AY2025-2026 Doshisha University Student Exchange Program Pledge
To President of Doshisha University,I, upon participating in the Doshisha University Student Exchange Program (hereinafter Exchange), pledge to observe thefollowing. In case of violation, I consent that I will be disqualified as an exchange student and will not be receiving
support from Doshisha University, and shall not object to such penalties.
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I confirm that I am applying to this program with the understanding that once I am selected as an Exchange
candidate, I will not be able to withdraw from the program unless for a legitimate reason recognized by Doshisha
University. (hereinafter Doshisha)
I understand the purpose of the Study Abroad Program and undertake to study earnestly while at the hostinstitution.
I understand that I may not be allowed to study abroad if I am absent without proper reason from orientations heldat the university prior to my trip, or if I fail to fulfill my assignments or obligations. I will take full
responsibility for any cancellation fees incurred in this case.
I shall check the necessary procedures for the Study Abroad Program (including but not limited to preparation ofapplication documents for the host institution, obtaining a passport, and payment of fees) well in advance andfollow the procedures without delay on my responsibility.
During the Study Abroad Program, I understand that I must follow the academic calendar/program schedule of the hostuniversity and adhere to the study abroad period approved by Doshisha. I will consult with the Office ofInternational Affairs (hereinafter OIA) as soon as possible if special circumstances prevent me from continuing mystudy abroad.
I shall report to the OIA of Doshisha and the relevant office at the host institution when I leave the hostinstitution for a certain period during recess for a trip or other reasons.
I shall inform the OIA of my address during the Exchange as soon as I have confirmed it. I understand a Program
participant must stay in the dormitory designated by Doshisha. I shall also keep the OIA of Doshisha informed ofany changes to my address.
I understand that Doshisha may cancel the Study Abroad Program or advise me to return to Japan depending on thesecurity situation of the country (region) where my host institution is located. I am aware of such a possibility
and agree to follow the advice of Doshisha without delay in such circumstances. I also agree to release Doshisha
from any liability for damages and loss arising from such circumstances.
I shall act on my initiative and responsibility as a Doshisha student while on the Study Abroad Program. I agree torelease Doshisha from any responsibility for damages caused by natural disasters, riots, terrorist attacks,accidents, infectious diseases, plague, and crimes during the Study Abroad Program.
While on the Study Abroad Program, I shall observe the laws of the host country and regulations of Doshisha, aswell as follow the regulations of the host institution, instructions of my supervisor, and the officer taking careof the Study Abroad Program at the host institution. I shall take care not to offend the public order and morals ofthe host country.
I shall not drive a car, motorcycle or involve in dangerous activities that are not covered by my travel insurance
during the Study Abroad Program.
Upon participating in the Study Abroad Program, I shall join a prescribed study abroad insurance that covers mystudy abroad period, as well as the health and other insurances designated by the host institution, if any
insurance services are provided.
In case of using the assistance service of the risk management company, I agree that my personal information
regarding the illness or troubles that I provided to the risk management company to be shared and used by Doshisha
and the persons in charge of risk management.
I shall send regular reports to the OIA of Doshisha regarding my arrival and recent activities during the Exchange,
after returning to Japan, I shall submit the designated report and questionnaire without delay.
I authorize Doshisha to use the personal information of myself and my guarantor that I submitted to Doshisha and toprovide them to third parties (e.g. host institution, risk management company, overseas travel insurance providers,etc.) for necessary procedures for the Study Abroad Program and in emergencies.
I authorize my host institution to release to Doshisha my academic records and personal information during theStudy Abroad Program that are obtained by the host institution, for necessary procedures for the Study AbroadProgram, ensuring my safety and confirming my study progress during the Study Abroad Program. I also authorize theOIA of Doshisha, my affiliated faculty office, and the host institution to share this information as necessary.
I shall take full responsibility for my actions outside the study abroad period.
I shall provide information to future exchange students and public relations of Doshisha, as well as to actively
participate and cooperate in promoting the Study Abroad Program at Doshisha. (e.g. providing photographs,participation in events, etc.)

I hereby pledge to observe the above.
Date:
Faculty/Graduate School:
Student’s Name

Student ID
Student’s Signature

I hereby guarantee that the above-named student will observe the above.

Date:

Parent/Guardian’s name
Parent/Guardian’s signature

Relationship: