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Japanese Language Program

Application Form for Admission-Spring 2016

Application Deadline: December 4th, 2015 in Japan Standard Time

Please complete this form in English. Handwritten forms (except signatures and the part indicated to write by hand) will NOT be accepted. Please print on one side. (Eligible Students: Students enrolled in overseas undergraduate/graduate courses)

Name

Roman

Alphabet

Last First Middle

*Spelled exactly the same as it appears on applicant’s

passport

Katakana

Last First Middle

Sex □ Male

□ FemaleAge Nationality

Date of

Birth

Year Month Day

Applicant’s First Language

If applicant’s first language is not English, please provide

information of English proficiency.

*Applicant’s English proficiency must be TOEFL iBT 61 or IELTS 5.5 or CEFR B2 or equivalent.

Name of the Applicant’s Home

University/College

Applicant’s Major and Minor

Major Minor

Present

Academic

Status

Undergraduate □1st Year □2nd Year □3rd Year □4th Year

Graduate □1st Year □2nd Year □3rd Year □4th Year □5th Year

Expected Year and Month of Graduation

Year Month

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Person to Contact in Emergency

Passport Data

Present Mailing Address

Postal

Code Email

Phone Fax

Valid until Year Month Day

Permanent Mailing Address

Postal

Code Email

Phone Fax

Name

Occupation Relationship with the Applicant

Mailing Address

Postal

Code Email

Phone Fax

Signature of the Contact Person

in case of Emergency

Passport

Number

Issuing

Authority

Date of

Issue

Date of

Expiration

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Special Needs Applicants are requested to provide information if they have special needs during their stay at

KCUFS. This information will only be used for special support.

Proposed Period of Study

☞ Note: The calendar of the Japanese Language Program(JLP) and that of the regular course are different.

On the one hand, Japanese language classes finish in the very beginning of August in the spring semester, but

the regular course classes finish in the middle of August. JLP students who take the classes of the regular course

can return to their home country after Japanese classes finish. The students taking the classes of the regular

course need to consult with the lecturer of the classes about grades if they would like to return to their home

country after Japanese language classes finish but before the classes of the regular course finish.

Questionnaire on Applicant’s Japanese Language Background

(1) Experience of Japanese Language Study

Total Study Period: years and months; hours in total

(2)Questions

i) Have you taken any kind of Japanese proficiency tests?

□ Yes Name of the Test Score/Level

□ No

ii) Do you accept that in KCUFS’s JLP there is neither a lower elementary level course

(corresponding to the JLPT N5 level approximately) nor an advanced level course. (Therefore, we

will not be able to accept applicants who are considered to be at these levels.)

□Yes □ No

□ I do not have special needs

□ I have special needs

□Wheelchair/ □Dyslexia/ □Blind (Partly Sighted)

□Deaf (Impaired Hearing)/

□Mental Health Difficulties/

□Other( )

□Spring Semester (April -August)

□Spring and Fall Semester

* Fall Semester (September – February)

Name of

Institution Type of Study Country/City

Period

(YYYY/MM)

Hours

per

Week

Textbooks Used

□University

□Language School

□Self-study

/ -

/

□University

□Language School

□Self-study

/ -

/

□University

□Language School

□Self-study

/ -

/

□University

□Language School

□Self-study

/ -

/

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(3) Please answer the following questions:

Why do you want to participate in this program? What are your interests in Japanese culture and

language? What do you expect from this program?

Please write in Japanese in your own hand. You don’t need to be afraid of making mistakes in

Japanese.

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Request Form for Accommodation (Availability is dependent on room / host-family.)

➊ Apartment “Manabigaoka College Heights” It is a 6-minute bus ride from the nearest bus stop to KCUFS.

A three-month commutation ticket from the apartment’s nearest bus stop to KCUFS’s costs 20,520 yen.

Note:

(1) Before you move into the apartment, you have to make an apartment contract in Sannomiya (Sannomiya is the central

part of Kobe City). You can move into the apartment on the same day. The recommended contract-making and move-in

date will be indicated after the screening.

(2) Upon arrival, a JLP student must pay a damage deposit and first month’s rent in Japanese yen in cash.

(3) Daily payment applies only for the first and last month if a JLP student does not stay for the whole month.

(4) If a JLP student damages the furniture or room, repair costs will be covered by the damage deposit, if possible. If the costs

exceed the damage deposit, students will be additionally charged.

➋Kobe International Student Center Housing (KISCH)It is a 15-minute walk from KCUFS, and houses international students from various universities.

Note:

(1) Applicants for KISCH must have an interview at the Kobe International Center (KIC).

The interview will be held in Sannomiya (Sannomiya is the central part of Kobe City) at 10:30am on Tuesday, March 29th.

After passing the interview, you will be permitted to reside in KISCH on the same day as the interview is held. If you can’t

attend the interview, you cannot reside in KISCH.

(2) Please stay in a hotel near Sannomiya station until the interview date. You have to arrange the hotel by yourself.

(3) Students are required to pay both the initial fees and the first month’s rent upon arrival, in Japanese yen in cash.

(4) KISCH does not provide an Internet connection. Therefore, in order to use the Internet, you will need to make a contract

individually with an Internet service provider (a company which establishes the Internet connection), or rental a Wi-Fi router.

So it will take some time before you can start to use the Internet. It costs about 4,500yen/month.

(5) If you receive a scholarship for more than 150,000yen/month, the monthly payment will increase. For the details, please

contact the International Office.

➌ Home-stay Monthly Payment Includes Excludes

Home-stay 70,000 yen (80,000 yen from November to March

to cover heating costs)

Internet, Utilities,

Furnishings, Meals Lunch on weekdays

*Meals: Breakfast & Dinner on Weekdays / Breakfast, Lunch, & Dinner on Weekends

Daily Payment: When international students do not stay for a whole month, they can pay 2,300 yen / day (2,600 yen per

day in winter). For instance, if a student leaves on August 4th, the monthly payment will be 9,200 yen. This way of the

calculation shall be applied to the month of your arrival in Japan and return to your country only.

Number your preference

in order (1-3)

□ Apartment“Manabigaoka College Heights”

□ Kobe International Student Center Housing

□ Home-stay

Planned Period of Stay

(YYYY/MM - YYYY/MM) ( / ___ / )

Monthly Payment Damage Deposit Includes Excludes

Single

39,000 – 43,000 yen

35,000 – 39,000 yen

( Refundable)

Internet, Air Conditioner, Kitchenette, Bathroom, Closet, Shoe Rack,

Laundry(100yen/use), Bed, Bedding, Refrigerator, Chair, Desk, Microwave

oven, Curtains, Rug

Meals,

Utilities

Monthly Payment Initial fee Includes Excludes

Single 24,000 yen 20,000 yen

Bed, Bath, Refrigerator, Desk, Chair, Bookshelf, Closet, Air Conditioner, Shared Kitchen, Shared Laundry

Internet, Bedding, Meals,

Utilities

Double for single

use 33,000 yen 25,000 yen Kitchen(In addition to the above) Same as above

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Declaration I hereby declare all information in the application form and documentation provided to be true. I am

completely responsible for my educational and living expenses during my stay at KCUFS, and I agree to pay all

fees to KCUFS by the due date. I will immediately notify KCUFS if there is any change in terms of any given

information in this application form.

Applicant’s Study Abroad Advisor or Academic Advisor at Home University

Application Deadline: December 4th, 2015 in Japan Standard Time

Please send this application form enclosed with all other required documents by air-mail to the

following address:

International Office

Kobe City University of Foreign Studies

9-1, Gakuen-higashimachi, Nishi-ku, Kobe 651-2187, Japan

Tel: ＋81-78-794-8171 / Fax: ＋81-78-794-8178

Email: international-office@office.kobe-cufs.ac.jp

(Inquiries welcome)

*Your application must be received no later than Friday December 4th, 2015 (to be eligible for the

spring semester, 2016).

*Screening of the applicants will be held after the application deadline. Notification will be sent

by both email and mail to each applicant by January 15, 2016.

Applicant’s Name

Date Applicant’s

Signature

Name

Position

Phone Email

Date Signature