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5 The personal information written in this application form is only used for your extension apply and its selection.0Indeed, we never proveide your personal information to others except fllowing to Law no.9.rs 5"The day when you enter Yamaguchi U 58Application for Living in Yamaguchi International House  50J0000000t^0000 0g00000e00^0 00000t^00 000g0 0000eF5 000000000000!( /-, f[xvzy(5 000000000'*, To the director of the International House. 5((Wee\tk$500000002History you live in International House until now. 5History you live in Japan 5Name 5w mi 5t^b50000 Occupation 5Age  5 2t^b 3uˊBf .5 0000000000S0n03uˊfk0eQU00_0 PN`1Xo00q\S'Yf[VNAmO(n0eQE\x0eQE\1S0 N1SwSs0eQE\_n0eQE\{tn0_00k0O(uY000n0g0B000S00k00c0f0__0 PN`1X00rzL?elNI{n0O gY00 PN`1Xn0Owk0Y00l_,{agk0[U00f0D004XT0dM003uˊ,gNn0 Ta0_0S0h0j0O0Nn0vvg0O(uSo0,{ Nk0cOY00S0h0o0B00~0[000eQE\n03uk0d0D0f0o00Vz'Yf[lNq\S'Yf[VNAmO(GRk0We0M0,{9ag0O(k0eQE\0 ^gY00o00@b[n0f^k000(wk0XD0Q00n0h0Y000 eQE\3uˊf0cQW0_0n0a00VNAmO(eQE\xOk000zl[U00~0Y00 5400000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000  #',0"5$8'<*?,A.G2L4OTY]aeimqvz} Tenants will be determined by the International House Selection Committee based on University rules after submitting the applicationa form. (Article 9: Those who wish to move in the International House are required to submit the application form to the Derector of International House.) 5; S(J00s0E\[000o0xy0~0[00n0g0T0NbO0`0U0D00 5BFamily members who live together in Yamaguchi International House  5bq\SVNAmO(g0n0 TE\[e^5000000000000000000000000   Y500 T500 Family name 5 Given name 5/; eQE\L01SU00_04XT0]0n01Sgn0YSs0B}Neo00 NeQE\ ^ggn0F0a00s^eh0W0~0Y00500000000000000000000000000000000000000000000000000  !& )",(< 00N[k0W0f0D00)5000  P[O0|Ts0[[00N[k0W0f0D00 & 500000xb6,gf[g0n0(WM|R25 00000000000Q ; In case you re permitted, the move-in start date and end date are weekdays only.( 5+eQE\ ^g:SR ; D0Z00K00xb XS[0+YfZ[Ss0[e[n0͑ ^go0 g0M0~0[000  56eQE\ ^gg ; D0Z00K00xb25 00000000000$ Period of living ; Choose either one.( 5Choose from the list= Scholarship or stipend etc. 000 9< 52hYf[ё`1X.5 000000000000*There is no parking slot for residents. Therefore, you are required to lease a parking slot outside and submit a photocopy of the lease agreement together with this form. 5Remarks 50 Ty:  5&00gM 00 Q 5 0Name of scholarship: . 5*Amounts of montly payment : JPY  58,gf[g0n0@b^\ ; D0Z00K00eQ45 000000000000 $000000t^0000g0000e0^000000t^0000g0000e500 0xvz500 ,0f[xvzu+T0 (5 000000000 B0xvzy('Yf[bu)>500000000000000  0f[t^(xvzu0n0^0O0),5 000000000006"0(000 000t^000 000g000 000e00^000 000t^000 000g000 000e)50000, B,gf[g0n0(WM|N[g>500000000000000  Researcher 0 5'Department (including reserch students) 5#Research cource (graduate students) 5"Year (Except for reserch students) 5/From Year / Month / Day to Year / Month / Day 50From Year / Month / Day to Year / Month / Day 51 00From Year / Month / Day to Year / Month / Day0 5 If you are planning to do further study in YU, please indicate the estimated period of your study. From Day / Month / Year, To where you are going to enter c2d 5d First choice of your favorable room type. You only can choice one room type. ; Choose any of them.++,N+OP*Q3 5= Your Department or Faculty in Yamaguchi U ; Write any of them.*++ 59 *Sci.&Tech for InnSciences and Technology for Innovation4 5"oW[ T 5000000 5Chinese character ( if any ) 5 Middle name 5 Age (When you apply  5;*We regret that you cannot choose the dorm or type of room. 5, between September 2026 and March 2027.) 5G child(ren) or his/her spouse between September 2026 and March 2027.) 5: >?5CNG HJ-LFP3QY[_aOdD iccRB ZO 2Gq  dMbP?_*+%0&(\?'(\?()\(?)ףp= ?M DocuWorks PDF`2  4[,`27.4.197.02DocuWorks PDF  < 4 2X,http://tss3161.e-timing.ne.jp/astdtssvr/TSRequest%MYDOCUMENTS%" [,,{Gz?)\(?&(U} ?}  ?}  ?}  ?} ?}  ?}  P2 v@@@@ @  @  w@w@w@ w@ h@ @ @ hl  @ +@ @ @ @ +@ +@ +@ @ @ @  ? ?   Q   Q QR SSS Q R ?  T U   ? QL Y yyyyyz{||||}  T~~~~~  U Z  fW S??? ? WWWWW X    O P y x V! Y"  V  Z V YI [ e h V i g W V j V  w V a ^ b BX&.":.&00&04"&&`<^F..ZF! @" @# @$ ^% ^& ^' ( ) * + , - . I@/ @0@1F@ ![! "[A "V" "k" #V ## $] $$@@@ %l %>%@@@ & &&@@@ ' ''( (( )N ))* * * *_ *_ *_F *mE+``pn,``pn-aaqo .\ .V. .. /V/0bccccccc 1J1&@&F28842.2^F&4(  ~  <B))A@@ ]6   "'<O2026t^09g014e00^002027t^03g011e00gweQE\g <$f'~~  <@B))A@@]6   " < NNYT0eQ NU0D0 0<% ~~  <B))A@# ]6   "<XS[0 ^gY000(XS)<%~~  <B))A@#  ]6   "+P<W+YfZ[0 ^gY00(+YfZ0W0O0o002026t^9g^2027t^3g~0g0k0MvP0|Ts0[[00<P%$% $%-$% $%+~~  < B))A@Q]6   "+P<W[e[0 ^gY00(P[O04OF0[e0W0O0o002026t^9g^2027t^3g~0g0k0MvPh0<P%$% $%- $!% "$#%T+><d>,,--!!""**((++""&&''    ....%&%%//'(11##$$)-))5 [,00000xbZSXZSX_g OXZSXMRg f[uxvzuNcYuf[uxvz i300000xbVYV?e^>mcJICAJDSq\S we-NhYRO]0n0N( Ty0eQ)y*[ 500000xb1t^2t^3t^4t^5t^6t^?  00000xb7usYt^ o600000xbNef[Yef[L}nf[tf[;Sf[]f[f[qQ Tcs;Sf[V}Tyf[O )00000xb!q g(ek0a00eQ)f[""?  00000xb!q ge..b(b(  ggD ZO 4Ua  dMbP?_*+%&i4F?'i4F?(M&d2?)q= ףp?M DocuWorks PDF`2  4[,`27.4.197.02DocuWorks PDF  < 4 2X,http://tss3161.e-timing.ne.jp/astdtssvr/TSRequest%MYDOCUMENTS%" [,, BP(?{Gz?&zU} A}  A} `A}  A}  B4  v@  @   @ @ @ @ @ @  w@ w@ w@ w@ ,@ @ @   @ +@ @ h@ @ +@ @ ,@ @ f @ A=AAAAAAABB A@ BB BB ?# BB B$BBBB DDgggBB h% CDCCCCBB h&DDDDDBB  igDhhhBB h' D( DDDDBB  k )) )))jBB ?* i} #u $%& %& -~----&%&777778 ' ' #[*+++++,' q O 9X++++++ ?+DDDDD X,./2 -3  Q! 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"3"(((( #C# #\# #Es #556 $44$5 $4$$55556 %<% %4$%55556JJ &#5&$ &*q&++++,JJ '' ':t';;;;<JJ (B (*r(+++++,) )r) *M **6*+++++,+I +?7 +?@ +L8 +L9 +LH +tG,I==>MMur-I==>MMur.JJKNNvs /d: /\/( /L_/LLLM 0C`01OIIIIIII 2H;2HHHHHHH 3FK3GGGGGGG*h2&N:>>42.2^F&&@ %((  R % C ]F%! d P~~  <0B))A@  ]6   "+<,Apply for SINGLE room (Only for one person)<'+~~  <B))A@ ]6   "^ <_Apply for COUPLES room (Only for a couple or a person who intends to only call his/her spouse < 'g$'^~~  <0B))A@]6   "`<aApply for FAMILY room (Only for a family with child(ren) or a person who intends to call his/her<'-`~~  <B))A@M R]6   "BX<CSeptember 14, 2026 to March 11, 2027 (Maximum period of living)<X$A ' $ '$'$5 '%$&'B~~  <`B))A@@s]6   "<Other (Write the period.)<'><dB3322*...**%%--00////,,++(( ######$$$$ &'''&&%% ()!!""))""  5% urChoose from the listPhd studentMaster studentUndergraduate studentResearch studentExchange studentResearchera Choose from the listMEXTForeign government sponsored JICAJDSYamaguchi prefectural budget (scholarship)Scholarship from Japan and China associationOther(write the name)Private paymentc I # Choose from the listMaleFemalei Choose from the listHumanitiesEducationEconomicsScienceMedicine and Health SciencesEngineeringAgricultureJoint Faculty of Veterinary MedicineGlobal and Science StudiesEU /,Choose from the list1st2nd3rd4th5th6thtT .+Choose from the listNoYes(write the date)##D Choose from the listNoYes //b(b(  ggD Oh+'0HPdx  Rw @Microsoft Excel@9@@X i ՜.+,0HP X`hp x  JPNENGENG!Print_AreaJPN!Print_Area  [NV[g Otꗗ  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~Root Entry FоOHWorkbooka SummaryInformation(DocumentSummaryInformation8