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[null,null,null,null,"",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"1/4"]
[null,null,null,null,null,null,null,null,null,null,null,"入 学 願 書",null,null,null,null,null,null,null,null,null,null,null,null,null,"東北多文化アカデミー"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TOHOKU TABUNKA ACADEMY"]
[null,null,null,null,null,null,null,null,null,null,null,"   Application Form for Admission　",null,null,null,null,null,null,null,null,null,null,null,null,null,"〒980-0813 宮城県仙台市青葉区\n米ヶ袋1-1-14-303"]
[]
[]
["注意　　　：　入学願書は楷書で日本語または英語で記入のこと",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"TEL：022-796-8596"]
["NOTE    　： 　Ｆill out the application form in Japanese or in English.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FAX：022-796-8597"]
[null,null,"申請者情報　/　Personal Information"]
[]
[]
["氏名(ローマ字)\nName(s) as shown\non your passport　　"]
[]
[]
["氏名　（漢字)\nName(s) in\nChinese characterｓ　"]
[]
[]
["国籍・地域\nNationality/Region",null,null,null,null,null,null,null,null,null,null,null,"性別\nSex",null,null,"        男（Male）\n      女（Female）",null,null,null,null,null,"婚姻\nMarital Status",null,null,null,"  既婚(Married)\n 未婚（Single)"]
[]
[]
["入学希望コース\nCourse of Admission",null,null,null,"         4月入学（April intake）1 Year Course\n       4月入学（April intake）2 Year Course\n       10月入学（October intake）1.5 Year Course",null,null,null,null,null,null,null,"生年月日\nDate of birth",null,null,null,null,null,null,null,null,"年齢\nAge"]
[]
[]
["出生地\nPlace of  birth"]
[]
[]
["本国の戸籍住所\nHome address"]
[]
[]
["現在の住所\nPresent address"]
[]
[]
["電話番号\nPhone Number",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," Ｅメール\n E-mail "]
[]
[]
["旅券番号\nPassport No.　　　　　                   　　　　                    　",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"有効期限\nDate of expiration"]
[]
[]
["職業\nOccupation "]
[]
[]
[null,null,"卒業後の進路　Plans for after graduation"]
["日本国内での進学\nHigher education in Japan",null,null,null,null,"学校種別\nType of schools"]
[null,null,null,null,null,"学校名\nName of School"]
[null,null,null,null,null,"希望科目（専攻）\nMajor "]
["就職\nEmployment",null,null,null,null,"希望する職種\nAimed occupational category"]
["帰国・復学\nReturn to home country",null,null,null,null,"いつ頃帰国する予定ですか？\nWhen will you return?"]
["その他\nOthers"]
[null,null,"過去の在留資格認定証明書交付申請歴\nPast history of applying for a certificate of eligibility",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"あり　Yes",null,null,null,null,null,null,"　なし　No"]
[]
[]
["回数\nNo. of times",null,null,null,null,null,null,null,null,null,null,"回",null,"うち不交付となった回数\nOf these applications, the number of times of non-issuance",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"回"]
[]
[null,null,"過去の来日歴　/　Record of entry to Japan",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"あり　Yes",null,null,null,null,null,null,"なし　No"]
[]
[]
["回数\nNo. of times",null,null,null,null,null,null,null,null,null,null,"回",null,"直近の出入国歴\nThe latest entry",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
["出入国年月日\nPrevios dates of entering and leaving Japan",null,null,null,null,null,null,null,null,null,null,null,null,null,"在留資格\nResidential Status",null,null,null,null,null,"入国目的\nPrevios purpose of entering Japan"]
[]
[null,null,null,null,null,"～"]
[]
[null,null,null,null,null,"～"]
[]
[null,null,null,null,null,"～"]
[]
[null,null,null,null,null,"～"]
[]
[null,null,null,null,null,"～"]
[]
[null,null,"学歴　/　Educational background"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"2/4"]
[]
["学校名\nName of School",null,null,null,null,null,null,null,null,null,null,null,null,"入学年月　　　　",null,null," ～","卒業年月　　　",null,null,"修学年数",null,null,"所在地\nLocation"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"Enrollment\nYear/Month",null,null,null,"Completion\nYear/Month",null,null,"Total school years"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
["在籍状況\nRegistered enrollment",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"修学年数(小学校から最終学歴まで) \n Total period of education (from elementary school to the last school attended). ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"年\nYears"]
[]
[]
[null,null,"職歴　/　Occupational experience",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"あり　Yes",null,null,null,null,null,null,"　なし　No"]
[]
[]
["会社・事業所名\nName of company",null,null,null,null,null,null,null,null,null,null,null,null,"就職年月　　　　",null,null," ～","離職年月　　　　",null,null,"職業",null,null,"所在地\nLocation"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,"Enrollment\nYear/Month",null,null,null,"Completion\nYear/Month",null,null,"Job content"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"～"]
[]
[]
[null,null,"空白期間／兵役　Blank period／Military service",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"あり　Yes",null,null,null,null,null,null,"なし　No"]
[]
[]
["詳細\nDetails"]
[]
[]
[null,null,"日本語学習歴　Learning experience for Japanese language",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"あり　Yes",null,null,null,null,null,null,"なし　No"]
[]
[]
["学校名及び所在地\nName of Institution and location",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"学習期間\nPeriod of Study"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"開始年月\nEnrollment Year/Month　",null,null,null,null,null,null,null," ～",null,null,"終了年月\nCompletion Year/Month"]
[]
["\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ～"]
[]
[]
["\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ～"]
[]
[]
["\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null," ～"]
[]
[]
[null,null,"日本語能力　Japanese Language Proficiency",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"あり　Yes",null,null,null,null,null,null,"なし　No"]
[]
[]
["受験名称\nExamination",null,null,null,null,null,null,null,null,null,null,null,null,null,"受験年度\nExam year",null,null,null,null,"受験等級\nExam Level",null,null,null,null,null,null,null,"受験点数\nScore",null,null,null,null,null,"受験結果\nResult"]
[]
[null,null,"JLPT（日本語能力試験）"]
[null,null,"J-TEST(実用日本語検定)"]
[null,null,"NAT-TEST"]
[null,null,null,null,null,null,null,null,null,null,null,"other"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"3/4"]
[null,null,"家族　Family members"]
[]
[]
["続柄\nRelationship",null,"氏名\n Name",null,null,null,null,null,null,null,null,"生年月日\nDate of  birth",null,null,null,null,"国籍\nNationality",null,null,null,null,"職業\nOccupation",null,null,null,null,null,null,"住所／電話\nAddress/Telephone"]
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[null,null,"在日親族（父・母・配偶者・子・兄弟姉妹・祖父母・叔(伯)父・叔(伯)母など）及び同居者\nFamily in Japan (father, mother, spouse, children, siblings,grandparents, uncle, aunt or others) and cohabitants",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"あり　Yes",null,null,null,null,null,null,"　なし　No"]
[]
[]
["続柄\nRelationship",null,"氏名\nName",null,null,null,null,null,"生年月日\nDate of birth",null,null,null,null,"国籍\nNationality",null,null,"住所／電話\nAddress/Telephone",null,null,null,null,null,null,null,null,null,null,"勤務先・通学先\nPlace of employment/school",null,null,null,null,null,null,"在留カード番号\n（在留資格種類）\nResidence card number \n(Type of status)"]
[]
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[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"\n"]
[]
[]
[null,null,"経費支弁者　Financial supporter (Person responsible for your tuition fees and living expenses)"]
["氏名\nFull  Name",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"本人との関係\nRelationship"]
["住所\nCurrent address",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話番号\nHome Phone No. /\nMobile Phone No."]
["勤務先名\nEmployer/Company Name",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"業務内容・役職\nOccupation(Position)"]
["勤務先住所\nAddress of workplace",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"電話番号\nEmployer/Company Phone No"]
["年収(JP￥）\nAnnual income of the supporter",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"レート\nExchange rate"]
[]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"4/4"]
[]
["▼　志望理由　Statement of purpose"]
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[]
[" 以上のことはすべて事実であり、私が記入したものです。また、本入学願書に記述した全ての内容、及びその他の出願に必要となる提出書類については、その情報の取り扱いにつき、貴校の募集要項の内容に同意の上出願を行うものです。\nI hereby declare the above statement that I wrote is true and correct. By signing below, I give consent to all of the information stated in this application form. The submitted documents will be treated in accordance with the enrollment guidelines."]
[null,null,"作成日\nDate",null,null,null,null,null,null,null,null,null,null,null,null,null,"署名\nSignature"]