久留米大学別科願書

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1 2021 年度久留米大学 2021 Kurume University 日本语言文化特别课程入学报名表 ( 四月入学 ) 准考证号 NO. Intensive Japanese Course (Ryugakusei Bekka) Admission Application() 课程一年课程 One year course 一年半课程 18 month course 片假名 Katakana 英文字母 Roman alphabet 汉字 Name (kanji) 姓 Family Name 名 First Name (Middle name) 照片 Picture ( 高 4.0cm 宽 30cm) 1 正面免冠上半身 2 报名前三个月内拍照 3. 照片背面写上姓名 4. 浆糊涂匀 h. 4.0cm w. 3.0cm 1. Front face, chest up 2. Recent within last three months of application 3. Write name on picture 4.Apply paste evenly 出生年月日 Date of Birth 年月日 Year Month Day 年龄 Present Age 性别 Sex ) 男女 Male Female 国籍 Nationality 出生地 Place of Birth 婚姻状况 Marital Status 已婚未婚 Married Single 邮政编码 Zip code 现住址 Present Address 电话 phone 手机 Cellphone # 住址 Address ( 本国 ) (Home country) 邮政编码 Zip code 电话 phone 手机 Cellphone # 姓名 Name 与本人关系 ( 详细填写 ) Relationship to Applicant (in detail) 年龄 Age 居住在日本的保证人 / 代理人 Guarantor or Agent residing in Japan 住址 Address (Home country) 职业 / 职务 Occupation / Position 工作单位地址 Workplace Address 邮政编码 Zip code 电话 phone 手机 Cellphone # 邮政编码 Zip code 电话 phone

2 现在在日本有朋友或亲属吗? * 如果是学生要写大学 ( 学院 )/ 研究生院 ( 研究科 ) 的名称 At present, do you have an acquaintance or a relative in Japan? *If your acquaintance or relative is a student, provide university name (include division or graduate division) 有 Yes. 姓名 Name ( ) 关系 Relationship to applicant ( ) 没有 No 日本语言文化特别课程结业后计划 Course of Study after finishing as International Student of Intensive course 升学研究生院 Graduate School Continue Education 久留米大学研究生院研究科 ( ) Kurume University ( )Division 其他大学研究生院 ( ) Other University Graduate School ( )Division 大学 University 久留米大学 ( ) 学院 ( ) 学科 Kurume University ( ) Faculty / Division 其他大学 ( ) Other University ( )Division 其他 Other ( ) 回国 Return to Home Country 其他 Other ( )

3 简历 Resume 学历 ( 请准确填写自小学至现在的所有学历 ) Education (List all education from first to final) 学校名称 School Name 地址 Address 在校时间 Dates of Attendance From (y/m) ~ (y/m) 情况 Status 年数 Total Years Elementary School 小学情况填写毕业 / 即将毕业 / 退学 / 转学等详细情况 Graduation (including prospective), withdrawal, transfer, etc. 初等 / 中等教育总计在校年数 Total Years of Schooling 〇有转入编入在家学习等经历, 请准确填写所有情况, 不要出现空白期间 Include all instances of transfer, admission, homeschooling, leaving no period of time unaccounted for. 日语学习经历 Japanese Language Study 学校名称 School Name 地址 Location 学习时间 Term of Study From: (y/m) ~ To: (y/m) 工作简历工作单位 Place of Employment Work Experience 地址 Location 职业 Position 工作时间 Dates of Employment From: (y/m) To: (y/md) Retired In office 辞职 / 在职辞职 / 在职辞职 / 在职

4 以往出入境经历 History of emigration to Japan 有 Yes 次数 Number of times / 无 No 日本入境年月日 ~ 出境年月日 Date of Entry (y/m/d) ~Date of Departure (y/m/d) 滞留资格 Visa Status 入境目的 Purpose of Stay 滞留地点 Location of Stay 年月日 ~ 年月日年月日 ~ 年月日年月日 ~ 年月日年月日 ~ 年月日滞留资格认定证明书的申请经历 Certificate of Eligibility for Resident Status [Past and Present] : Have you ever submitted the Application for Certificate of Eligibility? (circle one each) 滞留资格认定证明书申请批准经历 Application for Issuance of Certificate 无有 ( 批准未批准 ) No Yes Granted Refused 有 ( 未批准 ) 请尽量详细填写未批准理由 If yes, and issuance not granted, list the reason for refusal in the box to the right 以前申请过滞留资格认定证明书者务必填写未批准或没有入境者也必须填写以前申请滞留资格认定证明书未获批准者不得报名 Include all past applications for residency whether status was refused or entrance was not made. If you have a previous record that application of your CoE has been denied, you cannot start applications. 报名时滞留在日本者请填写下表 If you live in Japan when you apply for the admission, please fill out the following items 护照号码 Passport No. 外国人登录号码 Alien registration No. 来日本时间 Date of Arrival in Japan 年月日 year month day 滞留到期时间 Date of expiration 年月日 year month day 滞留资格 Present Status of Residence 留学就学其他 ( ) College Pre-college Others student student 我宣誓 : 所有报名材料所填写的信息提交的文件 / 资料等完全属实材料和简历等如有虚假, 入学考试结果视为无效亦不得提出异议 I, the undersigned, vouch that all information and attendant documents are true and unaltered. I understand and consent that if this is found not to be the case, my application will be rendered null and void. 签名 ( 必须 ) 日期年 / 月 / 日 Name (required) Date y/m/d 请保存好所有提交材料的复印件以备用 Make a copy of all documents included in this application for your personal records.

5 保证书 Letter of Guarantee 久留米大学校长 To: President, Kurume University 报名者姓名出生年月日国籍 Applicant s name Date of Birth Nationality 上面报名者在贵校留学生预科学习期间, 我将为其身份担保, 对其一切行为负责, 保证不给贵校添麻烦 I hereby declare that I will bear full responsibility for the above applicant during his/her stay in Japan as a student at Kurume University. 保证人姓名年龄国籍 Guarantor Name Age Nationality 签名 Signature Seal 印现住址 Address 邮政编码 Zip code 电话号码 Home phone 手机号码 Cellphone 职业 ( 详细填写 ) Occupation (in detail) 工作单位 Place of employment 电话号码 Tel. no 传真号码 Fax no. 与本人关系 Relationship to applicant 宣誓时间 Date of pledge / / 年 / 月 / 日 (year/month/day)

6 经费支付书 Financial Guarantee 久留米大学 To: Kurume University 报名者姓名 Name of applicant 必须由经费支付人本人填写 This form must be written by the sponsor. 本人此次作为上述报名者在日本留学期间的经费支付人, 对经费支付的理由及经费支付进行如下说明我宣誓负责支付报名者在日本留学期间的费用 I have agreed to become the above applicant's financial sponsor for his/her studies in Japan and provide the following information as an explanation of my financial circumstances. I guarantee to take responsibility for all of the applicant's expenses during his/her stay in Japan. 1 经费支付理由 Reason for accepting role of guarantor. ( 请具体填写接受报名者经费支付的理由及与报名者的关系 ) (Please also provide description of relationship with the applicant) 記 2 经费支付内容 Contents of support 本人对上述报名者在日本滞留期间按如下方式支付费用, 特此证明在上述报名者申请滞留时间变更许可时, 提交汇款证明或本人名义的存折 ( 记载汇款事实经费支付事实 ) 的复印件等材料, 以证明生活费等的支付属实 I, do herewith confirm that I will be fully responsible for the expenses below in regard to the applicant. In addition, in the event that the applicant applies for extension of his/her stay, I will submit proof of payment, or a copy of my bankbook as proof of support for living expenses. (1) 学费 University fees 每年 / 半年日元 (2) 生活费 Monthly living expenses 月额日元 (3) 支付办法 Method of support ( 请具体写明汇款 / 转账等支付办法 ) (state clearly -- mailed remittance, bank wire, or other means) 经费支付人姓名 ( 签名 ) Name of sponsor (Signature) Seal 印与学生的关系 Relationship 住址 Address 电话号码 Home phone 手机号码 Cellphone 宣誓时间 Date of pledge / / 年 / 月 / 日 (year/month/day)

7 报名理由书 / 日本语言文化特别课程结业后计划的说明 Reason for Application Plans upon Completion of International Student Program 本人亲笔填写 The applicant must respond below in his/her own handwriting 用日语以外的语言书写时请附上日语译文 If it is written in a language other than Japanese, it s applicant s responsibility to attach a Japanese translation. 你为什么要在久留米大学日本语言文化特别课程学习日语? Write an explanation of your reason for wishing to study Japanese language as an international student at Intensive course. 日本语言文化特别课程结业后的计划 Describe you plans after finishing study as an international student of Intensive course. 报名者姓名日期 / / 年 / 月 / 日 Applicant s name Date (year/month/day)

8 调查问卷 Questionnaire 请报名者如实回答 Applicant, please answer the questions below honestly. 1. 你会说日语吗? How well are you able to speak Japanese? 很好 Excellent 好 Good 一点儿 Fair 不会 Poor 2. 你会读日语吗? How well can you read Japanese? 很好 Excellent 好 Good 一点儿 Fair 不会 Poor 3. 你会写平假名 / 片假名吗? Are you able to write hiragana or katakana? 平假名 Hiragana 会 Yes 不会 No 片假名 Katakana 会 Yes 不会 No 4. 你能读多少个日语汉字? How many Japanese kanji are you able to read? 5. 你能写多少个日语汉字? How many Japanese kanji are you able to write? 约 (app. ) 约 (app. ) 字字 6. 你是否参加过下面的考试? Have you taken any of the tests listed below? (1) 日语能力考试 ( 通称 JLPT 财团法人日本国际教育支援协会 / 独立行政法人国际交流基金主办 ) Japanese Language Proficiency Test (known as JLPT and administered by Japan Educational Exchanges and Services or administered by Japan Foundation 是 Yes Year taken 年参加,Level 级合格 Pass 不合格 failure), 否 No (2) 实用日语检定 ( 通称 J.test 日语检定协会主办 ) Practical Test of Japanese (known as J.Test and administered by the Japanese Language Examination Committee) 是 Yes Year taken 年参加,Level 级合格 Pass 不合格 failure), 否 No (3) 日语 NAT-TEST( 专门教育出版主办 ) The Japanese Language NAT-TEST is created, organized, and administered by Senmon Kyouiku Publishing Co., Ltd. 是 Yes Year taken 年参加,Level 级合格 Pass 不合格 failure), 否 No (4) 其他考试考试名称 : Year taken 年参加,Level 级合格 Pass 不合格 failure) 考试名称 : Year taken 年参加,Level 级合格 Pass 不合格 failure) 报名者姓名日期 / / 年 / 月 / 日 Applicant s name Date (year/month/day)

9 日本国内居住者 (Domestic residents) 报考费缴费凭据 Receipt of payment for entrance examination 报考费汇款证明粘贴栏 Paste Proof of payment here ( 浆糊只涂在此处 ) apply paste only in this section 注意 Note 确认是否有汇款银行的出纳印章 Ensure that the receipt includes a stamp from the issuing bank. 不粘贴证明报考费汇款的凭据 ( 银行收据 ), 报名材料不予受理 Applications for entrance examination that do not include this receipt will be rejected.

10 日本国外居住者 (Foreign residents) 报名材料一览表 Application Documents Checklist 确认提交的材料, 请划上对号 ( ) 后签名下面的材料为必须提交的材料材料不足或不全不予受理, 请认真确认 Verify that all documents are included with the application by checking the boxes on signing below. All documents must be included in the application. Kurume University will not process applications with missing documents. 此报名材料一览表作为提交材料封页, 务必请一并装入袋中 Be sure to include this checklist with your signature as the cover page in your application package. 入学报名表 Admission Application 简历表 Resume 报名理由书 Reason for Application 调查问卷 Questionnaire 最后毕业学校的毕业 ( 即将毕业 ) 证明 ( 原件 )Certificate of graduation(original) 最后毕业学校的成绩证明 ( 原件 ) Grade Transcripts (original) 在校证明 ( 原件 ) Certificate of Enrollment(original) 在职证明 ( 原件 ) Certificate of Employment(original) 日语能力证明 (JLPT 合格证明或日语检定认定证明 / 成绩单 ) Certification of Level ln5 or above from JLPT, or Certificate of Level F or above from J-TEST 报考费缴纳汇款证明 Receipt of Payment of Entrance Examination Fee 护照复印件 Complete copy of Passport 保证书 Letter of Guarantee 关于经费支付的证明材料 Certificates on Payment 经费支付书 Letter of Financial Sponsorship 经费支付人的在职证明 Verification of Employment of Sponsor 经费支付人的收入证明及纳税证明 ( 过去三年份 ) Certificate of Income and Tax Payment Certification(with the data of the past 3 years) 经费支付人的存款余额证明 Certification of Bank Balance of Sponsor 经费支付人与报名者关系的证明材料 Proof of Sponsor s Relationship to Applicant 户口或可替代户口的证明 Family Register or Equivalent Certificate (such as birth certificate) 我发誓提交材料无虚假成分提交伪造的报名材料或提交材料中有虚假记载, 报名被取消也不会提出异议 I certify that the information on all application materials is correct and true. If the submitted documents contain false statements, no objection will be made even if the application is cancelled. 报名者姓名 ( 签名 ) Applicant s name (Signature)

11 日本国内居住者 (Domestic residents) 报名材料一览表 Application Documents Checklist 确认提交的材料, 请划上对号 ( ) 后签名下面的材料为必须提交的材料材料不足或不全不予受理, 请认真确认 Verify that all documents are included with the application by checking the boxes on signing below. All documents must be included in the application. Kurume University will not process applications with missing documents. 此报名材料一览表作为提交材料封页, 务必请一并装入袋中 Be sure to include this checklist with your signature as the cover page in your application package. 入学报名表 Admission Application 简历表 Resume 报名理由书 Reason for Application 调查问卷 Questionnaire 最后毕业学校的毕业 ( 即将毕业 ) 证明 ( 原件 )Certificate of graduation(original) 最后毕业学校的成绩证明 ( 原件 ) Grade Transcripts (original) 在校证明 ( 原件 ) Certificate of Enrollment(original) 在职证明 ( 原件 ) Certificate of Employment(original) 日语能力证明 (JLPT 合格证明或日语检定认定证明 / 成绩单 ) Certification of Level ln5 or above from JLPT, or Certificate of Level F or above from J-TEST 报考费缴纳汇款证明 Receipt of Payment of Entrance Examination Fee 护照复印件 Complete copy of Passport 保证书 Letter of Guarantee 关于经费支付的证明材料 Certificates on Payment 经费支付书 Letter of Financial Sponsorship 经费支付人的在职证明 Verification of Employment of Sponsor 明确经费支付人收入的证明 Documentation of Annual Salary of Sponsor 日语译文 Translation 经费支付人的收入证明及纳税证明 ( 过去三年份 ) 日语译文 Certificate of Income and Tax Payment Certification(with the data of the past 3 years) Translation 经费支付人的存款余额证明 Certification of Bank Balance of Sponsor 经费支付人与报名者关系的证明材料 Proof of Sponsor s Relationship to Applicant 户口或可替代户口的证明 Family Register or Equivalent Certificate (such as birth certificate) 我发誓提交材料无虚假成分如提交伪造的报名材料或提交材料中有虚假记载, 报名被取消也不会提出异议 I certify that the information on all application materials is correct and true If the submitted documents contain false statements, no objection will be made even if the application is cancelled. 报名者姓名 ( 签名 ) Applicant s name (Signature)

12 留学生调查表 ( 日本国内居住者用 ) International Student Survey (For residents in Japan) 同居情况 ( 在日本共同居住者 )People who live together in Japan 与本人关系 Relationship to Applicant 姓名 ( 片假名 ) Full Name (Furigana) 年龄 Age 职业或学校名称学院学科学年 Profession or school name, Undergraduate, Department, Grade 经费支付计划 Expense payment plan 请填写在久留米大学留学期间将如何支付学费和生活费 When you study abroad at Kurume University, please describe how you will pay for the tuition and living expenses. 1. 经费支付人是谁?( 用圈上, 请填写姓名等 ) 可多选 Who is the expense supporter? Please circle adequate alternatives and write down the names, etc. 1 报名者 applicant 2 父母 parents 3 其他 other 经费支付人 (2 或 3)Sponsor (2or3) 姓名 Full Name 住址 Present address 与报名者关系 Relationship to Applicant 电话 Telephone 2. 请填写您现在 ( 报名时 ) 的存款余额日元 Please fill in your current (at the time of application) deposit balance. 3. 请详细填写进入本校时经费的收入支出金额等 Please fill in the income, the amount of expenditure, etc. about the expense support when you enter university. 收入 ( 入学后 )Income (Plans after Entrance) 1. 经费支付人的汇款 Supplied by sponsor 月额 Monthly 一次性汇款 Lump-sum 日元日元 2. 打工收入月额日元 Part-time job Monthly ( 打工单位 : ) Place of employment 支出 ( 入学后 )Expenditure (Plans after Entrance) 1. 居住费用 ( 房费公益费等 ) Housing (Rent, Public expenses, etc.) 月额 Monthly 日元 2. 生活费 ( 伙食费水电煤气费电话费等 ) Living (Food, Utilities, Phone Charges, etc.) 月额 Monthly 日元 3. 其他 ( 具体填写 : ) Others (Please tell me specifically) 日元 ( 工作内容 : ) Contents of work 3. 其他 ( 具体填写 : ) Others (Please tell me specifically) 日元请附上经费支付的证明等 Please attach certificate affecting payment of expenses. 上述情况均属实 I hereby certify the above to be true and correct information. 年 year 月 month 日 day 报名者姓名印 Applicant s name (Signature)

13 提交材料请附上下面的材料 Please attach the following documents. 1 本人存折的复印件 Photocopies of the applicant s Savings Passbook All photocopies of the savings passbook in which the history of banking in the last year is clearly recorded are required. The savings passbook that can show the income is preferred. Copy of all pages including the cover (the past one year is necessary) 包括封皮在内所有页面的复印件 ( 需要过去一年份 ) 2 滞留资格外活动许可书的复印件 ( 符合条件者 )Copy of non-qualified activity permit (as applicable person) The confirmation document on the activities beyond the permitted Status of Residence: The photocopies of Permission to engage in activity other than that permitted under the status of residence previously granted or the seal/stamp on the passport. 关于超出许可的滞留资格活动的确认书 : 以前滞留时的滞留资格允许从事许可以外活动的复印件或护照上的盖章

모집요강(중문)[2013후기외국인]04.26.hwp

모집요강(중문)[2013후기외국인]04.26.hwp 2013 弘益大学后期外国人特别招生简章弘益大学 http://ibsi.hongik.ac.kr 目次 I 招生日程 3 II 招生单位 4 III 报名资格及提交材料 5 IV 录取方法 8 V 报名程序 9 VI 注册指南 11 VII 其它 12 附录提交材料表格外国人入学申请