SAMPLE VISA APPLICATION FORM TO ENTER JAPAN

SAMPLE VISA APPLICATION FORM TO ENTER JAPAN
Smith
Sallie May
Different name used N/A
Name in full
Date & place of birth 01/01/1979 Philadelphia, PA
Sex
Female
married
Marital status
USA
single √
United States of America
Nationality or citizenship
Former nationality, if any N/A
Study
Purpose of journey to Japan
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
Profession or occupation
Tel
215-555-5555
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
Student
Principal former positions
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-]
(Paste a photo here)
VISA APPLICATION FORM TO ENTER JAPAN
Name in full
approx. 45mm ×45mm
Please print.
KNEDDY
(Surname)
2in×2in
Surname should be capitalized.
John Firzgeraid
(Given and middle name)
none
Different name used, if any
Date and place of birth
Sex
15
April
(Day)
Male
(Year)
Yorkshire
(City)
Marital status: married
Nationality or citizenship
United Kingdom
(Province)
×
(Country)
single
Please paste a photo here. (Do
America
Former nationality, if any
NOT staple.)
United Kingdom
Purpose of journey to Japan
to visit relatives
Length of stay in Japan intended
15 days
Route of present journey : Probable date of entry
Port of entry into Japan
Narita AP
Please clarify as concrete as
The photo should be clear and
possible.
identifiable, taken within the
last 6 months.
May 25, 2007
Name of ship or airline JAL-006
(Refugee or stateless should note the title of Travel Document)
Passport
No.
: Skipton
1970
(Month)
A11223344
Diplomatic, Official, Ordinary Issued at
Issuing authority
Criminal record, if any
Home address
U.S.Dept. of State
Valid until
Boston
on
March 10,2007
March 10, 2012
If not applicable, please write “none” or “N/A”.
none
321 East Maple Street, Los Angeles, California 90012, United States of America
Tel.start from the area code.)
Please write accurately. (Phone numbers should
Profession or occupation
Company Employee
Please write accurately.
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(Phone
numbers should
start from the area code.)
Post or rank held at present Assistant Director
Principal former positions Section Chief
Please
writeProfession/occupation
accurately.
＊Partner’s
(or Parents’ Profession/occupation)
In case the applicant is a dependant.
(Phone
numbers
start
the area
code.)with whom applicant intends to stay
Address
of hotelsshould
or names
andfrom
addresses
of persons
Hotel Kayu Kaikan, 8-1, Sanbancho, Chiyoda-ku, Tokyo 102 (03)3230-1230 Please write accurately.
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
Relationship to applicant
(Phone numbers should
Tel.
start from the area code.)
(03)3230-1111
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
(Day)
*These items are not essential to be filled
April
(Month)
2007
(Year)
Signature of applicant
KNEDDY
In case of an infant, parents or a
legal representative can sign here.
Please indicate the relationship.
(eg. Signed by mother)