Examinee’s

3rd year・October

Number*Application Form for October 2024 Admission
Date (mm/dd/yyyy):_____/_____/_ _____To the president of Osaka University,
I hereby formally submit my application for transfer into the third year of the doctoral program at theGraduate School of Frontier Biosciences, Osaka University.
Applicant’s Name (Name in Full):_____________________ _______________________ _______________________First name

Sex:

Middle nameMale

Family nameFemaleDate of Birth (mm/dd/yyyy):_______/_______/_________
If you are an Osaka University graduate, please enter your student ID number

Name of University / Institution:
Department / Major:
Date of (expected) completion (mm/dd/yyyy): _______/_______/_________*If you have graduated (or are expected to graduate) from a university overseas, please fill inthe date on which you applied to AAD in the column labeled "Application Date to AAD" below.

Application
Eligibility* If you have applied for the Qualifying Review, please indicate the date on which you
received the results.
Date (mm/dd/yyyy): _______/_______/_________
Please fill out the score of the English proficiency test you are submitting.
Exam Date (mm/dd/yyyy): _______/_______/_________TOEIC:TOEFL:IELTS:

Thesis Title
Nationality
Applicant’sInformation（〒
Current Address－

Phone Number:）()－E-mail Address:
Application Date to AAD, Admissions Assistance Desk (mm/dd/yyyy):

Prospective Supervisor* Obtaining informal acceptance in advance is mandatory.

______/______/_______

Educational Background* Provide your educational history starting from elementary school.
* For universities and graduate schools, please also include the faculty/graduate school, department/major, and program.
* Please include the period of research student as well.

Period (mm/yyyy)
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:

Name of Institution////////////

Work Experience (if any)
Period (mm/yyyy)
From:
To:
From:
To:
From:
To:
From:
To:

Name of Employer or Organization / Job Title////////(Note)○ After submitting the application, no changes to the application details will be permitted.
○ Please fill in using block letters instead of cursive.
○ Do not fill in the Examinee’s Number.

Please answer the following three questions:
Do you wish to apply for the Tuition Fee Exemption for International Honors Students?
*Submission of an essay is required. Please refer to “10. Tuition Fee Exemption for International Honors Students.

Yes, I wish to apply.

No, I do not wish to apply.

Did you complete your university education in a country where English is the primary language,
and was it conducted in English?
 Yes

NoDo you currently reside outside of Japan and therefore wish to take the exam online?
 Yes, I wish to take the exam online.
No, I wish to take the exam on-site at the venue.

3rd year・October

Record of research achievements
Examinee’s Number

Full Name*______________________________

Date of Birth (mm/dd/yyyy) ________/________/_____________*Please leave the Examinee’s No. blank.
Please list your record of research achievements.
(Please provide specific details of published books, obtained patents, inventions, etc.)

3rd year・OctoberStatement of purpose
Examinee Number*Full Name

Please state your purpose in applying for the Graduate School of Frontier Biosciences.

*Please leave the columns (*) blank.

3rd year・October*Please submit only if you meet the application criteria (7) or (8)Date (mm/dd/yyyy): _______/______/________

Application for Qualifying Review

To Dean of Graduate School of Frontier Biosciences,

Full Name: ___________________________________
Date of Birth (mm/dd/yyyy): _______/______/________

I wish to transfer into the third year of the doctoral program at the Graduate School of Frontier
Biosciences, Osaka University. Therefore, I am applying for the aforementioned review with thenecessary documents attached.

3rd year・October

Application for Qualifying Review
Receipt
number*Examinee Number

*

Name

Date of Birth (mm/dd/yyyy)//

Current Address
Phone Number:
Current Job(Institution/Position)
Address of the institution
Phone Number:
Period (mm/yyyy)
From:

/To:

/

From:

/

To:

/

From:

/To:

/

From:

/

To:

/Period (mm/yyyy)

From:

/

To:

/

From:/

To:

/

From:

/

To:

/
Month / Year

Educational Background*Provide your educational history starting from elementary school.

Work Experience (if any)

Activities and contributions to academic societies, as well as any othernoteworthy achievements.

*Please submit only if you meet the application criteria (7) or (8). Do not fill in the receipt/examination number.

3rd year・October

Graduate School of Frontier Biosciences
Research Plan for Current Employees
Full Name

Prospective Supervisor

Research plan after enrollmentPlease provide a specific research plan, including the research location, hours dedicated to research,etc., assuming enrollment in the Graduate School of Frontier Biosciences while remaining employed.

* Please add the additional paper (A4 size) if you need more space.

3rd year・October
Examinee’s Number*Dear Dean of Graduate School of Frontier Biosciences

Study Permit (for current employees)

Full Name: ___________________________________
Date of Birth (mm/dd/yyyy): _______/______/________The individual mentioned above is permitted to enroll in the doctoral program at the Graduate
School of Frontier Biosciences, Osaka University.

Date (mm/dd/yyyy):_______/______/________Name of the Employer:________________________________________________________________________________

Address of the Employer:________________________________________

Head of the Employer
Institution / Organization:*Please leave the Examinee’s Number blank.

__________________________ Official Seal

3rd year・October

Photo

Examination admission card (October 2024)
Examinee’s※
NumberName

1. Taken within thelast 3 months,
showing your upper
body, without a hat,facing forward, andtaken alone.
2. The same photo as
per the examination
photo card
3. Vertical (4.0cm) ×
Horizontal (3.0cm)

Taken in (Month/Year):_______/_______

Graduate School of Frontier Biosciences
Important Note:
1.

Please always carry the examination admission card with you at the examination venue.

2.

Arrive at the examination venue well before the scheduled time and follow the instructions of the staff.

3.

Your examination admission card may be used as an identification document until enrollment, so
please keep it safe even after the announcement of the results.
(Please do not tear)

3rd year・October

Photo

Examination photo card ( October 2024)
Examinee’s※
NumberName

1. Taken within thelast 3 months,
showing your upper
body, without a hat,facing forward, andtaken alone.
2. The same photo asper the examination
admission card
3. Vertical (4.0cm) ×Horizontal (3.0cm)

Taken in (Month/Year):_______/_______

Graduate School of Frontier Biosciences
Notes on filling out:
1.

Please do not fill in the Examinee’s Number.

2.

Please write clearly in block letters rather than cursive.

3.

Please do not fold this sheet except along the perforated lines.

3rd year・OctoberContact details seal
*Please submit this seal only if you reside in Japan.
This seal will be used for addressing the Enrollment Procedures Guide and other correspondence.

Please fill in your postal code, address, and name with a ballpoint pen in all four spaces.

After submitting this seal, please promptly notify the Graduate School of Frontier Biosciences if there
are any changes to your address or other contact information.

Address

Address

Name

Name

Examinee’s No

Examinee’s No

Address

Address

Name

Name

Examinee’s No

Examinee’s No