SAMPLE visa application form - dubai.uae.emb-japan.go.jp · VISA APPLICATION FORM TO ENTER JAPAN Surname (as in passport) KENNEDY Given and middle names (as shown in passport) JOHN

Please write in block letters

Please paste a photo with GLUE here. (Do NOT use staple.) The photo should be clear and identifiable, taken within the last 6 months.

Please tick the appropriate box.

Surname should be capitalized. Please provide the city, state / province and country in which you were born.

Please fill out other nationality or citizenship if applicable.

Please provide your original country ID number (if applicable).

Please write accurately (phone numbers should start from area code.)

Please fill out your nationality.

Attention: All fields must be filled. Please write N/A or None if not applicable.

First page

If you stay in multiple hotels, write the first hotel information. The rest of hotels to be written in the form of “Schedule of stay”.

Go to second page

Please write accurately, if applicable. ＊For tourism purposes please write N/A.

For example, if there are humanitarian considerations that should be taken into account.

Please tick the appropriate box.

In case of Minor, parents or legal representative can sign here.

Please indicate the relationship (e.g. signed by Mother )

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

N/A

Second page