ࡱ>  T8\pQgq\0T~ Ba=OLMP ThisWorkbook=p/8W@"1 -3 000001 -3 000001 -3 000001 -3 000001 -3 000001  -3 000001 $-3 000001 x-3 000001 -3 000001 -3 000001 h8-3 000001  -3 000001 <-3 000001 4-3 000001 -3 000001 4-3 000001 -3 000001 ,8-3 000001 8-3 000001 8-3 000001 -3 000001 ?-3 000001 -3 000001 >-3 000001 -3 000001( Arial Narrow1-3 0fg1( Arial Narrow1 -3 000001( Arial Narrow1-3 0fg1-3 0fg1-3 0fg1-3 0fg1-3 0fg1-3 0fg1 -3 000001( Arial Narrow1( Arial Narrow1 -3 000001-3 0fg1( Arial Narrow1-3 0fg1(x Arial Narrow1Century1 -3 000001( Arial Narrow1" Meiryo UI1 -3 00000""#,##0;""\-#,##0""#,##0;[Red]""\-#,##0""#,##0.00;""\-#,##0.00#""#,##0.00;[Red]""\-#,##0.007*2_ ""* #,##0_ ;_ ""* \-#,##0_ ;_ ""* "-"_ ;_ @_ .))_ * #,##0_ ;_ * \-#,##0_ ;_ * "-"_ ;_ @_ ?,:_ ""* #,##0.00_ ;_ ""* \-#,##0.00_ ;_ ""* "-"??_ ;_ @_ 6+1_ * #,##0.00_ ;_ * \-#,##0.00_ ;_ * "-"??_ ;_ @_ \$#,##0_);\(\$#,##0\)\$#,##0_);[Red]\(\$#,##0\) \$#,##0.00_);\(\$#,##0.00\)% \$#,##0.00_);[Red]\(\$#,##0.00\)"Yes";"Yes";"No""True";"True";"False""On";"On";"Off"],[$ -2]\ #,##0.00_);[Red]\([$ -2]\ #,##0.00\) 0.E+00                                                                   ff         `     & ( P P    a>            @@ @ @  @ @       !  ! @      "   `  @   0@ 0 0 #0  @   !     @  #          @  @      @  @   #  !@ ! !    `  @   ` !` @@ ! 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( ("@ @ ("@ (" @ (@@ (@ "@@ "@  " @ @@ @   @ %@@ %@ %  @  @    @   ||[ }(}00_)}(}00_)}<}00_)\([$}(}00_)}(}00_)}<}00_)\([$ 20% - 00000 10 20% - 00000 1 20% - 00000 20" 20% - 00000 2 20% - 00000 30& 20% - 00000 3 20% - 00000 40* 20% - 00000 4 20% - 00000 50. 20% - 00000 5 20% - 00000 602 20% - 00000 6 40% - 00000 10 40% - 00000 1 40% - 00000 20# 40% - 00000 2 40% - 00000 30' 40% - 00000 3 40% - 00000 40+ 40% - 00000 4 40% - 00000 50/ 40% - 00000 5 40% - 00000 603 40% - 00000 6 60% - 00000 10 60% - 00000 1 60% - 00000 20$ 60% - 00000 2 60% - 00000 30( 60% - 00000 3 60% - 00000 40, 60% - 00000 4 60% - 00000 500 60% - 00000 5! 60% - 00000 604 60% - 00000 6"00000 1$00000 1#00000 2$!00000 2$00000 3$%00000 3%00000 4$)00000 4&00000 5$-00000 5'00000 6$100000 6 (00000000)0000 00$0000 00*i0a00g00j0D0$i0a00g00j0D0+ 00000,$0000000 -00 00.000 00"000 00 /`D0`D0 0{{ 1fJTe fJTe2Ah:SR03, Ah:SR0 [0.00]4QW0 1 QW0 15QW0 2 QW0 26QW0 3 QW0 37QW0 4 QW0 4 8ƖƖ 9QRQR :fe5fe;<(  [0.00] =eQReQRjn> . h:yn0n00000000 ?oD0oD0XTableStyleMedium2PivotStyleLight16`3uˊN(u@K3uˊN(u3uˊN(u3uˊN(uψ QQ   ;U!  ;R!"f^fH( @P$ *3 A@@   N,Year 5Month 5L3uˊNI{\Ob(u 0000 0Yuf[ 0 H50000000000000000000 &210f[HQ"5000000^220Of[t^pe \f[!h^gB}f[tk Z50000000000000000000000000  X230gB}f[tk So0(Wf[-Nn0f[!h T50000000000000000000000  .(1)(WM|rl*5 0000000000RSmi(Wf[-NOf[-N-N'Yf[b ZSX 'Yf[b OX wg'Yf[\f[!hؚI{f[!h-Nf[!h (2)f[!h T5000000)Date of graduation or expected graduation*fk000<f&500000000$ f T 5000002 }So0ppe.5 000000000e,gYe0SQ0_0Ye_jSs0g_j T500000g5000 e,gn0YeSo0e,gk000Ye0SQ0_0Ye_jSs0g5 ""0000000000000000000000000000000000   B260n(Wn0/e_elI{>500000000000000  0(3)L}/e_,500000000 `$l0 T5000$a$OO0@b 500000 @b$wmi RRHQn0 Ty <50000000000000000 $c$t^0S 500000L3uˊNI{\Ob(u 0000 0Yuf[ 0 H50000000000000000000 +YY6rkVy6rVyk 6r kDQ_YYS6r /O6r 0Sk/Ok SeQYe_jSN0wNSN0wNn0e S_O0s0WOmiI{wTS_O0s0WOmiI{wTn0e (5)hYf[ё/ef}_j  N(1)g0hYf[ё0xbW0_04XTk0eQ 5$$000000000000000000000000000000000000   YV?e^e,gV?e^,0WelQqQVSO(5 000000000lQv>yVlNSo0lQvVlN 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5Elementary school 5Others 5Name of the school 5Year 5Month 5Day 5 Japanese language ability (Fill in the followings when the applicant plans to study at advanced vocational school or vocational school (except Japanese language)) 5'Proof based on a Japanese language test 5Name of the test 5Attained level or score 5DOrganization and period to have received Japanese language education 5 Organization 5K00 5~0g0 5Period 5from 5Year 5Month 5to 5Others 5250e,gf[tk ؚI{f[!hk0J0D0f0Ye0SQ004XTk0eQ  5f Japanese education history (Fill in the followings when the applicant plans to study in high school) 5p Organization and period to have received Japanese language education / received education by Japanese language 5 Organization  54Method of support to pay for expenses while in Japan 5>Method of support and an amount of support per month (average) 5Self 5Supporter living abroad 5Supporter in Japan 5 Scholarship 5Others 5(Remittances from abroad or carrying cash 5Carrying from abroad 5Remittances from abroad 5  5 Name of the individual 5Date and time of 5 carrying cash 5 carrying cash 5 Supporter 5Name 5Address 5 Telephone No. 5 Occupation (place of employment) 5 Annual income 5&For applicant, part 3 P ("Student")  5Relationship with the applicant (Check one of the followings when your answer to the question 26(1) is supporter living abroad or Japan) 5Husband 5Wife 5Father 5Mother 5 Grandfather 5 Grandmother 5 Foster father 5 Foster mother 5Brother / Sister 5 Uncle / Aunt 5Educational institution<  5Friend / Acquaintance 5!Relative of friend / acquaintance 53Business connection / Personnel of local enterprise 5  5?Relative of business connection / personnel of local enterprise 5Others 5xOrganization which provide scholarship (Check one of the following when the answer to the question 26(1) is scholarship) 5Foreign government 5Japanese government 5Local government 5RPublic interest incorporated association / Public interest incorporated foundation 5Plans after graduation 5Return to home country 5* Enter school of higher education in Japan 5Find work in Japan 5 Others 5$280,gk0J0Q003uˊNn0vwNf[HQL0-Nf[!hSo0\f[!hn04XTk0eQ 5 ,,00000000000000000000000000000000000000000000   %(!Name 5Relationship with the applicant 5Address 5 Telephone No. 5Cellular Phone No. 5n Applicant, legal representative or the authorized representative, prescribed in Paragraph 2 of Article 7-2. 5Relationship with the applicant 5EI hereby declare that the statement given above is true and correct.  5KSignature of the applicant (representative) / Date of filling in this form  533uˊf\Ob_3uˊ~0g0k0 Q[k0 YfL0uX0_04XT 3uˊNNtN L0 Yf{@b0ckW0 r TY00S0h00 5 Attention 5In 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. 5Name 5Address 5'Organization to which the agent belongs 5 Telephone No. 5P(3)RSmiSo0RSmi0t^gL5000000000000000000  2903uˊN l[NtN l,{agn0,{k0[Y00NtN 51 j(4)3uˊNh0n0O  N(1)g0(WYL}/e_bSo0(WeL}/e_b0xbW0_04XTk0eQ  $f50000000000000000000000000   Actual guardian in Japan0( Fill in the following if the applicant is to study at a junior high school or elementary school ) 5, 240e,gR \Of[!hSo0T.zf[!hk0J0D0f0e,gYeNYn0Ye0SQ004XTk0eQ 55500000000000000000000000000000000000000000000000000000   %( -#.&1) %R,{mQSn0 Ni_,{mQagn0NO !5 000000000000000000000000000      <3uˊNI{\Ob(u 8500000000000000 <e,gV?e^lRw8500000000000000 For applicant, part 1 5(Ministry of Justice, Government of Japan 5(W0Yu0nj0KAPursuant 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, Item 2 of the said Act. 5  50 5  5 410V0M|00W0W050000000(20ut^ge$50000000Nationality/Region 5 Date of birth 5Year 5Month 5Day 5 Family name 5 Given name 530l0 T 5Name  540'`0%R 57u50000 5sY5000 50Qu0W5000000  560MvPn0 g!q g 500 5!q 50Sex 5Male 5/ 5Female 5Place of birth 5Marital status 5Married 5Single 5&70w0mi"5000000 .80,gVk0J0Q00E\OO0W*5 0000000000 Occupation 5Home town/city 5 ,90e,gk0J0Q00#a}HQ(5 000000000Address in Japan 5 Telephone No. 5Cellular phone No. 5"100e8R50000"(1)ju0S50000((2) gRgP$50000000  5  Passport  5Number 5Date of expiration 5N110eQVvv !kn0D0Z00K0rS_Y000n00x0g0O0`0U0D00 J500000000000000000  -Purpose of entry: check one of the followings 5% 5 ) 0Yec 0500000 ) 0Ye 0 * 0S 0* 0eS;mR 0 5+ 0[Ye 0, 01XS 0 5 "Professor" 5 "Instructor" 5"Artist" 5"Cultural Activities" 5"Religious Activities"  5 "Journalist" 5  M 0L}U0{t 0 5 , , 0xvzR 0(5 000000000"Intra-company Transferee" 5"Business Manager  5"Researcher (Transferee)" 5. 0bS0NewX0VmiR 0. 0b 0 "Researcher" 5?"Engineer / Specialist in Humanities / International Services"  5"Skilled Labor" 5%  5R. 0yr[;mRxvz;mRI{ 0N50000000000000000000   / 0L 0 0 0Yuf[ 05000001 0xO 0 Y 0b[S 0H"Designated Activities ( Researcher or IT engineer of a designated org)" 5 "Entertainer" 5 "Student" 5  "Trainee" 5#  "Technical Intern Training ( i )" ! 5<  2 0[en(W 0 5^2 0yr[;mRxvz;mRI{[e 0Z50000000000000000000000   2 0yr[;mREPA[e 0 "Dependent" 5T"Designated Activities (Dependent of Researcher or IT engineer of a designated org)" 5)"Designated Activities(Dependent of EPA)" 5  4 0e,gNn0MvPI{ 0  4 08lOOn0MvPI{ 04 0[OO 0&"Spouse or Child of Japanese National" 5'"Spouse or Child of Permanent Resident" 5"Long Term Resident" 5  0ؚ^\wS0 0 5  0ؚ^\wS0 0 5  0ؚ^\w1S0 0 55 0]0n0N 0#"Highly Skilled Professional(i)(a)" 5#"Highly Skilled Professional(i)(b)" 5#"Highly Skilled Professional(i)(c)" 5Others 5 @120eQVN[t^ge<5 0000000000000 4130 NxN[/n05 0000000000  5 Date of entry 5 Port of entry 5 4140n(WN[g05 0000000000 *150 T4On0 g!q&500000000 g5000 5 Intended length of stay 5 Accompanying persons, if any 5Yes 5No 5 8160g<3uˊN[0W45 000000000000" Intended place to apply for visa 5 8170NSn0QeQVtk45 000000000000 ) Past entry into / departure from Japan 5A @ Ng00 g00xbW0_04XT 0(Fill in the followings when the answer is "Yes")<5 0000000000000  Vpe50000V500>vяn0QeQVtk:5000000000000000 K00 5time(s) 5The latest entry from 5 Day to 5'l180rj0t1uh0Y00QR0SQ0_0S0h0n0 g!q e,gVYk0J0Q000n00+T00 h500000000000000000000000   #%Criminal record (in Japan / overseas) 5,wQSOvQ[(5 000000000  5  5!q 50Yes 5  ( Detail: 5)  5/ 5 No 5n190S7_6RSo0QV}TNk000QVn0 g!qj5000000000000000000000000000   , Departure by deportation /departure order 5@ Ng00 g00xbW0_04XT <5 0000000000000 Vpe500006vяn0tk25 00000000000 2 (Fill in the followings when the answer is "Yes") 5#The latest departure by deportation 5200(Wee6r0k0MvP0P[0DQ_YYj0i0 Ss0 TE\5 ##00000000000000000000000000000000000  e Family in Japan (Father, Mother, Spouse, Son, Daughter, Brother, Sister or others) or co-residents 5 }0g5000 l0 T5000(ut^ge$500000004V0M|00W0W050000000( TE\N[$500000006RRHQ0f[HQ25 00000000000 (WYu000juS 50 yr%R8lOO<ffjuS 50 Relationship 5Name 5 Date of birth 5Nationality/Region 5(Intended to reside with applicant or not 5Place of employment/school 5Residence card number 5-Special Permanent Resident Certificate number 5o0D00D0D0H0 5  5Yes / No 5o0D00D0D0H0 5Yes / No 5;  5` 20k0d0D0f0o0  kL0 NY004XTo0%R}k0eQW0f0mNY00S0h000j0J0, 0xO 0 0b[ 0k0O03uˊn04XTo0 Ng0Y00 Regarding item 20, 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 item 20 for applications pertaining to  Trainee /  Technical Intern Training .A5110000000000000000000000000000000000000000000000000   &+-"1$3(6+9.;o l ψbSgqn0 N 3uˊk0_j0f^0\ObW0f0 NU0D000Note : Please fill in forms required for application. (See notes on reverse side.)~5 0000000000000000000000000000000  :,S0n0000o0cQY00_o0B00~0[000This sheet is not required to submit. (5 000000000 303uˊNI{\Ob(uK00 @b^\_jI{\Ob(uI{K00o0 eQVvvk0_c0f0 !kn0i_0O(uW0f0O0`0U0D005440000000000000000000000000000000000000000000000000000 $(!+%-'1*K Select type of form which corresponds to the purpose of entry in Japan. 5 ,eQVvv00Purpose of entry/(5 000000000 O00Example/500 ,O(uY003uˊf00Type of form% (5 000000000<3uˊNI{\Ob(u8500000000000000  N@b^\_jI{\Ob(uI{J500000000000000000 For applicants 5For organization 5! 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%))-,0 V?e^O_j Omin0xvzR5000000000000000000000  % 5. 5 Activities of highly skilled professionals who engage in research,research guidance or education at colleges0Except in cases falling under 1 ; mo 5*Researcher of a government body or company 5nQY}k0We0M0SeQ04OF0xvz0LF0;mRj5000000000000000000000000000  4Activities to engage in research that provide income 5Jؚ^n0\vj0R0 gY00NPgh0W0f06qyf[So0Neyf[n0RΑn0\v bSSo0wX0_h0Y00miRk0_NY00S0h0k0rS_Y004XT0dO00 ; 533000000000000000000000000000000000000000000000000000 $&(+"0&3*<.@1C._jh]f[I{n0bS 0000000miR_N*5 0000000000 Activities of highly skilled professionals who engage in services which require knowledge pertinent to the field of natural science or human science Except in cases falling under 4 ;  57 Engineer of mechanical engineering Marketing specialist"# 5C6qyf[W0O0o0Neyf[n0RΑn0\vbSW0O0o0wX0_h0Y00miRSo0YVn0eSk0Wv0 gY00`I{0_h0Y00miRk0_NY00S0h05FF0000000000000000000000000000000000000000000000000000000000000000000000  #!'#)%-(0+3.5183:5>:B=Activities to engage in services which require knowledge pertinent to the field of natural science or human science or to engage in services which require specific ways of thinking or sensitivity acquired through experience of foreign culture 5e Pq}W0_0b0Y00miRk0_NY00S0h0 Activities to engage in services which require skills belonging to special fieldsL5000000000000000000  9 JYVetn0t+^ 0000c\ Foreign cuisine chef, Sport's instructorF5000000000000000000 yr[n0xvz;mR xvzNmi;mR `1XQt;mR5 &&00000000000000000000000000000000000000    "Jc[U00_0_jn0xvz0`1XQtbSF5000000000000000000 uDesignated activities to engage in research, business related to research or information< -processing- relatedservices 5KResearcher or Information-technology engineer of a designated organization 5 L 0 Entertainment  5 LkKb 00000Singer, Model5000/ 5 *b[00Technical intern training&500000000 .b[u00Technical intern trainee*5 0000000000Y 5 Rf[00 Study50000 "Yuf[u00Student500000000 5xO500000h[RxO0L0j0D0xOu lQvxO0d5000000000000000000000000000  1 5TrainingLF0xOu;Trainees not including in the on-the-job training, trainees 5"who participate in public training 5#FU(u01\w0vvh0Y00 eS;mRSo0Yuf[n0(WYunjSpouse or child of Japanese national, Permanent resident, etc. 5Spouse of Japanese national NNYn0vv 5 HYN lQ(u _wX lQOX ;S+^ D500000000000000000  5 5- 5  5 Other purpose 5[NO(uN 0000000000  5000000000xKb 0000000050000 6Diplomat, Official, Lawyer, Public accountant, Doctor,/Housekeeper, Working holiday, Amateur athlete,  5 Internship 5<; k0d0D0f0o0 3uˊNL0,gk0J0D0f0LJ0F0h0Y00;mRk0_X0f0 J K OSo0Un03uˊf0O(uW0f00]W0/eH0B00~0[0005 !!000000000000000000000000000000000    %)+-24 0For; it is also possible to use forms J,K,O and U in accordance with the activities in which the applicant is to engage while residing in Japan.%% 500 3uˊfk0N[k0SY00 0W0_0S0h0L0$RfW0_04XTk0o0 N)Rvj0qbD00SQ00S0h0L0B00~0Y00 In case of to be found that you have misrepresented the facts in an application, you will be unfavorably treated in the process. 5+0 @b[n0kk0 Y00S0h0L0g0M0j0D0h0M0o0 %R}k0 n0 N S000mNW0f0O0`0U0D00  00When the space provided is not sufficient for your answer, write on a separate piece of paper and attach it to the application.% 50 (u}n0'YM0U0o0 e,g]miJKANNPO'Q R !T =U W&Y*M[T\]~__`b!chef/g@i0Ol"nlpu;y{2|$}~im0^'qň]̋CN  `ݘ @pߡQ?oIUѮ *N6C+F. dLccB T8  g48  dMbP?_*+%&C &M&d2?'M&d2?(M&d2?)M&d2?MApeosPort-V C6680 4PXXA4DINU"t\i?e SMTJFX ApeosPort-V C6680 T2InputBinFORMSOURCERESDLLUniresDLLPaperSizeA4ResolutionDPI600ColorModeColorCollateONIsSetByPrintTicketFalseDuplexNONEMediaTypeNoneOrientationPORTRAIT\FPXFi\FPXFie4 SameAsPaperSized9.5dd............................  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