Bank Account Information for International Students

Please attach a copy of your bankbook (the cover page and first page) when you submit
this form.

Please note that this form is NOT a registration form of your bank information.


School/Graduate School


Student ID Number


Name in Katakana


Name in Kanji(Chinese Character)


Name in Romaji(Alphabets)


Address




Telephone Number


Cellphone Number

E-MAIL
E-mail Address



Name of Bank


Name of Branch


Branch Code


Type of Account
Circle either of the types
Deposit/Saving Account
Checking Account

Account Number


Account Name



Note