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 活動内容証明書 ╝ ╢

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早稲田大学政治経済学部グローバル入試

証明資料No. ※受験番号(大学記入) フリガナ

氏 名

活 動 内 容 証 明 書

Certification of Activities

・活動記録報告書と同一の活動期間・活動内容を志願者本人が記入し、証明者記入欄に学校長・

各種団体長等の証明を受けること。

The applicantshould write by himself/herselfthesame activity periodsand activitiesasthose in theofficialactivityrecordreport.Thismustbecertified usingthesignatureoftheprincipalofyour institution intheentryspaceforthecertifier.

活動期間 Activityperiod

活動内容・役割・役職(具体的に記入すること)

Activities・Role・Position(Pleasegiveconcretedetails.)

以下証明者記入欄/The following entry space is for the certifier.

上記活動の記載事項に誤りがないことを証明する。

Icertifythattheabovedescriptionoftheactivitiesistrue.

年 月 日

Year Month Date

学校名・団体名

Name ofinstitution

証明者役職・氏名 印

Positionandnameofcertifier Seal

所在地

Address

電話

Phonenumber

- -

参照

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