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Registration
Student Registration Form
Full name
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Sex
*
-- Select --
Male
Female
Date of Birth(BS)
*
Date of Birth(AD)
*
Marital Status
*
-- Select --
Married
Unmarried
Mobile Number
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Email
Citizenship Number
*
Citizenship Place of Issue
*
Citizenship Issue Date(BS)
*
Passport Number
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Passport Place of Issue
*
Passport Issue Date(BS)
*
Passport Expiry Date(BS)
*
Permanent Address
Province
*
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Koshi
Madesh
Bagmati
Gandaki
Lumbini
Karnali
Sudurpashchim
District
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Municipality/VDC
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Ward number
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Temporary Address
Province
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Koshi
Madesh
Bagmati
Gandaki
Lumbini
Karnali
Sudurpashchim
District
Municipality/VDC
Ward number
Family Members
Father Name
Father Date of Birth
Father Occupation
Father Mobile Number
Mother Name
Mother Date of Birth
Mother Occupation
Mother Mobile Number
Husband/Wife Name
Husband/Wife Date of Birth
Husband/Wife Occupation
Husband/Wife Mobile Number
Family member in Japan
Yes
No
Health
Height(cm)
Blood Group
Tattoo(If yes only write)
Weight(Kg)
Pressure
Allergy(If yes only write)
Laterality
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Right Hand
Left Hand
Vision
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Right
Left
Vision Remarks
Education
SEE/SLC Admission Year(BS)
SEE/SLC Graduation Year(BS)
SEE/SLC Institute Name
SEE/SLC Institute Faculty
+2 Admission Year(BS)
+2 Graduation Year(BS)
+2 Institute Name
+2 Institute Faculty
Bachelor Admission Year(BS)
Bachelor Graduation Year(BS)
Bachelor Institute Name
Bachelor Institute Faculty
Master Admission Year(BS)
Master Graduation Year(BS)
Master Institute Name
Master Institute Faculty
Japanese Language Exam Name
Japanese Language Level
Japanese Language Passed Year
Working Experience
Institute Name 1
Joined Date 1
Resigned Date 1
Position 1
Job Details 1
Institute Name 2
Joined Date 2
Resigned Date 2
Position 2
Job Details 2
Institute Name 3
Joined Date 3
Resigned Date 3
Position 3
Job Details 3
Past history of applying for COE in Japan
Yes
No
Number of Times
Visa Category
Reason of Rejection
Alcohol Consume
Yes
No
Smoking
Yes
No
Message
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