Preliminary Application Form

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J. F. Oberlin University
Institute for Japanese Language and Culture (Prep Course)
FAX：+81-(0)42-704-7033
Preliminary Application Form

If you are not able to use the inquiry form over the Web, please send a fax to the following number: (+81)(0)42-704-7033.

Did you read the newest application guidebook and confirm that you meet the admission requirements?required	This item is required. Yes No Since I have questions, I am going to contact the Institute.
Date of birth	This item is required.
Applicant's namerequired	This item is required. First name Middle name ※Optional Family name
Sexrequired	This item is required.
Nationality, etc.required	This item is required.
Birthplace (Chinese applicants only)
Address (the place you wish your application documents to be sent)required	This item is required.
Telephone numberrequired	This item is required. + - -
E-mailrequired	This item is required.
E-mail(reenter)required	This item is required.
Planned path of study after completing our prep courserequired	This item is required. Admission to university as a freshman Admission to university as a junior Admission to graduate school Vocational school
The last school you graduated from (not including Japanese language school）required	This item is required. High school Vocational high school Vocational school Two-year college Three-year college Four-year university
Present statusrequired	This item is required. A. In final year of last school attended(not including Japanese language school) Date of expected graduation Y M B. Japanese language school student after graduation of last school attended Date of graduation from last school attended (not including Japanese language school) Y M C. Full-time worker Date of graduation from last school attended (not including Japanese language school) Y M D. Other Date of graduation from last school attended (not including Japanese language school) Y M
Years of education (elementary school to last school attended, not including Japanese language school)required	This item is required.Elementary school years → Junior high school years → High school years → Vocational school / Two-year college / Three-year college / Four-year university years Total years
Present Status of Residence (Visa) in Japanrequired	This item is required. I don't have a visa for staying in Japan. I live in Japan now.I have a visa This visa will expire on Y M D
Have you ever been rejected for a certificate of eligibility?required	This item is required. No Yes Y M D
History of study in Japan	From Y M to Y M
Name of school where you studied in Japan
How did you get information about our Institute?	From a teacher From one of our university's current students or graduates From the Internet From data in an embassy etc. Other
Total hours of Japanese study completed at high school, university Japanese language institute, etc.	Less than 150 hours 150-300 hours 301-500 hours 501-1000 hours Over 1000 hours
Dates of Japanese study at high school, university, Japanese language institute, etc.	From Y M to Y M
Name of high school, university, Japanese language institute, etc, where you studied Japanese.
Can you provide a certificate of studying Japanese from a Japanese language institute?	Yes No
Official Japanese language test(s) passed	JLPT N1 N2 N3 N4 N5 Date of acquisition Y M Other official Japanese language test(s) passed Date of acquisition Y M

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Personal information in this document will be used only to evaluate you. Submitting this form alone does not complete your application. After we check this preliminary application form, we will send you application documents. When you finish remitting the application fee and sending us your application documents, we can consider you for admission.