Visa Request Form

Request form for supporting documents for Visa application

to enter Japan and attend ICCSA-2010

Note: Send the scanned registration payment receipt, the filled request form, and other information to:

Prof. Kazuaki Goshi

ICCSA-2010 Local Arrangement Co-Chair

Instructions:

I. Pay the required registration fee. Attach the scanned payment receipt (pdf file) in an email and send together with the other required information.

II. Fill up the following form: (All items are required)

1) Name of applicant: ________________________________________________

(In Roman letters and Chinese whenever applicable)

2) Occupation: _____________________________________________________

(In Roman letters and Chinese whenever applicable)

3) University/Company name and address: (In Roman letters and Chinese whenever applicable)

__________________________________________________________________

4) Date of birth: _____________________ Age: ________ Gender: ________

5) Date of arrival in Japan: ______________

Port of Entry: ________ Flight No.: ____________

6) Date of departure in Japan: ______________

Port of departure: ________ Flight No.: ____________

7) Accommodation during your stay in Japan:

Hotel / Friend / Relative name and address:

__________________________________________________________________

8) If you are a teacher/professor, provide some basic information about yourself (research area, email address, etc.), or the URL address of your homepage.

__________________________________________________________________

9) If you are a student, send a letter of introduction or certification from your adviser/supervisor with his contact number and email/URL address.

10) The postal address to where the invitation letter and related documents will be sent:

__________________________________________________________________

11) Detailed plan of your visit. Provide specifics if you plan to go sightseeing/tour, or visit someone aside from attending ICCSA-2010 conference:

12) Write the address of the Japanese Embassy or the name and address of the Japanese Consular Office to where you will send/submit your Visa application documents.

_________________________________________________________________

Note:

For Chinese applicants, the following URL will provide you information of the Embassy of Japan and Consular Offices for your Visa application.

http://www.cn.emb-japan.go.jp/aboutus.htm#kankatsu

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Visa Request Form

Request form for supporting documents for Visa application

to enter Japan and attend ICCSA-2010

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