TOKYO INSTITUTE OF TECHNOLOGY

Global Scientists and Engineers Program (GSEP)

Applicant Evaluation and Recommendation Form
This form should be completed by a principal, supervisor, head of department, or similar official at the last educational institute attended.

1. Applicant Information
Name of the applicant
(in block letters)
Last name (or Surname) First name Middle name

GPA (example: 3.5/4.0)

GPA grading scale description
(example: lowest or fail is 0.0, highest is 4.0, grade is
rounded off to 0.5 intervals)

Ranking within the school/institute

(example: 10/100) /

2. Recommender Information
Name of the recommender
(in block letters)
Last name (or Surname) First name Middle name

Title

Name of school/institute

Address of school/institute

Email address
Phone number
Relationship to the applicant
Number of years you have known the
applicant
3. Recommender’s evaluation
Please rate the applicant in relation to other students in the same grade at your high school/institute. The rating
should reflect the applicant’s academic record and other objective data.

Below
Evaluation area Outstanding Excellent Good Average
average

Academic performance □ □ □ □ □
Interpersonal skills □ □ □ □ □
Leadership □ □ □ □ □
Creativity □ □ □ □ □
Motivation to study at Tokyo
Tech □ □ □ □ □
Motivation to study multiple
fields of science and
engineering
□ □ □ □ □
Motivation to study liberal arts
courses □ □ □ □ □
4. Additional information
Please write candidly and analytically about the applicant’s qualifications and potential to study at GSEP,
Tokyo Tech. Highlighting both strong and weak points will be helpful. Describe such attributes as motiva -
tion, flexibility, communication skills, and other relevant characteristics and notable achievements, including
extracurricular activities.

Recommender’s signature:

Date:
■ Submission instructions
Please submit this form with your handwritten signature to the Admissions Division of Tokyo Tech via the
online submission system. The applicant will notify you of the URL to access the system.