sample visa application form to enter japan - Temple University ...

SAMPLE VISA APPLICATION FORM TO ENTER JAPAN
Name in full Smith
Sallie May
Different name used N/A
Date & place of birth 01/01/1979 Philadelphia, PA USA
Sex Female Marital status married single √
Nationality or citizenship
United States of America
Former nationality, if any N/A
Purpose of journey to Japan
Study
Length of stay intended
6 months
Route of present journey: Probable date of entry 01/08/12
Port of entry Narita Name of ship or airline Continental Airlines
Passport (...) United States (if dual, list the one used on your COE application)
No. 1234567 CIRCLE “Ordinary” Issued at New Orleans on 05/15/2006
Issuing Authority United States Passport Agency Valid until 05/14/2016
NEWER PASSPORTS are usually just “Dept. of State” b/c no city is listed.
Criminal record, if any None
Home Address 123 Main Street, Apt. 1
Philadelphia, PA 19111 Tel 215-555-5555
Profession or occupation Student
Name and address of firm or organization Temple University Law Program in Japan
4-1-27 Mita Hall, Minato-ku, Tokyo 108-0073, Japan
Telephone: 81-3-5441-9841
Post or rank held at present
Principal former positions
Student
Student
Address of hotels (list your own accommodation if arranged, or see list for short-term
housing, or list TUJ as last resort)
Dates / durations of previous stays in Japan 07/23/2004 – 07/31/2004
CIRCLE “Reference” in Japan Name: Sumi Sakata
Address Temple University Law Program in Japan, 4-1-27 Mita Hall, Minato-ku,
Tokyo 108-0073, Japan Telephone 03-5441-9841
Relationship to applicant Professor and Program Director

[SAMPLE –ENGLISH-]
VISA APPLICATION FORM TO ENTER JAPAN
Name in full
KNEDDY
Different name used, if any
(Surname)
Surname should be capitalized.
John Firzgeraid
(Given and middle name)
none
Please print.
(Paste a photo here)
approx. 45mm ×45mm
2in×2in
Date and place of birth 15 April 1970 : Skipton Yorkshire United Kingdom
(Day) (Month) (Year) (City) (Province) (Country)
Sex Male Marital status: married × single
Nationality or citizenship
Former nationality, if any
America
United Kingdom
Please paste a photo here. (Do
NOT staple.)
Purpose of journey to Japan to visit relatives
Length of stay in Japan intended 15 days
Please clarify as concrete as
possible.
The photo should be clear and
identifiable, taken within the
Route of present journey : Probable date of entry May 25, 2007
last 6 months.
Port of entry into Japan Narita AP Name of ship or airline JAL-006
Passport
(Refugee or stateless should note the title of Travel Document)
No. A11223344 Diplomatic, Official, Ordinary Issued at Boston on March 10,2007
Issuing authority U.S.Dept. of State Valid until March 10, 2012
Criminal record, if any
none
If not applicable, please write “none” or “N/A”.
Home address
321 East Maple Street, Los Angeles, California 90012, United States of America
Please write accurately. (Phone numbers should Tel. start from the area code.)
Profession or occupation
Company Employee
Name and address of firm or organization to which applicant belongs America Trade Inc.
654 Park, Avenue, New York , N. Y. 10171, U. S. A. Tel. (212) 333-8888
Post or rank held at present Assistant Director
Principal former positions Section Chief
Please write accurately.
(Phone numbers should
start from the area code.)
Please *Partner’s write Profession/occupation accurately. (or Parents’ Profession/occupation)
In case the applicant is a dependant.
(Phone Address numbers of hotels should or names start and from addresses the area of persons code.) with whom applicant intends to stay
Hotel Kayu Kaikan, 8-1, Sanbancho, Chiyoda-ku, Tokyo 102 (03)3230-1230
Dates and duration of previous stays in Japan February 4 – April 3, 2007, 3 month
Guarantor or reference in Japan : Name Mr. Roberr Taylor
Address 2-2-1, Kasumigaseki, Chiyoda-ku, Tokyo 100 Tel. (03)3230-1111
Please write accurately.
(Phone numbers should
start from the area code.)
Relationship to applicant
brother in law
*(Remarks) Special circumstances, if any
In case the applicant has humanitarian reasons should be considered.
I hereby declare that the statement given above is true and correct. I understand that immigration status and period of stay to
be granted are decided by the Japanese immigration authorities upon my arrival. I understand that possession of a visa does not
entitle the bearer to enter Japan upon arrival at port of entry if he or she is found inadmissible.
Date of application 25 April 2007
(Day) (Month) (Year)
Signature of applicant
*These items are not essential to be filled
KNEDDY
In case of an infant, parents or a
legal representative can sign here.
Please indicate the relationship.
(eg. Signed by mother)