FOR UNIVERSITY USE
大学使用欄
受験番号
Student Exchange Application Form
I. Applicant Information
1. Home University:
Please affix a photograph
2. Name of Department:
3. University Address:
(4cm X 3cm),
City / State
Country
Postal Code
taken within the last 3 months.
4. Family Name:
Given Names:
months in a plain
5. Name in Chinese Characters (if applicable):
background.
6. Date of Birth:
Year
Month
8. Nationality:
Date
7. Gender:
Male
Female
No cap or hat is allowed.
9. Native Language:
10. Email:
11. Current Address:
City / State
Country
Phone: Country Code(
Postal Code
)
Mobile: Country Code(
)
12. Mailing Address（if different from above）:
City / State
Phone: Country Code(
Country
)
Postal Code
Mobile: Country Code(
13. Emergency Contact Person:
)
Relationship to you:
Emergency Contact Address:
City / State
Phone: Country Code(
Country
)
Mobile: Country Code(
Postal Code
)
II. Program of Study
1. Program Commencement:
Spring (April)
Fall (September)
2. Language Basis:
English
Japanese
3. College Choice:
College of Asia Pacific Studies (APS)
College of International Management
(APM)
4. Period:
1semester
1 year
III. Education History
Have you completed 12 years of official education?
Yes
No
expected completion date:
Total years of Education
Primary school
years
Junior high school
years
High school
years
University level
years
Others (
)
years
1. Type of School (Degree you will receive upon completion)
University (Bachelors Degree)
Graduate School (Master’s Degree)
Junior College (Degree Course, Associate Bachelor Degree)
Vocational/Technical College (Certificate Course, Vocational School, etc)
Other (Please explain in detail):
2. Language you were taught in:
3. Title of Degree:
Obtained
Scheduled to Obtain Date:
Yr
M
D
IV. Employment History
If you are currently working or have been employed previously, please complete details below. Part-time work must not be
included.
Company Name and Address:
Started (yy/mm)
Competed (yy/mm)
Responsibilities:
2
V. Declaration and Signature
I understand that the University may change or cancel any decision if any incorrect or incomplete information is given. Submitted
documents for this application will become the property of the University and will not be returned to me.
I hereby declare that all information provided are true and correct.
Date:
Applicant’s Signature:
3
Application Essay
Please write the reason/s why you wish to study in APU.
4
FOR UNIVERSITY USE
大学使用欄
受験番号
International Students
Certificate of Eligibility (CoE) Application
I. Applicant Information
1. Name: (Surname)
(First Name)
(Middle Name)
2. Name in Chinese Characters (if applicable):
3. Place of Birth:
4. Marital Status:
6. Current Status:
Single
Student
Married
5. Home town/city:
Name of School:
Employed (Excluding part-time jobs)
Name of Company:
Occupation:
Others (Please specify):
7. Do you currently possess a valid passport?
Yes, Passport Number:
Expiry Date:
No Scheduled to obtain:
Year/
Month/
Year/
Day/
Month/
5
Day/
II. Immigration-Related Issues
1. Port of entry (Name of Airport):
2. Place to apply for visa (City, Country):
3. Have you entered Japan previously
The last entry
Yes. If “yes”, number of times
No
Year/
Month/
Day/
To
Year/
Month/
Day/
4. Criminal Record (In Japan or overseas):
No
Yes.
If “yes”, details:
5. Departure by deportation/departure order in the past:
The latest departure by deportation
No
Year/
Yes,
Month/
Time(s)
Day/
6. Family or relatives currently living in Japan (if any)
Relationship
Name (English)
Date of
Nationality
Intended to reside
Place
with applicant or not
employment/school
of
Alien registration
Birth
certificate number
Yes/No
Yes/No
Yes/No
Yes/No
III. Family Information
1. Father or Guardian
Name:
Date of Birth:
Home Address:
Home Tel:
Company Name:
Occupation:
Company Address:
Company Tel:
6
yy/mm/dd
2. Mother or Guardian
Name:
Date of Birth:
Home Address:
Home Tel:
Company Name:
Occupation:
Company Address:
Company Tel:
yy/mm/dd
3. Siblings
Name
Relationship
Age
Occupation (Name of School/Company)
IV. Financial Information
Method of support to meet the expenses while in Japan. * Minimum 80,000yen per month.
1. Method of support and an amount of support per month (average)
Self
yen
Remittance from outside Japan
Carrying from abroad
yen (Who
Guarantor in Japan
yen
Scholarship
yen
Others (Please specify):
yen
When
yen
)
2. Financial Supporter
Name:
Date of Birth:
Home Address:
Home Tel:
Company Name:
Occupation:
Company Address:
Company Tel:
Annual income:
in Yen
7
yy/mm/dd
V. Confirmation Note of application for CoE by proxy
APU will apply by proxy for the “Certificate of Eligibility for Status of Residence” at the request from accepted students who meet
the following conditions and are considered suitable by APU.
① Applicants who wish to apply for a “College Student Visa” to Japan and have not requested an institution other than APU to act
as proxy for the application of their “Certificate of Eligibility for Status of Residence.”
② Applicants who have finalized all payments necessary before the designated payment deadline, including Registration Fee,
Tuition Fee A, and AP House Fees.
③ Applicants who have proved they have sufficient financial support while they are residing in Japan.
【NOTES】
※ The Japanese Immigration Bureau is the issuing body of the “Certificate of Eligibility for Status of Residence.” APU will apply
by proxy to the Immigration Bureau for issuance of the “Certificate of Eligibility for Status of Residence” for accepted applicants
whom APU deems suitable after the completion of necessary procedures for enrollment. However, there may be circumstances
that prevent the Immigration Bureau from issuing this certificate. Please be aware that APU will not accept any responsibility in
cases such as this.
※ In the case that an individual intends to enter Japan on a visa other than a College Student Visa(e.g. Dependant Visa, Spouse
Visa etc.), it is necessary for such individuals to complete all the respective procedures by themselves (again, in these cases
APU will not apply for a “Certificate of Eligibility for Status of Residence” on behalf of the individual). Also if an individual presently
already has a “Pre-College Student Visa” or a “College Student Visa” or are residing in Japan, then they must apply to change or
renew their visa by themselves (in these cases APU will not apply for a “Certificate of Eligibility for Status of Residence” on behalf
of the Individual).
I agree with the above conditions and meet all the requirements. Therefore I request that Ritsumeikan Asia Pacific
University apply by proxy for my “Certificate of Eligibility for Status of Residence” at the Japanese Immigration Bureau.
Date：
Signature：
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Study Abroad Financial Support Plan
Name, as given on the application
University:
Please specify the source of funds and the total amount necessary to cover housing and living expenses while you are studying at
Ritsumeikan Asia Pacific University.
AMOUNT
SOURCE OF FUNDS
NB: Please fill out this form so that total expenses amount to:
1. One Semester Exchange or Study Abroad = ￥500,000
2.One Year Exchange or Study Abroad = ￥1,000,000
Financial Sponsor’s Income (Estimated)
Financial Sponsor’s name
Local Currency:
Occupation
Company Name
Work Phone Number
Annual Income Local Currency:
Financial Sponsor’s Personal Savings (Bank account
Local Currency:
balance)
Scholarship:
Name of Awarding Institution：
Local Currency:
Name of scholarship you will receive ：
Other
Local Currency:
Details :
TOTAL AMOUNT:
Local Currency:
Local Currency
Japanese Yen:
I hereby state that the above information is true and correct.
Signature of Applicant:
Date:
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Statement of Financial Support
To the Minister of Justice of Japan
Name, as given on the application (Student)
I hereby agree to become the financial sponsor of the applicant mentioned above after his/her entry into Japan and my reason for
doing so is as follows.
a) The reason why I will become the financial sponsor of the mentioned above and my relationship to
the applicant:
b) Financial Support
I,
, hereby certify that I will provide financial support as described below during the
applicant’s stay in Japan. Also, when the applicant needs to renew his/her permitted length of stay, I agree to submit certificates of
remittance or a copy of bank statements (showing records of remittance and financial support) that prove my financial support to
the applicant.
(1) Living expenses:
Japanese Yen monthly
(2) Method of financial support (Indicate the method of your providing financial support, such as wire remittance)
Date:
Financial sponsor
Address:
Telephone number:
Name and signature (or seal):
Relationship to the applicant:
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AP House Application
1. AP House Regulations and Fees
1. AP House Regulations and Fees
Exchange/Study Abroad students are guaranteed rooms at AP House on campus and in principle, are required to live at AP House.
Total housing fees are to be paid prior to arrival and the AP House invoice will be sent with the Letter of Acceptance.
Fees to be paid prior to moving-in
The following fees must be paid prior to enrollment.
(1) Students enrolling in the Spring Semester
＊1 semester
① Moving-in fee*1
32,000yen
② 4.5months fee(April 1 toAugust15 )
175,500yen
Total
207,500yen
＊１ year
① Moving-in fee*1
32,000 yen
② 10.5months fee(April 1 to February 15)
409,500yen
Total
441,500yen
(2) Students Enrolling in the Fall semester
＊1 semester
①
Moving-in fee*1
②
5months fee(September 15 to February 15)
32,000 yen
195,000 yen
Total
227,000 yen
＊１ year
①
Moving-in fee*1
②
11months fee(September 15 to August 15)
32,000 yen
429,000 yen
Total
461,000 yen
*1 Once paid, the Moving-in Fee will not be refunded under any circumstances.
*2 Please be sure to pay your dormitory fees in Japanese yen.
*3 Moving-in fee and rent are subject to change.
*4 Residents will be billed separately for any damages caused by the renter’s fault.
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2. Room Types
There are individual rooms and share-typed rooms in AP House. The AP House fee for both types is the same. In individual
rooms, you will have to share the kitchen and shower with other residents.
share the kitchen, toilet and basin.
On the other hand, in a share-typed room, you will
In addition, you will share the room with a newly enrolling Japanese student. Therefore,
these rooms are more ideal for brushing up on your Japanese and making Japanese friends on campus than individual rooms.
Each room is divided by a wall in order to secure the privacy of each resident (Please refer to “Details of share-typed room”). If
you have a special reason to apply for an individual room, please write down the reason below.
only a survey and you may not be able to reside in the room you wish.
Please check one of the following:
I wish to reside in a share-typed room.
I wish to reside in an individual room (Please write down the reason in the space below).
Either is fine
（Reasons for applying for an individual room）
I agree with the above conditions.
Date：
Signature：
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Please keep in mind that this is
Details of individual room
Room Area: 13 ㎡
Equipped items: Desk, chair, bookshelf, lighting, telephone, TV aerial socket, closet, bed, refrigerator,
shelves, air-conditioner / heater, basin, toilet, shoe holder and VDSL Modem.
Common area: Kitchen, Shower room
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Details of share-typed room
Room Area: 13.5 ㎡
Equipped items: Desk, chair, bookshelf, lighting, telephone, TV aerial socket, closet, bed, refrigerator,
shelves, air-conditioner / heater, basin*, toilet*, shoe holder and VDSL Modem.
Common area: Kitchen, Shower room, Toilet and Basin
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