2025 Graduate School of Sciences and Technology for Innovation, Tokushima University
Doctoral Course
Application Guide for Non-Degree Students
Summary of System
This program is for students who seek to take course(s) in the Graduate School of Sciences andTechnology for Innovation. At the end of course(s), students are able to achieve credits after passing
examination(s). Achieved credits will be certified as Doctoral level credit in some cases.

１２

Requirements
University graduates or those with equivalent academic qualifications

３

Application Procedure
Necessary documents must be brought to the Student Affairs office in person.

(1) Application Period
First Semester
International Applicant without visa: Monday, December 16, 2024 ～ Friday, December 20, 2024
Other applicants: Monday, January 27, 2025 ～ Friday, January 31, 2025
Second Semester
International Applicants without visa: Wednesday, May 7, 2025 ～ Monday, May 12, 2025
Other applicants: Monday, July 28, 2025 ～ Friday, August 1,2025(2) Reception Hours

8:30am to 5:15pm(3) Place to submit the application documents
Student Affairs Section of Faculty of Bioscience and Bioindustry, Tokushima University 2-1(Refer to ★ ”9 Campus Map”)
Minamijosanjima-cho, Tokushima 770-8513
Telephone: +81-88-656-8020
E-mail: bb.stu.section@tokushima-u.ac.jp(4) Application documents①Fill in the application and attach a picture (photographed within 3 months;
Enrollment Application half of the upper-body, without a cap, the front and sized 4cm×3cm).
②Must receive official stamp of approval from the tutor in charge.
Letter of acceptance

Submitted by applicants who are employed.

Medical Certificate

Applicants should have a medical checkup within 3 months of applying andshould submit an official Medical Certificate that is written and sealed bya doctor.

Warranty Certificate①Should be handwritten by the applicant.
②Unnecessary for international applicants.

Promissory Letter

Should be handwritten by the applicant.

Graduation Certificate

Graduation certificate of the last school or institution the applicant
graduated from or completed.

Reply Envelope(on request only)

Applicants within Japan who wish to be notified by post should write theirname, postal code, and address on a standard envelope and attach therequired amount of stamps.

Examination Fee

9,800yen
At the Josanjima Accounting Office after applicant has received theconfirmation at the Student Affairs Section of and Bioindustry the Facultyof Bioscience.

Enrollment Certificate
Application

Submitted by applicants who need an enrollment certificate for visa
acquisition.

OthersAny documents proving qualification to enroll.

Note1）We are not able to accept incomplete documents.
2 ） Any certificates written in languages other than Japanese should attach the information ofJapanese translation .
Enrollment Period
Enrollment is generally in April and October.

４

Notification of Examination Results
You will be notified by email in principle. Please provide your E-mail address to the Student Affairs
Section of Faculty of Bioscience and Bioindustry (bb.stu.section@tokushima-u.ac.jp).

５６ Enrollment Procedures(1) Expense (as of April 1st, 2024)①Enrollment Fee
28,200 yen※Not required for graduates of the Tokushima University and the Graduate School of Tokushima
University.
②Tuition Fee (per credit)
14,800 yen(2) Payment Period①Enrollment Fee: After enrollment is permitted by the end of March for First Semesterby the end of September for Second Semester②Tuition Fee: by the end of April for First Semesterby the end of October for Second Semester(3) Place of Payment
Josanjima Accounting Office, Tokushima University
2-1 Minamijosanjima-cho, Tokushima 770-8506(Refer to ● “9 Campus Map”)(4) Payment Method
Generally applicants should pay in cash at the counter.
７Website about Course Outline Introduction
The course outline (syllabus) is posted on the Internet.
http://eweb.stud.tokushima-u.ac.jp/Portal/Public/Syllabus/

８

Note

(1) It is important that please contact the lecturer to confirm about the course(s) before applying.
(2) Course schedule may change due to unforeseen circumstances at Tokushima University.
(3) Any changes will not be accepted after applications are submitted.
(4) If you cancel the attendance, please submit a request of revocation by the following deadline.
After the deadline, applicants must pay the tuition fee regardless of attendance.
＊Deadline for cancellation: First semester: Monday, February 10, 2025 by 17:00
Second semester: Monday, August 18, 2025 by 17:00(5) The information of enrollment fee is based on April 1st, 2024 and is subjected to change.

９Campus Map●★

⑮ Building for Department of Civil and Environmental Engineering & Research Center forManagement of Disaster and Environment★ Student Affairs Section, Faculty of Bioscience and Bioindustry⑱ The Common Lecture Building● Josanjima Accounting Office（別紙第１の３号様式）(Annex Form 1-3)

令和年度徳島大学科目等履修生入学願書((year) Tokushima University Non-Degree Student Student Enrollment Application)
令和(Date:年月日)

徳 島 大 学 長殿
(To the President of Tokushima University)
私は貴学の科目等履修生として入学したいので，許可くださるようお願いします。
(I hereby apply to enroll at Tokushima University as a Non-Degree Student.)
ふ り が な

写真貼付

( Furigana )氏男・女(Male / Female)

名年( N a m e )最 終 学 歴(Highest level ofeducation)

勤務先

現住所

年

月

月

(Date of birth)（正面・脱帽）(Full face with nohat)（卒業・卒業見込・修了・修了見込） 縦 4cm×横 3cm(Vertical 4 cm ×horizontal 3cm)

(Date:)(Graduated / Expect to graduate / Completed a course/ Expect to complete a course)(Place of work)(Current address)

日生(Attach photo here)

ＴＥＬ（）－ＴＥＬ（）－〒(Postcode)履 修 希 望 学 部
又 は 研 究 科(Faculty where
you want to studyordepartment)

在学希望期間令和年(Desired period(From (date):of study)
単位数
授業科目名
履
(Course name)(Number of修credits)
希望科目(SubjectYouwanttostudy)

月日～ 令和年前後期(Semester)

曜日・講時(Day of theweek / time)

授業担当教員氏名(Name of the tutor)

to

同一年度における他の学部又は教育部での履修の有無（

Are you taking courses at another faculty or school in the same year?

有の場合は学部名又は教育部名（有・無月日)
承認印(Approval)）( Yes / No )）If Yes, which faculty or school?
※１ 願書は志願者本人の自筆で記入してください。(*1 The applicant should fill in the application themselves.)※２ 「承認印」欄は，事前に受講が可能であることを授業担当教員に確認の上，押印を依頼してください。
(*2 Ask the tutor who has agreed to accept you for their signature in the Approval field.)※３ 願書は，学部又は教育部ごとに提出してください。(*3 Submit a separate application for each faculty or school)※４ 提出された個人情報は，入学の選考，学籍管理に関する業務（追跡調査を含む。
）のみに使用します。
(*4 Personal information will only be used for selection and registration purposes (including tracking studies).)
検定料納付確認印

印

（別紙第１の３号様式）(Annex Form 1-3)

履

歴事

学
年

月日

年

月日

年

月日

年

月日

年

月日

年

月日

年

月日

年

月日

(Date:(Date:(Date:(Date:(Date:(Date:(Date:(Date:)))))))

年月日

年月日

年月日

年月日

年月日

年月日

(Date:(Date:(Date:(Date:(Date:賞

歴 (Academic background))

職(Date:

項 (Personal background)

歴 (Professional background)))))))罰 (Awards and penalties)※１ 学歴は高等学校卒業から記入してください。
ただし，外国人出願者は小学校から記入し，大学等で研究生として在学歴がある場合は，その期間も記入してください。
(*1 Fill in your academic background starting with the name of your high school.
However, foreign applicants should start with the name of their elementary school and add the period for any
time spent as a research student at university.)※２ 履歴に虚偽の事項を記入したことが判明した場合は，入学許可を取り消すことがあります。
(*2 If any falsehoods are discovered in the information provided, your admission may be revoked.)（別紙第２号様式）(Annex Form 2）
令和年(Date:月日)

徳 島 大 学 長殿
(To the President of Tokushima University)

所属長(Supervisor)
氏 名(Name)

印(Seal or Signature)

承諾書(Letter of acceptance)

下記の者が貴学にとして入学することを承諾します。

(I consent to the person named below to attend Tokushima University as a)記(Details)
氏名(Name)所属(Affiliation)
在学期間
令和(From (date):

年

月日 ～ 令和
to年月日)

（別紙第３号様式）(Annex Form 3)

令和

年度徳島大学入学志願者健康診断書((year) Tokushima University Applicant Medical Certificate)(科目等履修生・研究生)(Non-degree student / research student)
ふりがな( Furigana )氏

男(Male)名女(Female)(Name)

生年月日

年(Date of Birth)

月日 生(Date of birth)

現 住 所(Current address)
TEL （）－

胸部健(Chest)

その他の疾病及び異常

康間接(Other(Indirect)

diseasesの直接or状(Direct)

Abnormalities)

況

撮影年月日
(Date:医 師 所 見)(Medical(Stateof（health)(Date:年月日）Findings))

所見(Findings)

診断の結果上記のとおり相違ないことを証明する。
(I hereby certify that the above findings are correct.)
令和

年月(Date:日)

住所(所在地) (Address)
医療機関名 (Name of medical institution)
医師の氏名 (Name of doctor)

TEL （）

印(Seal or Signature)（別紙第４号様式）(Annex Form 4)

保証書(Warranty certificate)

島大学

長殿

令和

都道府県名(Prefecture)

年

月日提出

(Submitted date:(To the President of Tokushima University)

現住所
保 (Currentaddress)証
ﾌﾘｶﾞﾅ
人 (Furigana)
氏名(Gu (Name)aran ﾌﾘｶﾞﾅtor) (Furigana)

年 度(Year:)

学部・学科(Faculty,Department)
及び専攻(and Majoror)※徳

令 和入学年度(Academicyear of enrollment)

市区又は郡町村名(City or village)

町名・番地等)
郵名 (Street)便 番 号(Postal code)－電印 生 年月 日
(Seal or Signature)(Dateof birth)

学生との関係
大正 ・ 昭和 ・平成(Taisho / Showa/Heisei) (Relationshipwith the年
月日
student)(YearMonthDay )勤務先及び職業話番号(Telephone)

自宅(Home)(Place of work and勤務先(Place of work)

occupation)

下記の者について，貴学在学中は，諸規則を遵守させることはもとより，本人の一身上のことについては，私が責任を持ちます。
なお，所定の授業料等貴学に対する一切の債務については，本人と連帯して責任を負い，貴学の御指示に従い私が納付します。
以上のことを確約するため本書を提出します｡(I hereby assume responsibility for the personal behavior of the above named person, including compliance with the various regulations while at Tokushima University
Moreover, I will ensure that the specified tuition fees and other obligations to Tokushima University are fulfilled and take responsibility for payment by the deadline set.)
現住所
学 (Currentaddress)
生

都道府県名(Prefecture)

市区又は郡町村名(City or village)

町名・番

地等

名 (Street)

郵便番号(Postal code)－

ﾌﾘｶﾞﾅ(Furigana)(Student)

氏名(Name)

電生 年月 日ﾌﾘｶﾞﾅ

(Date(Furigana)of birth)（注）(Notes: )昭和・平成(Showa / Heisei)
年月日(YearMonthDay )世帯主
氏 名(Head ofhousehold)

学生との続 柄(Relationship withthe student)

１ ※印は記載しないこと。 (*Do not sign.)
2 保証人は，なるべく保護者とすること。ただし，やむを得ないときは，保護者以外で満21歳以上の身元確実な者でもよい。
(The guarantor should be a parent if possible. However, if this is not possible, the guarantor should be a person of good standing, aged 21 or more.)
3 保証人は，「保証書」，「身上調書」とも全て同一とすること。 (The guarantor should be the same for warranty certificate and personal record.)
4 保証人の変更又は住所等記載事項に変更を生じたときは，速やかに届け出ること。 (If the guarantor changes or changes their address, notify the university promptly.)
5 保証人 欄及び学生欄は，本人が自ら記入すること。 (The guarantor field and student fields should each be filled in by the relevant person.)

話番号(Telephone)

自宅(Home)
携帯(Mobile phone)（別紙第５の２号様式）(Annex Form 5-2)

誓約書

(Promissory letter)

徳 島 大 学 長殿

(To the President of Tokushima University)

私 は 貴 学 に 入 学 の う え は ，
大 学 院 学 則 及 び 諸 規 則 を 守 り ，そ の 構 成 員 と し て の 責 務 を 履 行す る こ と を 誓 い ま す 。
(On enrolling with Tokushima University , I hereby swear to abide by the regulations of theuniversity and act responsibly as a member of the university.)

令和(Date:年月日)

所属(Affiliation)
氏

名(Name)