In order for you to prepare official documents to apply for entry visa into Japan, please fill in and send back the form to the Secretariat. (Please type or print CLEARLY in BLOCK LETTERS).

JSAE Paper No. On-line Registration No.

e.g., s171000

1. Personal Data(□Mr. □Ms.)

Name / *Please print your name as shown in your passport
*If you are Chinese, also please print your name in Chinese character.
Family / First / Middle
Nationality / Date of Birth (mm/dd/yyyy) / / /
Organization/Department
Job Title
Postal Address
*P.O.Box not accepted
Home Phone Number
(Incl. country code) / + / Passport Number
E-mail

2. Personal Data of Accompanying Person if Any(□Mr. □Ms.) *If more than 2, print the same details in [4. Memo].

Name / *Please print your name as shown in your passport
*If you are Chinese, also please print your name in Chinese character.
Family / First / Middle
Nationality / Date of Birth (mm/dd/yyyy) / / /
Organization/Department/
Affiliation
Job Title
Posting Address
*P.O.Box not accepted
Home Phone Number
(Incl. country code) / + / Passport Number
E-mail

3. Itinerary in Japan

*If your itinerary has yet to be decided, please let us know your planned schedule.

*If you have any other plans besides attending JSAE Annual Congress-spring, please specify the details in [4. Memo].

Arrival (to Japan)
Departure date
(from your country) / Departure airport
(in your country) / Flight No.
Arrival date
(in Japan) / ArrivalAirport
(in Japan)
Departure (to your country)
Departure date
(from Japan) / Departure airport
(in Japan) / Flight No.
Arrival date
(in your country) / Arrival airport
(in your country)
At which hotel will you be staying?
Address of hotel

4. MemoIMPORTANT if you have any other plans besides attending the congress, please specify, including dates.

I, the undersigned attending JSAE Annual Congress-spring2018 to be held in Yokohama, Japan,hereby certifies that

the statements made by me in this form are true and correct to the best of my knowledge.

I agree:

A)To comply with Japanese law during my stay in Japan.

B)To report to the Secretariat of JSAE Annual Congress-spring 2018, if requested any.

C)To report any schedule changeabout my stay to the Secretariat of JSAE Annual Congress-spring 2018, and to follow the instructions.

D)Not to engage in any unrelated activities other than attending the congress.

E)To return to my home country immediately after JSAE Annual Congress-spring 2018.

F)To declare that I am healthy and free of any contagious disease.

G)To be responsible for all necessary expenses regarding, but not limited to, my travel and accommodation expenses.

Date: Name:

Your signature is required.

NOTE)

You are required to prepare necessary documentsto apply for an entry visa to an embassy or consulate of Japan at your local. It may take 10 days to 3 weeks to prepare and send the following JSAE sealed support documents to you.

Letter of Guarantee 身元保証書

Letter of Reason for Invitation招聘状

Itinerary 旅行日程表

Other Related Documents

Secretariat:JSAE Annual Congress-spring 2018

E-mail:

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