APPLICATION FOR INTERNATIONAL JOINT EDUCATION PROGRAM

FOR SCIENCE AND TECHNOLOGY（IJEP）

GRADUATE SCHOOL OF SCIENCE AND TECHNOLOGY,

KUMAMOTO UNIVERSITY

INSTRUCTIONS

1. The application should be typewritten if possible, or neatly handwritten in block letters.

2. Numbers should be in Arabic figures.

3. Year should be written in the Anno Domini system.

4. Proper nouns should be written in full, and not be abbreviated.

Application for □ Master’s Course □ Doctoral Course

Prospective supervisor

1. Name in full, in native language

, ______
□ Male
(Family name) (First name) (Middle name) □ Female
In Roman block capitals
,
(Family name) (First name) (Middle name)

2. Nationality
3. Date of birth 19 , , ; Age
year month day

4. Present status; with the name of the institution, or the employer.

5. Present address, telephone number, facsimile number, and E-mail address.

Present address (Office): Phone

Fax

E-mail

Present address (Home): Phone

Fax

E-mail

6. GPA calculated according to the method described in ‘Qualifications of Applicants’ in Application

Information.
GPA=