学科長印

指導教員印(院生は不要)

学科/専攻
事務室確認印(Form No. 9)

Notification of Overseas Travel
Date:

To: The Dean, Faculty/Graduate School of Engineering
Address
Year of study_________

Division/Department

Year admitted/Transferred:
Student ID No.

－year

month

Zip code

day

Phone

－Name（Please write by hand.）

E-MailI hereby present notification that I will travel overseas, as described below:(1) Purpose: (Please select one of the following. If you select No. 10, please provide further details)
1. Leisure

2. Visit home / Extracurricular activities 3. Language study

6. Japan overseas cooperation volunteers

4. Study

5. Internship(*)

7. Research 8. Fieldwork 9. Academic meeting

10. Other _____________________________________

11. Joint Degree / Double Degree*Choose Internship only if you intend to have working experience.

(2) Period: FROM year

monthday/ TO year*If your purpose falls into any of 3 to 8 or 11, please provide the period of the study: From year

month
monthdayday/ TO year

monthday(3) Destination(s):* In case you visit more than one country and your purpose falls into any of 3 to 10 above, please attach
Form No.9-a for each destination.

(4) Hosting institution: _____________________________________________________(5) Program name: _____________________________________________________*Please attach any relevant documents describing the program contents.

(6) Scholarships, Sponsors, etc. which finance this travel:___________________________________________(7) Please choose one of the following:1. I intend to earn academic credits at the host institution during this trip.
2. I intend to earn academic credits at Kyoto University during this trip.
3. I do not intend to earn academic credits during this trip.

(8) Emergency contact in Japan during period of travel:
Name__________________ Relationship__________________ Telephone No. _______________(9) Contact details during period of travel:
E-Mail_______________________________________ Passport No. ______________________Address_______________________________________ Telephone No.______________________(10) Travel insurance:
Name of company_____________________________ Insurance No.________________________(11) Registration for Tabi-regi or OPR (overseas residential registration) net systems: ____________
1. I have already registered.
2. I will register before departure.
3. I do not need to register (as I am not a Japanese national).(12) Items to be confirmed regarding security export control regulations:（https://www.kyoto-u.ac.jp/ja/research/rule/export）① Will any forms of technology be provided to others during the overseas travel?

Yes / No

② Will research equipment, measuring instruments, samples, etc., other than commercially availablecomputers, digital cameras, and mobile phones be carried or sent separately to the oversea travel
destination?

Yes / No

*In the case of overseas travel for personal purposes, please select “No” for both(①②) of the questions.
Examples of “personal purposes”:
・Tourism, returning to home country, extracurricular activities
・Self-financed study abroad・Personal job hunting, etc.
*In the following cases, please select “No” at ① question.
・In the case that technical information, etc., taken abroad will be used only for personal purposes, andwill never be provided or disclosed to others.
・In the case that information will be provided at an international conference, academic meeting, etc., inwhich anyone can participate, as there are no eligibility restrictions on participation.
*If you answered “Yes” to either ① or ②, please inform your primary supervisor as additional
procedures are required.
【For Official Use】
Leave of Absence

Exchange Agreement

Credit transfer

JD./DD.

Confirmation of Eligibility to Join the Japan IR&C Support Center
Emergency Support Service
The IR&C is intended for risk management as a university, such as accident response costs and compensation
payments, in the event that undergraduate/graduate students encounter unforeseen situations such as incidents oraccidents overseas. (This support service does not cover the medical expenses of students themselves.)
Please confirm the following items, and be sure to complete the necessary procedures.
1. Is the purpose of the trip personal (Travel, Leisure, Visit-home, etc., excluding research activities)?
・YES→ You do not need to join the IR&C (Confirmed).
・NO → 2 question
2. Have you already joined the IR&C for a study abroad program implemented by Kyoto University,
such as an exchange program?
・YES→ Confirmed
・NO → 3 question
3. Who will pay for travel expenses?
・Public expenses (Faculty of Engineering/Graduate School of Engineering)→ Submit a copy of the Travel Expenses Application form . Confirmed
・Public expenses (other than Faculty of Engineering/Graduate School of Engineering)→ 4 question, and submit a copy of the Travel Expenses Application form
・Private expenses → 4 question
4. The purpose of the travel is research such as fieldwork, research, academic meeting, seminars, etc., anddose the primary supervisor agree that the travel is educationally beneficial?
・YES→Please get your primary supervisor's consent to join the IR&C in the field below.

本届出の海外渡航は教育上有益であると認めますので、アイラック加入を承諾します。
年月日
主指導教員氏名：印

・NO → You do not need to join the IR&C (Completed).
Those who have received your primary supervisor's consent to join the IR&C in 4 question above isrequired to submit the following documents in addition to this form (Notification of Overseas Travel).
・Travel itinerary that shows the entire schedule (Please include the flight number of the plane)
・A Copy of overseas travel insurance card
*Treatment and rescue costs: Choose a plan with unlimited coverage and the lowest insurance premiums.
〇Where to submit and contact
・Undergraduate students: Each Student Section office・Graduate students: Graduate Student Section of each cluster