[Kumamoto University] Short-Term Exchange Program Fall 2019 for Undergraduate Students

This is an online application form for Kumamoto University Short-Term Exchange Program Fall 2019.
Please fill all required fields and attach required files, then submit the form.
The system does not allow you to save temporaly, so it is recommended to check entire form first before actually start entering any field.
Also, please note that once submitted, information given/sent cannot be altered/revised.
* Please refrain from using Internet Explore (Firefox is recommended)
* Please note that zip files cannot be attached
* Also, if the system gives you an error message, please ensure that your files trying to attach are not too big in sizes

熊本大学短期交換留学プログラムのオンライン申請書です。
必須項目および該当項目をご入力いただき、確認資料を添付のうえ、申請してください。
なお、一時保存ができないので、事前に項目を確認してから入力を開始することをお勧めします。
また、申請後の修正はできません。申請内容をよくお確かめのうえ、送信をお願いします。
※漢字は繁体字を使用してください。
※Internet Explore以外(Firefox推奨)をご利用ください。
※Zipファイルを添付することは出来ませんので、ご注意ください。
※添付ファイルのサイズにご注意ください。エラーに成場合があります。


※ 必須項目 ( Required )
Applicant's Family Name (as shown on your passport)

Applicant's Given Name (as shown on your passport)

Middle Name(s) (as shown on your passport, if any)

Applicant's Name in Katakana

Applicant's Name in Chinese Characters (if any)

Birth Year

Birth Month

Birth Date

Gender

Home Country/Region

Current Address (in English or Japanese language only)

Phone Number (including Country Code)

Emergency Contact: Full Name

Emergency Contact: Relationship to you

Emergency Contact: Address

Emergency Contact: Phone Number

Emergency Contact: E-mail Address

Name of Home University

Faculty

Department or Major

Year (as at the commencement of the progam)

Expected Graduation Year

Expected Graduation Month

Expected Graduation Date

Academic History: Elementary Ecudation (Name of Elementary School)

Academic History: Elementary Ecudation (Elementary School) start year

Academic History: Elementary Ecudation (Elementary School) start month

Academic History: Elementary Ecudation (Elementary School) graduate year

Academic History: Elementary Ecudation (Elementary School) graduate month

Academic History: Secondary Ecudation (Name of Junior High School)

Academic History: Secondary Ecudation (Junior High School) start year

Academic History: Secondary Ecudation (Junior High School) start month

Academic History: Secondary Ecudation (Junior High School) graduate year

Academic History: Secondary Ecudation (Junior High School) graduate month

Academic History: Secondary Ecudation (Name of High School)

Academic History: Secondary Ecudation (High School) start year

Academic History: Secondary Ecudation (High School) start month

Academic History: Secondary Ecudation (High School) graduate year

Academic History: Secondary Ecudation (High School) graduate month

Academic History: Post-Secondary Ecudation (Name of University or Institute)

Academic History: Post-Secondary Ecudation (University/Institute) start year

Academic History: Post-Secondary Ecudation (University/Institute) start month

Academic History: Number of Years of Education (up to start of the program)

Language Proficiency (J-Course seeker:JLPT, E-Course seeker: score of TOEFL iBT, TOEIC, IELTS)

Proof of Language Proficiency (JLPT, TOEFL iBT, TOEIC, or IELTs)

Preferred Duration of Stay at Kumamoto University (number of semesters)

Preferred Faculty of Enrollment (First Choice)

Preferred Faculty of Enrollment (Second Choice)

Preferred Faculty of Enrollment (Third Choice)

Preferred Course

Your Mojor Field (area of specialized study) at Home University

Your Detailed Study Plan and Academic Objectives to be Achieved at Kumamoto University

Accomodation at Kumamoto University International House (Dormitory)

Application to Rent a Room at the Kumamoto University International House

Personal Page of Your Passport

Application for Certificate of Eligibility

Certificate of Health

Certificate of Enrollment

Academic Transcript

Letter of Recommendation (provided by a professor)

Bank Account Balance Statement

ID Photo (4 cm × 3 cm)


By clicking the submit button below, I hereby agree to and accept the following conditions

上記の申請内容には不備がなく、正確な内容であることを証明します。
I certify that all the information provided on this form and in the accompanying documents is complete and accurete to the best of my knowledge.

個人情報の利用目的

・お問い合わせにお答えするため
・本学でのサービス、催し物のご案内のため
・アンケート調査、モニター募集のため
・上記に係る確認のための連絡

Personally Identifiable Information (“PII”) collected from students or student applicants is used to register or enroll persons in the University, provide and administer housing to students, manage student accounts, provide academic advising, develop and deliver education programs, track academic progress, analyze and improve education programs, recruitment, retention, regulatory reporting, auditing, maintenance of accreditation, and other related University processes and functions.

第三者への提供

本学は法令に基づく場合を除いて、学生の個人情報を当該本人の同意を得ず第三者に提供することはありません。
Other than as required or permitted by law, Personally Identifiable Information (“PII”) is not shared. In particular, and regardless of how the information was collected, the University does not sell PII and it does not re-distribute PII for any non-University purpose.

Submit

Application Date (Year)

Application Date (Month)

Application Date (Date)

email