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APPLICATION FORM Nihongo Course (2023 session) at University of Miyazaki
日本語講座＠宮大 (2023.05～2024.02) 申し込みフォーム
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Email
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Your email
1-a. 名前 First name (in English)
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Your answer
1-b. 名前 Middle Name (in English)
Your answer
1-c. 名前 Last Name (in English)
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Your answer
2. 名前 カタカナ Full name in Katakana (if you can write)
Your answer
3. ニックネーム Your nickname in Katakana (if you can write)
Your answer
4. 生年月日 Date of birth
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MM
/
DD
/
YYYY
5. 国籍 Nationality
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Your answer
6. 母国語 Native language
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Your answer
7. その他話せる言葉 Other language(s) that you speak (If you have)
Your answer
6. 職業 Occupation
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学生UoM student
家族Family of UoM
スタッフ UoM staff
会社員 Office worker
主婦 housewife
技能実習生 technical intern trainees
Other:
7. 学生番号（宮崎大学の留学生）Student ID Number (if you are a UoM student)
Your answer
8. メールアドレス Email address
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Your answer
9. 電話番号 Phone Number
Your answer
10. 住所 Address
Your answer
11. 代理人氏名（家族またはサポーター）Emergency contact person (family members or your supporter)
Your answer
12. 代理人・緊急連絡先（電話番号またはメールアドレス）Emergency contact address (phone number or E-mail address)
Your answer
13. 来日年月日 When did you come to Japan?
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Your answer
14. 在住歴 How long have you been living in Japan?
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Your answer
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