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INSTRUCTIONS:1) Type or write in Roman block letters.2) Write numbers in Arabic numerals.3) Write years in the Anno Domini system.4) Do not abbreviate proper nouns.1Kyoto Institute of TechnologyApplication for AdmissionName in full, in native script (same as in your passport) (Family name) (First name) (All other names)Name in full, in Roman block letters (same as in your passport) (Form A) (Family name) (First name) (All other names)Name in Chinese characters, if applicable ____________________________Note: Your name will be officially registered as written above. Spell it exactly as it appears in your passport.KIT follows ward office policy on Chinese character-use in registration. If you are from a country where Chinesecharacters are in official use, the official KIT registration of your name will use these characters.2 Nationality 3. Date of birth 4. Sex Male Female / / Age Day Month Year5 Present status at home institution:i) Name of the home institution and department________________________________________________________________________________ii) academic program enrolled and school year (at the time of application)(Check one)□ Undergraduate Program Date of Enrollment: _______________________□ Master’s Program□ Doctoral Program ________ year Date of expected graduation: ____________________iii) Major 6 Present address and phone numberPaste yourphotohere.-Write your nameon the back of it.-Must be takenwithin the past 6months.-Size 4 x 3 cm. Phone: 7Permanent address and phone number Phone: 8.E-mail address ____________________________________________________(An e-mail address that can be used before you come to Japan, during your stay in Japan and after you return home is preferred.)
9 Person to be notified in applicant’s home country in case of emergencyi) Name in full (underline family name): ii) Address and phone number: iii) Occupation:iv) Relation to applicant 10. Educational background:PrimaryEducationName and Address of SchoolNameLocationYear and Monthof Entrance andCompletionFrom,To,Period ofschooling QualificationYearsandmonthsLowerSecondaryEducationNameLocationFromTo,,YearsandmonthsUpperSecondaryEducationNameLocationFromTo,,YearsandmonthsHigherEducation(Undergraduatelevel)NameLocationFromTo,,YearsandmonthsHigherEducation(Graduate level)NameLocationFromTo,,YearsandmonthsYearsTotal years of educationandmonthsNotes:1. Do not include kindergarten or nursery school education.2. Include extra-curricular activities and additional university preparatory schooling under secondary education.3. Where applicant has passed a qualifying examination for admission to a university, explain in the space marked *.4. If you require additional space, you may attach separate sheets. When attaching separate sheets, you must put your full nameand nationality on each sheet.
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Page 9 and 10: (Form C)Exchange StudentForm To: T
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