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Application Form Of The Member Registration

ရခိုင္လႈမႈေရးအသင္း၀င္အျဖစ္ေလ်ာက္ထားရန္ပံုစံ

1 Name 1.1 Sex( ) 1.2 Marital Status ( )


အမည္ က်ား/မ အိမ္ေထာင္ရွိ/မရွိ

2 Name of relatives in Japan 2.1 Concerned Person


ဂ်ပန္ရွိေဆြမ်ိဳးအမည္(ရွိလ်င္ေဖာ္ျပရန္) အသင္း၀င္ေရာက္ရန္ဆက္သယ
ြ ္ေပးသည္႕ပုဂၢိဳလ္

3 Date of Birth 3.1 Age


ေမြးသကၠရာဇ္ Note : As per passport အသက္

4 Place of Birth 4.1 Current Citizen


ေမြးဖြားရာအရပ္ Note : As per passport မည္သည္႔ႏိုင္ငံသား Note : As per passport

5 Father `s name
အဘအမည္

6 Enlistment Date in ASAJ


အသင္းသို႕၀င္ေရာက္သည္႕ေန႕ရက္

7 Charge amount ( ) Yen Total Member fees 2000 Yen + ( ) Months


ေပးသြင္းေငြ monthly fees ( , 20 ) to ( , 20 )

8 Current status Student/Scholar Student/Dependent/Diplomat/Employee/or Others


( if other, pls describes here )

လက္ရွိအေနအထား ေက်ာင္းသား/စေကာ္လာေက်ာင္းသား/မွီခ/ို သံ/၀န္ထမ္း

အထက္ပါတို႕မွမဟုတ္ပါက ေဖာ္ျပရန္

9 Address in Japan
ဂ်ပန္လိပ္စာ

10 Contact Number 9.1 E-mail address


ဖုန္းနံပါတ္

11 Aims of Joining ASAJ

အသင္းသို႕၀င္ေရာက္

ရျခင္း၏ရည္ရယ
ြ ္ခ်က္
xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx
မွတ္ခ်က္
အသင္းသားအျဖစ္လက္ခံသူထံမွျဖည္႕စြက္၇န္

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