3GPP SA Fukuoka Meeting 2025 Visa Application Form

Items marked with * must be entered.

Personal Data

Name (Full Name) ＊

Date of Birth ＊

Please select 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / Please select Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec / Please select 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

Gender ＊

• Male
• Female

Nationality ＊

----- Please select ----- BRAZIL CHINA EGYPT INDIA INDONESIA PAKISTAN PHILIPPINES RUSSIA USA Others

Enter if you select "Other" as your Nationality

Country and/or Consulate to submit your visa application ＊

----- Please select ----- CANADA CHINA FINLAND FRANCE GERMANY INDIA INDONESIA KOREA PAKISTAN PHILIPPINES RUSSIA SWEDEN SWITZERLAND TAIWAN UAE UK USA Others

Enter if you select "Other" in the Country Name

Affiliation Data

Name of Company/Organization ＊

Occupation and Job title ＊

Email address ＊

（Confirm）

Sub EMail Address Please enter if you would like it to be sent to a sub Email.

（Confirm）

Itinerary

Itinerary file ＊ File type is docx.(Max size 250KB)

Pledge

Do you need a “Letter of Guarantee” to be submitted to the Ambassador/Consul-General of Japan? ＊

• No
• Yes

if your answer is yes

Pledge file Please fill in and sign the pledge and upload it as a PDF file. (Max size 1MB)

Remarks If there are any special instructions, please enter them in the remarks column.