Queen's University
Undergraduate Admission and Recruitment
74 Union Street, Gordon Hall
Kingston, ON
K7L 3N6THE PRINCE TAKAMADO VISITING STUDENTSCHOLARSHIP

Application Form
Queen's University is honoured to join with the Canadian Embassy in Japan inestablishing The Prince Takamado Visiting Student Scholarship at Queen's
University - a fitting tribute to a loyal alumnus who dedicated so much of his life
to fostering a strong relationship between Canada and Japan.
His Imperial Highness Prince Takamado (1954-2002) was a good friend and is adistinguished alumnus of Queen's University. During his years at Queen's, Prince
Takamado embraced the opportunity to learn, eager to master the English
language and understand Canadian culture. Upon his return to Japan, Prince
Takamado strengthened his connection to Canada, becoming a patron of theCanada-Japan Society, and promoting business and cultural links between Canadaand Japan. In 1992, Queen's University awarded His Imperial Highness anhonorary degree, in recognition of his major contribution to the mutual
understanding and appreciation of the cultures of the peoples of Japan andCanada.
The Prince Takamado Visiting Student Scholarship at Queen's University isawarded to a second or third-year student of Japanese nationality (citizen) who iscurrently enrolled in a Japanese university, and who will study at Queen's
University on a Letter of Permission from their home university. Application
should be made to Queen's University Undergraduate Admission by December 1.
Value: Approximately $38,000 (Canadian Dollars), to be applied towards tuition
and fees at Queen's University based on guidelines established by Queen'sUniversity. A guaranteed residence room will be made available to the recipient if
on-campus accommodations are requested.

1 of 5APPLICATION PROCEDURE
All documents should be submitted to:Admission CoordinatorInternational Exchanges
E-Mail: intstudy@queensu.ca
Please submit the following documentation to Queen's University:•

The completed Prince Takamado Visiting Student Scholarship application form and essay must besubmitted by the deadline of December 1.
-This may be mailed or emailed by the applicant•

An official transcript from your home university by December 1.

•A satisfactory score on a test of facility in English by December 1. One of TOEFL, IELTS orMELAB is accepted for all programs except Law. Refer to:
http://www.queensu.ca/admission/about-applying/english-language-requirements•

For students applying to the Faculty of Law, TOEFL is required. iBT scores are preferred: a minimum
total score of 100 is required with no less than 24 on the Writing section, no less than 22 on theSpeaking Section, no less than 24 on the Reading Section and no less than 20 on the Listening Section.

•All supporting documents, including official transcripts, English-language proficiency test scores must
be sent by your home university. Emailed documents will be accepted if they come directly fromyour home institution international office. It is recommended that supporting documents be sent toQueen's University as soon as possible, and no later than December 1.
For any questions regarding the admission process, please contact Undergraduate Admission
Email: intstudy@queensu.ca / Tel: (613) 533-2218

For any questions regarding details about the scholarship, please contact Student Awards Office
Email: awards@queensu.ca / Tel: (613) 533-2216

INSTRUCTIONS: COMPLETING THE APPLICATION FORM
Enter all requested information and submit your application by the deadline date.
Note: You must type all of the requested information
PROGRAM NAME
Although there is space to enter three choices of program, please indicate second and third choices only if
you have a genuine interest in an alternative to your first choice.
Choose from the following program list:ARTS

LAW *COMMERCEMUSICCOMPUTINGNURSING SCIENCEENGINEERING AND APPLIED SCIENCESCIENCEFor those interested in LAW (J.D.), please note that you are eligible for this program only if you areregistered in the upper-years of an LL.B. or of a second-entry J.D. degree program in law. Information
about upper year courses in the J.D. curriculum is posted on the Queen's Law website at https://law.
queensu.ca/programs/jd/academic-program/course-information/upper-year If you are currently enrolled in
an undergraduate degree program in Law, you may also consider registration in Law-201 Introduction toCanadian Law as one of your course selections on exchange. Please see https://certificate.queenslaw.
ca/courses/introduction-to-canadian-law

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AREA OF STUDY :• For ENGINEERING:
Civil Engineering
Chemical Engineering
Computer EngineeringElectrical Engineering
Engineering ChemistryEngineering Physics
Geological Engineering
Mathematics and Engineering
Mechanical and Materials Engineering
Mining Engineering• For ARTS:
Applied Economics
Art History
Classical Studies
Computing & the Creative Arts
DramaEconomics
Environmental Studies
English Language and Literature
Film and Media
French Studies
Gender Studies
German Studies
Geography
Global Development Studies

Health Studies
Hispanic Studies
History
Indigenous Studies
Languages, Literature, and Cultures
Linguistics
Media and Performance Production
Music
Philosophy
Psychology
Political Studies
Politics, Philosophy, and Economics
Religious Studies
Sociology• For SCIENCE:
Astrophysics
Biology
Biology & Mathematics
Biology & Psychology
Biochemistry
Biotechnology
Chemistry
Environmental Science
Geography• For COMPUTING:
Biomedical Computing
Cognitive Science
Computing & Mathematics

Geology
Life Sciences
Kinesiology
Mathematical Physics
Mathematics
Physics
Psychology
Statistics

Computer Science
Software Design
Computing

UNIVERSITY APPROVAL :•The University Approval section must be signed by a university official at your home university:eg. a University Registrar, Dean or Department Head.

•Applications to study in the Faculty of Law at Queen's University must also be supported by aletter of recommendation from the Dean of Law at the university of origin. The letter shouldattest that the student is in good academic standing in the law degree program.

ESSAY QUESTION :•Please answer the essay question in no more than 400 words. Your essay should be double
spaced and typed with your name on each page. Attach it to the application form.

3 of 5APPLICATION FOR ADMISSION
THE PRINCE TAKAMADO VISITING STUDENT SCHOLARSHIPThe personal information on this form is collected under the authority of the Royal Charter of 1841, as amended. The informationcollected will be used by the Office of the University Registrar to assess your eligibility for merit-based student financial assistance.
Information regarding the receipt of student financial assistance may be reported to the Ministry of Training, Colleges and Universities.
In addition to external reporting requirements, the information will also be used for internal planning and statistical analysis. Information
about award recipients may be provided to donors who sponsor specific awards or to University departments who have contact withthese donors. For more information, please contact the Office of the University Registrar, Student Awards, Queen's University, Gordon
Hall. Email: awards@queensu.ca

Family Name (Surname):

Legal Given Name(s) in Full:

Marital Status: Single, Widowed, or Divorced
Birth Date:________ / _______ / ______
YY

MM

DD

Married or Separated
Gender:MaleFemale

Mailing Address: Please underline CITY name.

Telephone Number: _______________________________ Email: ________________________________________Are you are a Japanese National?

YesNo

Home University:___________________________ Academic Program: _____________________________

ChoiceProgram Name*

Subject of Interest*

1
2
3

HOME UNIVERSITY APPROVAL:
I hereby certify that(applicant's name) is enrolled in good standing at theuniversity indicated below and I grant him/her permission to study at Queen's University for a period of two terms.
Please Print_______________________________Name of University Official__________________________________ ___________________________________
Position
University_______________________________
Email_______________________________
Phone Number_______________________________________________________

Signature of University Official

Institution Stamp or Seal
4 of 5APPLICATION FOR ADMISSION
THE PRINCE TAKAMADO VISITING STUDENT SCHOLARSHIPESSAY QUESTION
The Prince Takamado Visiting Student Scholarship was established after His Imperial Highness passed away.
In order to continue fostering the international relationship between Japan and Canada:
1. Why do you think this is an important legacy to continue the international relationship between Japanand Canada?
2. What do you hope to experience if awarded The Prince Takamado Visiting Student Relationship?
The essay should not exceed 400 words. Applications without a completed essay will not be accepted.

APPLICANT DECLARATION
Release of Information:
We sometimes receive requests for information about award recipients from donors who generously support
specific awards or from University departments who have contact with these donors. Although it is normal practice
to release the recipient's name, we could be asked for the program of study, year, Hometown, or Queen's emailaddress. For further details refer to http://www.queensu.ca/studentawards/faq/release-student-information
Do you agree to have this information released?

Yes

NoI HEREBY CERTIFY THAT ALL STATEMENTS ON THIS FORM ARE CORRECT
Applicant's Signature:

Date:

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