All the Blanks Below Must Be Completed

VISA Questionnaire

All the blanks below must be completed.

Please make sure that your mailing address is correct because the letter is going to be sent to the address.

Accompanying person(s) must submit this form as wll.

Family Name
(As is passport) / Given and
middle name
Date of birth / Age
(Day) / (Month) / (Year)
Sex / Male Female
Nationality
Mailing Address
Home Phone / + / Office Phone / +
Affiliation
Job Title
Expected arrival date in Japan / Expected departure date from Japan
Embassy or consulate-general where you will be applying for visa.

[Flight and Accommodation Information]

A tentative flight schedule and accommodation are acceptable if they have not been set yet.

Hotel
Name / 1. / Date In Date Out
2. / Date In Date Out
3. / Date In Date Out
Hotel
Address / 1.
2.
3.
Arrival Flight to Japan
(No need to indicate a connecting flight, an immediate flight arriving in Japan only.)
Airline
Name / Flight No.
Departure
Airport / Arrival
Airport in Japan
Return Flight (Immediate return flight from Japan.)
Airline
Name / Flight
No.
Departure
Airport / Arrival
Airport

Schedule of Stay

See the sample below the form.

Applicant’s Name: ______

Accompanying Person’s Name: ______

Date / Activity Plan / Contact / Hotel Name
Aug. ,2016 / Arrive in ABC international airport
from ABC international airport
aboard ABC Airline, Flight XX.
Aug. ,2016

Schedule of Stay（Sample）

Date / Activity Plan / Contact / Accommodation
July. 31, 2016 / Arrive in Narita International Airport from ABC International Airport aboard ABC Airline, Flight ABC / Inviting Person / Hotel Name
Aug. 1, 2016
to
Aug. 5, 2016 / PRICM9 / Kyoto International Conference Center / Same as above
Aug 6, 2016 / Sightseeing in Kyoto / Inviting Person / Same as above
Aug. 7 2016 / Departure from Narita International Airport to ABC International Airport
aboard ABC Airline, Flight ABC