Applying for certificates証明書申込フォーム

Please make sure that all information is correct before submitting.

記入内容に誤りがないかご確認ください。

1.Choose Certificates/証明書および必要通数

Certificate of Enrollment/在学証明書 Quantity/通数:1
Certificate of Completion/修了証明書 Quantity/通数:1
Certificate of Academic Records/成績証明書 Quantity/通数:1
Certificate of Scholarship/奨学金受給証明書 Quantity/通数:1
Others/その他:ああああ Quantity/通数:1

2. ID Number/学籍番号

A000000

3. Name/氏名

Your Name

4. E-mail/メールアドレス

foo@example.co.jp

5. Phone Number/電話番号

01234567890

6. Purpose of Use/使用目的

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.

7. For Submission to/証明書提出先

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.

8. Preferred Date of Receipt/受取希望日

January 19th, 2021

9. Remarks/備考

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.