WRITTEN OATH
Name of Applicant :
SEISHIN YAMATO
Passport No. :
MK 0123456
Gender :
M a l e
Present Address :
4-4-21-6F, Minami Semba Chuo-ku
Osaka City 542-0081 Japan
I swear that during my stay in Indonesia, I declare the following
a. the willingness to be subject to Indonesian laws and regulations during my stay in Indonesia;
b. the willingness to follow all the rules and regulations set up by the Host University or Organizing Committee and Learning center;
c. not perform or participate any political activities or doing criminals in Indonesia’s Territory;
d. not perform activities of a certain ideologies or indoctrination;
e. not involve with any drug traffic: active user or drug seller;
f. not do and perform immoral acts;
g. not to work or be employed for financial benefits during the program;
h. the willingness to leave Indonesia immediately after the closing of program, at a date determined by the Indonesian Immigration Regulations;
i. accept to be sent back to my country if I violate the said regulations and the stay permit regulation in Indonesia
Signature:
Full Name :
Seishin Yamato
D a t e :
