university will apply "Certificate of Eligibility for a Status of Residence" to Nagoya Regional Immigration Bureau on behalf of successful applicants. Please be informed that we will submit some of your application documents for the above application if necessary.We have no responsibility if your "Certificate of Eligibility for a Status of Residence" is not issued by the Ministry of Justice, which is the responsible authorities.

（2）Remittances from outside of Japan① Transfer the application fee of 20,000 yen (Japanese Yen) to a designated account under the name of the

applicant. The fee charged for the cash transfer should be borne by each applicant. We will pay the fee charged at a bank in Japan for the cash transfer from each applicant.

② Paste a copy of the transfer certification of application fee stamped by on the reverse of the application.③ Keep the receipt for application fee as your proof. (No need to submit)

（3）Application Fee transfer accountTransfer to : The Ogaki Kyoritsu Bank, Hozumi Branch(Address : 632-2 Beppu, Mizuho, Gifu. 501-0222 JAPAN)Deposit Item : Ordinary depositAccount-number : 86596The Recipient's Account Name

: Asahi University educational foundation

SWIFT code : OGAKJPJT

（4）The application fee of 20,000yen is non-refundable.

・The Ministry of Justice abolished the guarantor system in April 1997, however, we request a guarantor for each applicant same as before.

・The requirements for a guarantor are as below:① A guarantor should be a father or a mother in principle. A guarantor must be a person who can assume all

responsibilities for the personal conducts and financial obligations of a student while enrolled at Asahi UniversityJapanese Language and Culture Course.

② A guarantor can be an adult relative or a friend who supports himself/herself when he or she can pursue theresponsibilities mentioned above.

③ It does not matter whether the guarantor lives in Japan or not. And it is acceptable that a person doubles as a guarantor and a sponsor.

Submit a bank certificate balance in sponsor’s (payer’s) own name, with the amount available in school and living expenses. (The original of certificate of deposit and duplicate of the receipt need to be submitted for China’s admission application.)(certification issued within past 3 months)

７６

How to Submit your ApplicationFirst, ensure that application documents have been completed. Next, transfer the application fee to our designated account and enclose all the application documents (prepared by an applicant, guarantor and sponsor) in an envelope, and mail it (need to be delivered by the deadline) or bring it to the Admission and Public Relations, Asahi University in person.（1） By mail

① If posting in Japan, send it by recorded delivery. ② If posting out of Japan, send it by Express mail Service (EMS).* We will not hold responsibility for problems with mail delivery.* Be sure to keep copies of documents you submit with you.

（2）Direct bringing inThe application will be accepted at the Admission and Public Relations as follows:

Monday to Friday 9:00～16:00 Saturday 9:00～12:00 Closed on Sundays, public holidays.

5

Where to Submit your ApplicationAdmission and Public Relations, Asahi University1851 Hozumi, Mizuho-city, Gifu Prefecture 501-0296

6

1 How to SelectSelection will be done on the basis of application documents. An interview will be held for applicants in Japan.

2 Announcement of Successful ApplicantsWe will notify you of your acceptance or non-acceptance into the Course by written document to be mailed to applicant.We cannot answer any inquires, except for the above, such as telephone.

Accepted applicants should submit required documents, pay tuition and fees, and complete the enrollment procedures according to the posted "enrollment guidance" by the enrollment deadline mentioned below.

1 Enrollment DeadlineEach enrollment deadline in April and September is set out in the “enrollment information”, which will be delivered to accepted students.

Enrollment

Selection

2 Required Documents2 documents to confirm the eligibility to stay in Japan ………… 1 of each

（1） A copy of Passport（2） A copy of resident card (two sides)

※ Applicants living in Japan should submit these required documents no later than the enrollment deadline.In case of any changes in your residential status, period of stay, and address after submitting the above document, you should resubmit renewals as soon as possible.When you applying from outside of Japan, take the necessary procedures soon after your entry to Japan and submit the above 3 documents no later than the entrance ceremony day.

3 Tuition and Fees（1）Tuition and Fees

Term Enrollment(April/September) Second Term Total

Payment PeriodExpenses Items

Enrollment Period

(Students Enrolled in April) :September(Students Enrolled in September) : April

-

SchoolExpenses

Admission Fee 100,000yen - 100,000yen

Tuition 225,000yen 225,000yen 450,000yen

Other Costs Student Insurance Fee 3,500yen - 3,500yen

Total 328,500yen 225,000yen 553,500yen

※Teaching-materials expense is not included in the tuition fee.

①“One-year Course”

Term Enrollment(April/September) Second Term Total

Payment PeriodExpenses Items

Enrollment Period

(Students Enrolled in April) :September(Students Enrolled in September) : April

-

SchoolExpenses

Admission Fee 100,000yen - 100,000yen

Tuition 225,000yen 225,000yen 675,000yen

Other Costs Student Insurance Fee 3,500yen - 5,250yen

Total 328,500yen 225,000yen

Third Term

(Students Enrolled in April ):April(Students Enrolled in September) : September

-

225,000yen

1,750yen

226,750yen 780,250yen

※Teaching-materials expense is not included in the tuition fee.

②“One-year-and-a-half Course”

（2）How to pay Tuition and Fees①Remittance in Japan　With our specified transfer form filled out completely, transfer the application fee from your convenient financial institution no later than the enrollment deadline.The fee charged for the cash transfer should be borne by each applicant.

②Remittance from outside of JapanRemit the school expenses and fees (328,500 yen) to our designated account under the name of the applicant no later than the date of the enrollment deadline.The fee charged for cash transfer should be borne by each applicant. We will pay the fee charged at a bank in Japan for the cash transfer from each applicant.

③Tuition and fees transfer accountTransfer to : The Ogaki Kyoritsu Bank, Hozumi Branch(Adress : 632-2 Beppu, Mizuho, Gifu. 501-0222 JAPAN)Deposit Item : Ordinary depositAccount-number : 86596The Recipient's Account Name

: Asahi University educational foundation

SWIFT code : OGAKJPJT

4 Other Important Information（1）We cannot accept uncompleted documents.（2）When any fraud or false is found in your enrollment documents at a later date, your admission of entrance will be

cancelled.（3）In the case where you don't finish all your enrollment procedures after the enrollment deadline, you are regarded as

having withdrawn from the admission into our University.（4）The tuition and fees are non-refundable except as follows: Your Certificate of Eligibility is not issued by the Japanese

authorities or you are not permitted to leave your country.（5）Any delay of your enrollment procedures should be informed us during the enrollment period.

We cannot accept any delay unless you inform us of the reason before the enrollment deadline.

７６

How to Submit your ApplicationFirst, ensure that application documents have been completed. Next, transfer the application fee to our designated account and enclose all the application documents (prepared by an applicant, guarantor and sponsor) in an envelope, and mail it (need to be delivered by the deadline) or bring it to the Admission and Public Relations, Asahi University in person.（1） By mail

① If posting in Japan, send it by recorded delivery. ② If posting out of Japan, send it by Express mail Service (EMS).* We will not hold responsibility for problems with mail delivery.* Be sure to keep copies of documents you submit with you.

（2）Direct bringing inThe application will be accepted at the Admission and Public Relations as follows:

Monday to Friday 9:00～16:00 Saturday 9:00～12:00 Closed on Sundays, public holidays.

5

Where to Submit your ApplicationAdmission and Public Relations, Asahi University1851 Hozumi, Mizuho-city, Gifu Prefecture 501-0296

6

1 How to SelectSelection will be done on the basis of application documents. An interview will be held for applicants in Japan.

2 Announcement of Successful ApplicantsWe will notify you of your acceptance or non-acceptance into the Course by written document to be mailed to applicant.We cannot answer any inquires, except for the above, such as telephone.

Accepted applicants should submit required documents, pay tuition and fees, and complete the enrollment procedures according to the posted "enrollment guidance" by the enrollment deadline mentioned below.

1 Enrollment DeadlineEach enrollment deadline in April and September is set out in the “enrollment information”, which will be delivered to accepted students.

Enrollment

Selection

2 Required Documents2 documents to confirm the eligibility to stay in Japan ………… 1 of each

（1） A copy of Passport（2） A copy of resident card (two sides)

※ Applicants living in Japan should submit these required documents no later than the enrollment deadline.In case of any changes in your residential status, period of stay, and address after submitting the above document, you should resubmit renewals as soon as possible.When you applying from outside of Japan, take the necessary procedures soon after your entry to Japan and submit the above 3 documents no later than the entrance ceremony day.

3 Tuition and Fees（1）Tuition and Fees

Term Enrollment(April/September) Second Term Total

Payment PeriodExpenses Items

Enrollment Period

(Students Enrolled in April) :September(Students Enrolled in September) : April

-

SchoolExpenses

Admission Fee 100,000yen - 100,000yen

Tuition 225,000yen 225,000yen 450,000yen

Other Costs Student Insurance Fee 3,500yen - 3,500yen

Total 328,500yen 225,000yen 553,500yen

※Teaching-materials expense is not included in the tuition fee.

①“One-year Course”

Term Enrollment(April/September) Second Term Total

Payment PeriodExpenses Items

Enrollment Period

(Students Enrolled in April) :September(Students Enrolled in September) : April

-

SchoolExpenses

Admission Fee 100,000yen - 100,000yen

Tuition 225,000yen 225,000yen 675,000yen

Other Costs Student Insurance Fee 3,500yen - 5,250yen

Total 328,500yen 225,000yen

Third Term

(Students Enrolled in April ):April(Students Enrolled in September) : September

-

225,000yen

1,750yen

226,750yen 780,250yen

※Teaching-materials expense is not included in the tuition fee.

②“One-year-and-a-half Course”

（2）How to pay Tuition and Fees①Remittance in Japan　With our specified transfer form filled out completely, transfer the application fee from your convenient financial institution no later than the enrollment deadline.The fee charged for the cash transfer should be borne by each applicant.

②Remittance from outside of JapanRemit the school expenses and fees (328,500 yen) to our designated account under the name of the applicant no later than the date of the enrollment deadline.The fee charged for cash transfer should be borne by each applicant. We will pay the fee charged at a bank in Japan for the cash transfer from each applicant.

③Tuition and fees transfer accountTransfer to : The Ogaki Kyoritsu Bank, Hozumi Branch(Adress : 632-2 Beppu, Mizuho, Gifu. 501-0222 JAPAN)Deposit Item : Ordinary depositAccount-number : 86596The Recipient's Account Name

: Asahi University educational foundation

SWIFT code : OGAKJPJT

4 Other Important Information（1）We cannot accept uncompleted documents.（2）When any fraud or false is found in your enrollment documents at a later date, your admission of entrance will be

cancelled.（3）In the case where you don't finish all your enrollment procedures after the enrollment deadline, you are regarded as

having withdrawn from the admission into our University.（4）The tuition and fees are non-refundable except as follows: Your Certificate of Eligibility is not issued by the Japanese

authorities or you are not permitted to leave your country.（5）Any delay of your enrollment procedures should be informed us during the enrollment period.

We cannot accept any delay unless you inform us of the reason before the enrollment deadline.

８８

Process Chart from Application to Entrance into Japan

You need to have a "Certificate of Eligibility for a Status of Residence" and a "Visa" to enter Japan for the purpose of study. We will file applications for "Certificate of Eligibility for a Status of Residence" which is needed to obtain a "visa" at the Nagoya Regional Immigration Bureau on behalf of successful applicants. When you don't have a passport, you should get one according to the process of your country soon after you are notified of your acceptance into our Course.Each applicant already living in Japan should pursue the necessary procedures to change the status of residence, the period of stay, or the address, if necessary.

1

Entry into Japan with "Certificate of Eligibility for a Status of Residence"

* Date of Arrival in Japan New students must arrive in Japan before the following date respectively; otherwise they will not have sufficient days of attendance required for regular examinations. April enrollment: April 15September enrollment: October 15

1

2

3

4

5

ScholarshipAsahi University establishes a scholarship for the students in Japanese Language and Culture Course.By screening students who are in good personalities and achieved excellent academic records at the end of their first term, we award a scholarship to eligibles of monthly 50,000yen for 6 months.The number of awardable students is up to 5.

Living expensesIn the metropolitan areas of Tokyo, Osaka and Nagoya, the cost of living is very high and reaches about 100,000 yen to 130,000 yen per month including housing. On the other hand, it goes down to around 80,000 yen in Mizuho-city where Asahi University located. You should take this into consideration when preparing your living fund in school.

HousingWe take on lease an private apartment building for students of Asahi University Japanese Language and Culture Course.Mark "Yes" on the item of your application form (for admission) when you want to lease a room.　●Asahi University Foreign Student Dormitory (1 student per room in principle)　　Monthly rent : Approx. 28,000 ～ 30,000 yen (excluding light, fuel and water expenses)

Medical-Expenses Support（1）National Health Insurance (compulsory for every student. Subscribe at a public office of your residence.)

This is a medical care insurance to cover medical expenses to take a medical treatment without financial burden when you suffer from illness or injury. All foreigners who stay in Japan more than one year have to subscribe to the National Health Insurance.You need to pay a premium when you subscribe, and your charge will be reduced to 30% of medical expenseswhen you receive medical services.Once you join the National Health Insurance, you can benefit from the medical expenses supports mentionedbelow.

（2）Medical Fee Support (Asahi University)In our university, there are the 3 medical institutions: the University Hospital, the University Murakami Memorial Hospital, and the PDI Gifu Dental Clinic. When you suffer from illness or injury and pay medical fees for your treatment in our attached hospitals, we will support all the expense you paid for a health insurance treatment.

Part-time EmploymentInternational students are allowed to work up to 28 hours a week (within 8 hours a day during a long vacation) by permission of the authorities. Students who want to work should contact the Educational Affair 2 for advice. Asahi University Japanese and Culture Courses guide students to concentrate on their schoolwork without part-time employment for the first half year. Before leaving your country, make sure that you have sufficient funds available in school plus living expenses.

Living Guide

screening

The status the

will be a

Send the Certificate of Eligibility for a Status of Residence and Certificate of Admission to the applicants

Final school of graduate (high school or higher

Final school of graduate (high school or higher

Final school of graduate (high school or

Final school of graduate (high school or higher educational institution, etc.)

Final school of graduate (high school or higher

Final school of graduate (high school or

educational institution, etc.)

higher educational institution, etc.)

and Copy of Passport and ID

educational institution, etc.)

higher educational institution, etc.)

A Copy of a Japanese capability of at least JLPT N5 (150 hours of Japaneselearning time)

注）大学を卒業または卒業見込みの者は、大学の成績証明書も提出してください。

Note: Submit an academic transcript from the university the applicant graduated from, or an academic transcript that states when you are expected to graduate.

日本語能力試験Ｎ5（日本語学習時間150時間）相当以上の日本語能力を有することを証明できる書類

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

educational institution, etc.)

およびパスポートの写しと身分証明書の写し

Pledge and Letter of Guarantee (Letter of Guarantee of student registration)

Family Registration

(The original of certificate of deposit and duplicate of

A copy of resident card (two sides)在留カードの両面の写し

Resident Card住民票

given

（＋　 　）の原本（中国の場合は存款証明（原本）及び存単（コピー））

（出生証明書、戸籍一覧）

the receipt need to be submitted for China’s admission application.)

(Birth Certificate and Family Registration)

氏名

出生地Place of birth

１年コース　　　　　　　１年半コース

7.留学生別科入学希望コースについて（該当欄に○印を記入すること）

Entrance Course (Circle the appropriate one.)

One-year Course One-year-and-a-half Course

Pledge and Letter of Guarantee (Letter of Guarantee of student registration)

Family Registration

(The original of certificate of deposit and duplicate of

A copy of resident card (two sides)在留カードの両面の写し

Resident Card住民票

given

（＋　 　）の原本（中国の場合は存款証明（原本）及び存単（コピー））

（出生証明書、戸籍一覧）

the receipt need to be submitted for China’s admission application.)

(Birth Certificate and Family Registration)

氏名

出生地Place of birth

１年コース　　　　　　　１年半コース

7.留学生別科入学希望コースについて（該当欄に○印を記入すること）

Entrance Course (Circle the appropriate one.)

One-year Course One-year-and-a-half Course

ElementaryEducation

ElementarySchool

SecondaryEducation

Lower andUpper

SecondarySchool

HigherEducation

UndergraduateLevel

Other,JapaneseLanguage

Schools etc.

Name of SchoolOfficially RequiredYears of Schooling Year and Month of Entering and Leaving

(Name)

(Total of the schooling years mentioned above)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Educational Background

Please attach a separate sheet if you need additional space.※

month and year.※

※上欄に書ききれない場合には、適当な用紙に記入して貼付すること。※卒業見込の場合は、卒業年月日欄に「見込」と記入すること

その他日本語学習機関等

入学及び卒業年月

Employment Record

From

To

From

To

From

To

(Name and Address of Organization) (Period of Employment) (Type of Work)

(Father)

(Mother)

(Spouse)

(Name) (Relationship) (Age) (Occupation) (Address)

Family Background

Military Service

Date of Entry

Duty to be completed on or about

Others

(date)

(date)

How did you learn about Asahi University?

9.

10.

11.

12.

8.

ElementaryEducation

ElementarySchool

SecondaryEducation

Lower andUpper

SecondarySchool

HigherEducation

UndergraduateLevel

Other,JapaneseLanguage

Schools etc.

Name of SchoolOfficially RequiredYears of Schooling Year and Month of Entering and Leaving

(Name)

(Total of the schooling years mentioned above)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(yrs)

(Name)

(yrs)

(Name)

(yrs)

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

(From)

(To) Year

Year

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Month

Educational Background

Please attach a separate sheet if you need additional space.※

month and year.※

※上欄に書ききれない場合には、適当な用紙に記入して貼付すること。※卒業見込の場合は、卒業年月日欄に「見込」と記入すること

その他日本語学習機関等

入学及び卒業年月

Employment Record

From

To

From

To

From

To

(Name and Address of Organization) (Period of Employment) (Type of Work)

(Father)

(Mother)

(Spouse)

(Name) (Relationship) (Age) (Occupation) (Address)

Family Background

Military Service

Date of Entry

Duty to be completed on or about

Others

(date)

(date)

How did you learn about Asahi University?

9.

10.

11.

12.

8.

Next stage of your education after the course, (if any)

Graduate School

College or University

College or University

Others

Why did you decide to study Japanese at Asahi University Japanese Language and Culture Course?Please make an entry of your studying abroad purpose definitely.

Would you like to get a room in an apartment for foreign students of Asahi University during your stay in school?Circle the appropriate one.

I hereby declare, upon my honor, the above is true and correct statement.

Yes No

Date of Application

Applicant's Name Applicant's Signature

Person to be notified in applicant's home country, in case of emergency

Occupation

Relationship

Name in Full

Present Address

Telephone Number

あなたはどうして朝日大学留学生別科で日本語を勉強しようと思いましたか。 留学目的を明確に記入してください。

＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊

Enter the name in Chinese characters, if applicable.

All items below must be completed by your Japanese language teacher.The teacher must acknowledge that this form is critical for us to determine your Japanese language proficiency. You make sure to assess and complete it accurately and properly.

School name where the applicant was educated

Total hours and period the applicant is educated

ge proficiency:

※Please attach documentary evidence issued by the Japanese language educational institute, for example a certificate for completing and an academic transcript.

Location

Last Name First Name

Country

〈Teacher to be notified〉

Phone Number

Date

Postcode

Fax Number

Signature

Address

Excellent PoorVery Good Good Fair

hours year month year month

Ask your Japanese-language teacher to complete this form, and attach it to your application.

Japanese Learning Background

Last Name

First Name

Japanese language teacher Occupation (position)

日本語教育に携わる教員に作成を依頼し、願書に同封してください。

志願者氏名をアルファベットで記入してください。

漢字表記がある者は記入してください。

以下は指導教員が記入してください。

この書類は、志願者の言語能力を示す重要な書類です。志願者の言語能力を正確かつ厳密に査定し、ご記入下さい。

時間

※日本語教育機関の修了証明書、成績証明書等を添付してください。

（1）極めて優れている

在住国名

〈指導教員の連絡先〉

電話番号

日　　付

郵便番号

F A X

署　　名

住　　所

（5）劣る（2）優れている （3）良い （4）平均的

日本語能力について、該当する評価を○で囲んでください。

年 月 年 月

指導教員氏名

志願者が日本語教育を受けた学校名

日本語の総授業時間数及び日本語教育を受けた期間

所在地

職業（身分）

～

日 本 語 学 習 歴

姓

姓 名

名

印

applicant's

applicant's

seal

13.

14.

15.

16.

Next stage of your education after the course, (if any)

Graduate School

College or University

College or University

Others

Why did you decide to study Japanese at Asahi University Japanese Language and Culture Course?Please make an entry of your studying abroad purpose definitely.

Would you like to get a room in an apartment for foreign students of Asahi University during your stay in school?Circle the appropriate one.

I hereby declare, upon my honor, the above is true and correct statement.

Yes No

Date of Application

Applicant's Name Applicant's Signature

Person to be notified in applicant's home country, in case of emergency

Occupation

Relationship

Name in Full

Present Address

Telephone Number

あなたはどうして朝日大学留学生別科で日本語を勉強しようと思いましたか。 留学目的を明確に記入してください。

＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊＊

Enter the name in Chinese characters, if applicable.

All items below must be completed by your Japanese language teacher.The teacher must acknowledge that this form is critical for us to determine your Japanese language proficiency. You make sure to assess and complete it accurately and properly.

School name where the applicant was educated

Total hours and period the applicant is educated

ge proficiency:

※Please attach documentary evidence issued by the Japanese language educational institute, for example a certificate for completing and an academic transcript.

Location

Last Name First Name

Country

〈Teacher to be notified〉

Phone Number

Date

Postcode

Fax Number

Signature

Address

Excellent PoorVery Good Good Fair

hours year month year month

Ask your Japanese-language teacher to complete this form, and attach it to your application.

Japanese Learning Background

Last Name

First Name

Japanese language teacher Occupation (position)

日本語教育に携わる教員に作成を依頼し、願書に同封してください。

志願者氏名をアルファベットで記入してください。

漢字表記がある者は記入してください。

以下は指導教員が記入してください。

この書類は、志願者の言語能力を示す重要な書類です。志願者の言語能力を正確かつ厳密に査定し、ご記入下さい。

時間

※日本語教育機関の修了証明書、成績証明書等を添付してください。

（1）極めて優れている

在住国名

〈指導教員の連絡先〉

電話番号

日　　付

郵便番号

F A X

署　　名

住　　所

（5）劣る（2）優れている （3）良い （4）平均的

日本語能力について、該当する評価を○で囲んでください。

年 月 年 月

指導教員氏名

志願者が日本語教育を受けた学校名

日本語の総授業時間数及び日本語教育を受けた期間

所在地

職業（身分）

～

日 本 語 学 習 歴

姓

姓 名

名

印

applicant's

applicant's

seal

13.

14.

15.

16.

Pulse Rate /min

Eye SightRightLeft

Right

Measurements

Present Address

Date of Examination

Nationality

Name of Applicant

(Family Name) (First Name) (Middle Name)

Date of Birth AgeSex

Left

Without Glasses Correction

Height Weight

Color Blindness Hearing

Blood Pressure m/Hg～

cm

m/Hg

(Month) (Day) (Year)

(Month) (Day) (Year)kg

/min

Chest X-ray Date (Month) (Day) (Year)

If there is any need for further and/or follow-up observation and/or treatment, specify.

General state of physical condition (Circle the appropriate one)

Date(Month) (Day) (Year)

Findings

Protein

Microscopic

Occult Blood Glucose

Urinalysis

PoorFairGoodExcellent

If there is any significant matter in family medical history, specify.

Signature of Physician

Name (Type or Print)

Name and Address of Medical Facility

Remarks

Date of Report(Month) (Day) (Year)

HEALTH CERTIFICATE健 康 証 明 書

身長 体重

視力 裸眼 矯正 色覚異常の有無 聴力

脈拍数 血圧

胸部X線検査 施行日

蛋白質

検尿 施行日

所見

鏡検所見

血尿 ブドウ糖

今後引き続き又はさらに精密な検査あるいは治療を必要とする場合は必要事項を記入すること。

総括的健康状態（◯印をつけること）

家族病歴に特記すべき事項があれば記入すること。

医師署名

医師名（タイプ又は活字体）

備考

医療機関名及び所在地

診断日

不良可良優

Pulse Rate /min

Eye SightRightLeft

Right

Measurements

Present Address

Date of Examination

Nationality

Name of Applicant

(Family Name) (First Name) (Middle Name)

Date of Birth AgeSex

Left

Without Glasses Correction

Height Weight

Color Blindness Hearing

Blood Pressure m/Hg～

cm

m/Hg

(Month) (Day) (Year)

(Month) (Day) (Year)kg

/min

Chest X-ray Date (Month) (Day) (Year)

If there is any need for further and/or follow-up observation and/or treatment, specify.

General state of physical condition (Circle the appropriate one)

Date(Month) (Day) (Year)

Findings

Protein

Microscopic

Occult Blood Glucose

Urinalysis

PoorFairGoodExcellent

If there is any significant matter in family medical history, specify.

Signature of Physician

Name (Type or Print)

Name and Address of Medical Facility

Remarks

Date of Report(Month) (Day) (Year)

HEALTH CERTIFICATE健 康 証 明 書

身長 体重

視力 裸眼 矯正 色覚異常の有無 聴力

脈拍数 血圧

胸部X線検査 施行日

蛋白質

検尿 施行日

所見

鏡検所見

血尿 ブドウ糖

今後引き続き又はさらに精密な検査あるいは治療を必要とする場合は必要事項を記入すること。

総括的健康状態（◯印をつけること）

家族病歴に特記すべき事項があれば記入すること。

医師署名

医師名（タイプ又は活字体）

備考

医療機関名及び所在地

診断日

不良可良優

Declaration Note for Authorization of Resident Eligibility Grant Application

Last NameName First Name

Male Female

Married Single

Nationality

Sex

Material Status

most recently: 年　　　月　　　日 年　　　月　　　日～year/month/day year/month/day

year/month/day

～

Number of times:Have you previously entered Japan?

Residence

Yes

Number:Do you have a valid passport?

Yes Effective period: 年　　　月　　　日

No

No

According to the form, the university will apply for Authorization of Resident Eligibility to Nagoya Regional Immigration Bureau on behalf of the student. Complete it correctly without any errors.

この書類を元に、名古屋入国管理局に在留資格認定証明書の交付申請を行います。虚偽のないよう、記入してください。

1. 姓氏名 名

2.

男

国籍

4. 性別

6. 配偶者

直近の出入国歴：（ ）

回数： 回（ ）9.

10.

日本への過去出入国歴

year/month/dayBirth of Date 年 月 日

3. 生年月日

Birth of Place5. 出生地

7. 現在の居住地

有

無

□

番号：（ ）8. 有効な旅券 有□ 有効期限：（ ）

□

無□

女

有 無

在 留 資 格 認 定 証 明 書 交 付申請 に 係る申告 票

●

●強制退去又は出国命令による出国の有無Do you have the experience of deportation or being ordered to leave the county?

If there is the time of choosing“Yes” Number of times The last time of deportation experience Year/month/day

Null

上記で「有」を選択した場合　　 回数　　　　回　　直近の送還歴 年　　　月　　　日

your passport.※「8」で有効な旅券を「有」と答えた方は、旅券のすべてのページのコピーを添付してください。※

Declaration Note for Authorization of Resident Eligibility Grant Application

Last NameName First Name

Male Female

Married Single

Nationality

Sex

Material Status

most recently: 年　　　月　　　日 年　　　月　　　日～year/month/day year/month/day

year/month/day

～

Number of times:Have you previously entered Japan?

Residence

Yes

Number:Do you have a valid passport?

Yes Effective period: 年　　　月　　　日

No

No

According to the form, the university will apply for Authorization of Resident Eligibility to Nagoya Regional Immigration Bureau on behalf of the student. Complete it correctly without any errors.

この書類を元に、名古屋入国管理局に在留資格認定証明書の交付申請を行います。虚偽のないよう、記入してください。

1. 姓氏名 名

2.

男

国籍

4. 性別

6. 配偶者

直近の出入国歴：（ ）

回数： 回（ ）9.

10.

日本への過去出入国歴

year/month/dayBirth of Date 年 月 日

3. 生年月日

Birth of Place5. 出生地

7. 現在の居住地

有

無

□

番号：（ ）8. 有効な旅券 有□ 有効期限：（ ）

□

無□

女

有 無

在 留 資 格 認 定 証 明 書 交 付申請 に 係る申告 票

●

●強制退去又は出国命令による出国の有無Do you have the experience of deportation or being ordered to leave the county?

If there is the time of choosing“Yes” Number of times The last time of deportation experience Year/month/day

Null

上記で「有」を選択した場合　　 回数　　　　回　　直近の送還歴 年　　　月　　　日

your passport.※「8」で有効な旅券を「有」と答えた方は、旅券のすべてのページのコピーを添付してください。※

When I am admitted to your university, I will pledge myself to observe the code of the school and other regulations, and make the payment of school expenses and tuition.I will submit to any reprimand if I break these regulations and never complain about it.

be usedseal to

Letter of Guarantee (Letter of Guarantee of student registration)在 学 保 証 書 （身元保証書）

seal

seal

seal

seal

在留カード番号Residence Card number特別永住者証明書番号Special Permanent Resident Certificate number

Submit copy of ID.14. 身分証明書のコピーを添付してください。

13.

12.

11.

When I am admitted to your university, I will pledge myself to observe the code of the school and other regulations, and make the payment of school expenses and tuition.I will submit to any reprimand if I break these regulations and never complain about it.

be usedseal to

Letter of Guarantee (Letter of Guarantee of student registration)在 学 保 証 書 （身元保証書）

seal

seal

seal

seal

在留カード番号Residence Card number特別永住者証明書番号Special Permanent Resident Certificate number

Submit copy of ID.14. 身分証明書のコピーを添付してください。

13.

12.

11.

志願者氏名

の

Applicant’s Name

志願者氏名

の

Applicant’s Name

材料确认表

申请人姓名

为了确认随信寄来的材料等，请在必要处打　。

申请材料

入学申请人本人应准备的材料

随信附上

填写例

事务确认栏（请不要填写）

入学申请书【本校所定用纸】

日语学习经历【本校所定用纸】

最终毕业学校(高中或高等教育机构等)的毕业证明书或毕业预定证明书的公证书

最终毕业学校(高中或高等教育机构等)的毕业证明书或毕业预定证明书的公证书的日语翻译

最终毕业学校(高中或高等教育机构等)的成绩证明书

最终毕业学校(高中或高等教育机构等)的成绩证明书的公证书

健康证明书【本校所定用纸】（请在背面贴上入学报名费的汇款通知书或者汇款受理证明书的复印件。）

关于在留资格认定证明书交付申请的申报单【本校所定用纸】护照的复印件以及身份证的复印件

照片【5张】

注）大学毕业者或大学预定毕业者，请提交大学的成绩证明书。

最终毕业学校(高中或高等教育机构等)的成绩证明书的公证书的日语翻译

最终毕业学校(高中或高等教育机构等)的毕业证明书或毕业预定证明书

请附上日本能力考試N5(日语学习时间150小时)以上的成績証明书（夏印可）

Postcode

注）大学を卒業または卒業見込みの者は、大学の成績証明書も提出してください。

およびパスポートの写しと身分証明書の写し

日本語能力試験Ｎ5（日本語学習時間150時間）相当以上の日本語能力を有することを証明できる書類

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

最終出身学校（高等教育機関）

職業（勤務先の名称）Occupation (Place of employment)

302018

Admissions Guide to Japanese Languageand Culture Course (for Entrance in 2018)

2018

入試広報課