日本語NAT-TEST 受験申込書
Form No. OLF-
JAPANESE LANGUAGE NAT-TEST APPLICATION FORM
POKHARA TEST CENTER
WRITE ALL THE CHARACTERS IN BLOCK LETTERS, EXCEPT FOR EMAIL ADDRESS
GRADE :
試験日
DATE OF TEST
試験会場
PLACE OF TEST
氏名
NAME
男女
GENDER
生年月日
DATE OF BIRTH
国籍
NATIONALITY
5Q
4Q
男 (MALE)　年(YEAR)　女 (FEMALE)
月(MONTH)　日(DAY)
住所
ADDRESS
email
電話
TELEPHONE
顔写真は添付しました。
PHOTOGRAPH (2 Copies)
PHOTO
受験料　Rpは　月　日に振り込みます。
EXAMINATION FEE　Rp ……………….……….. MONTH………………... DAY…………………….
Instructions :
1. Attach one (1) copy of Passport or Notorized copy of citizenship (no need to notorize only if the citizenship
has Date of Birth mentioned in AD) .
2. Fill all the details and Verify Name and Date of Birth for exact match with Passport/Citizenship.
3. Bring Original Identity Card and Cash Receipt during collection of Admission Ticket
4. Admission Ticket should be collected no later than one day before the test date.
5. Examinee should follow all the rules mentioned in the back page of the Admission Ticket.
Contact Office :
LA GRANDEE International College
Simalchaur, Pokhara - 8, 061523163/532844
Examinee's Signature
(Required for Verification)
[email protected]
URL : www.nat-test.com/pokhara/
©LA GRANDEE International College, 2014

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PRIX SPAS 2014