To provide an application form with a concealing function which enables concealment of a personal information entry space and presentation of a checking information entry space.

The application form has a sheetlike base 20 having a concealing base part 21 and an application base part 22, an adhesive layer 30 provided at least in a part of one side of the concealing base part 21, a first broken line part 23 provided between the concealing base part 21 and the application base part 22, the personal information entry space 25 provided on the same side of the application base part 22 as the adhesive layer 30, and the checking information entry space 26 adjoining the personal information entry space 25 and provided in the application base part 22. The sheetlike base 20 is folded along the first broken line part 23, and the concealing base part 21 and the application base part 22 are stuck together by the medium of the adhesive layer 30 so that it is possible at least to conceal the personal information entry space 25 and to check the checking information entry space 26.

COPYRIGHT: (C)2008,JPO&INPIT