31th_Study_Tour_CV_form

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31th_Study_Tour_CV_form

  1. 1. 第 31 回欧州青年日本研修データフォーム(Data Form) *在リトアニア大使館(担当官名:綱島)Write in Japanese or English* Write exactly as written in passport*印は在外公館が記入First name*: Surname*: First name*: First name*: Photo Surname*: Surname*: *(カナ表記) * (カナ表記)(カナ表記) (カナ表記) (カナ表記) * Nationality: (カナ表記) Lithuanian Nationality:Sex: M F Nationality: Lithuanian Lithuanian Date of birth ( 19yy / Nationality: mm / dd ): / / Date of Lithuanian birth ( 19yy / mm / Nationality:Date of birth ( 19yy / mm / dd ): / / dd ): / / Date of birth Lithuanian ( 19yy / mm / dd ): / / Passport No. : Date of birth ( 19yy / Passport No. : mm / dd ): / / Age: Passport No. : Passport No. :Passport No. : Passport No. :Address:Address: Address: Address: Address: Address: Address: Tel: +370 Email:Tel: +370 Email: Email: Email: Email:Airport you wish to use on departure: (カナ表記) ① Airport you wish to use on departure: Airport you wish to use on departure:① Airport you wish to use on departure:② ② ① ② ① ② ① ②
  2. 2. (カナ表記) ① (カナ表記) ① ② ②Present occupation / name of company or schoolPresent occupation / name of company or school Present occupation / name of company or schoolPresent occupation / name of company or school Present occupation / name of company or schoolPresent occupation / name of company or school Present occupation / name of company or schoolEducational qualifications1. Name of university / college / school:Educational qualifications Educational qualifications Educational qualifications Educationalqualifications Educational qualifications Educational qualifications1. Name of university / college / school:1. Name of university / college / school:1. Name of university / college / school:1. Name of university / college / school:1. Name of university / college / school:1. Name of university / college / school:2. Period of study:2. Period of study: 2. Period of study: 2. Period of study: 2. Period of study: 2. Period of study: 2.Period of study:3. Field of study / faculty of university:3. Field of study / faculty of university: 3. Field of study / faculty of university: 3. Field of study /faculty of university: 3. Field of study / faculty of university: 3. Field of study / faculty of university:3. Field of study / faculty of university:Hobbies:Hobbies: Hobbies: Hobbies: Hobbies: Hobbies: Hobbies:Foreign language:Foreign language: Foreign language: Foreign language: Foreign language: Foreign language: Foreignlanguage:Any specific request for possible inclusion in your study:
  3. 3. Any specific request for possible inclusion in your study: Any specific request for possible inclusionin your study: Any specific request for possible inclusion in your study: Any specific request forpossible inclusion in your study: Any specific request for possible inclusion in your study: Anyspecific request for possible inclusion in your study:Any forbidden food: Yes ( ) NoAny forbidden food: Yes ( ) No Any forbidden food: Yes ( ) No Any forbidden food: Yes ( ) No Anyforbidden food: Yes ( ) No Any forbidden food: Yes ( ) No Any forbidden food: Yes ( ) NoDo you smoke? Yes NoDo you smoke? Yes No Do you smoke? Yes No Do you smoke? Yes No Do you smoke? Yes No Doyou smoke? Yes No Do you smoke? Yes NoDo you mind if any pet inside the room? Yes ( ) NoDo you mind if any pet inside the room? Yes ( ) No Do you mind if any pet inside the room? Yes ( )No Do you mind if any pet inside the room? Yes ( ) No Do you mind if any pet inside the room? Yes( ) No Do you mind if any pet inside the room? Yes ( ) No Do you mind if any pet inside the room?Yes ( ) No備考備考 備考 備考 備考 備考 備考

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