Application form for entering dormitory
Nationality Name (Exactly as registered in Kyoto Univ.)
Name Age Job Work place and Position Earned Income
Father Mother
Name Age Education Institution Grade Where she/he lives
(You)
Kyoto University
(Public/Private) With parents / Not with parents
(Public/Private) With parents / Not with parents
(Public/Private) With parents / Not with parents Reason of your application and your fimily's circumstances
The Monthly earnings and expenses of the applicant
Allowance Scholarship
Earn from (part-time-)job Other Incomes
Expenses for your studies Expenses for cultural activities and entertainment
Living Expenses Other Expenses
Go to the back side
Japanese Kana Sex
Department / Graduate course and laboratory
Enrolled year
※Bachelor , Master , Docter , Reserch Student Auditor , Credit Auditor , Other Date of Birth (d). (m). (y). (age )
Home adress
(A Postal Code )
TEL
Family 's adress
(A Postal Code )
TEL
House -holds and Incom e
Except for attendin
g schools
Family relationshi
p
Job tenure
After tax Income (y)
(y)
※If some of your parents are seperated、or if the family budget supporter lost one's job, write the reasons and the date
(y)
(y)
Mark × at who lives apart
Mark
○ at who support
s the family budget
(y)
Attendin g schools
Family relationshi
p
