※外国人留学生は，出願書類とあわせて，この確認票も提出すること[For international students] Please submit this Check List as well.

北海道大学大学院工学研究院・工学部

研究生

出願書類提出確認票（外国人留学生：ビザの取得が不要な者）
Check List of Application Documents (Research Student)(International Students: do not need to get visas for the enrollment)
Faculty of Engineering and School of Engineering, Hokkaido University

志願者氏名(フリガナ)
Name of Applicant

国籍
Nationality

志望部門名/コース名Division/course

指導教員氏名Name of Supervisor

入学時期

4 月 ・ 10 月

※入学時期を選択し，○で囲んでください。

Admission

AprilOctober*Please select the term of enrollment.

費・国
経費区分
Financial Support/

政府派遣・私 費Japanese Government Scholarship / Supported by Foreign Government /Self - supporting(MEXT only)(Faculty of Engineering : CSC only
(Other who are not applicable listed left)
School of Engineering : Governmentof Malaysia only)【出願書類】Application Documents
すべての書類は，日本語又は英語で書かれていなければなりません。証明書等書類の原本が日本語又は英語以外の言語で書かれている場合は，公的な和訳又は英訳の原本を添付しなければなりません。
All documents must be written in Japanese or English. If the original document is written in another language, anoriginal of Japanese or English official translation with official seal must be attached.
□１．出願書類提出確認票
Check List of Application Documents□

２．研究生入学願書・履歴書（上半身脱帽写真（縦 4cm×横 3cm、3 ヶ月以内に撮影したもの）を研究生入学願書に貼付すること）
Application for Research Student, Curriculum Vitae (Paste a photograph of portrait of applicant without hats on your Application
for Research Student. (Size 4cm×3cm, taken within the last 3 months))□

３．卒業・修了（見込）証明書〔原本〕又は学位記等のコピー（本学工学院・工学研究科又は工学部出身者は不要）
Certificate of (expected) graduation/ completion〔The original〕or photocopy of diploma (except for graduates of Graduate School/
Faculty/ School of Engineering, Hokkaido University)□

４．検定料支払完了通知のコピー（文部科学省国費外国人留学生は不要）
Photocopy of Notice of Completion of Examination Fee Payment (except for MEXT Scholarship Student)□

５．研究計画書
Research plan□

６．学部成績証明書及び大学院成績証明書〔原本〕（本学工学院・工学研究科又は工学部出身者は不要）
Transcripts of Bachelor’s course and Master’s course〔The originals〕(except for graduates of Graduate School/ Faculty/ Schoolof Engineering, Hokkaido University)□

７．写真 3 枚（3 ヶ月以内に撮影したもの) 3 of photographic portraits of applicant (taken within the last 3 months)
・縦 4cm×横 3cm：2 枚（うち 1 枚は研究生入学願書に貼付）
2 of photographic portraits of applicant in size 4cm×3cm(Paste one of them on your Application for Research Student.)

・縦 3 ㎝×横 2.5 ㎝：1 枚

A photographic portrait of applicant in size 3cm×2.5cm

・写真の裏に氏名を記載すること。
Write your name on the back of the photo.

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８．最終出身学校の指導教員の推薦書〔原本〕（様式任意。本学工学院・工学研究科又は工学部出身者は不要）
Recommendation letter from a supervisor at graduate institution〔The original〕 (except for graduates of Graduate School/ Faculty/
School of Engineering, Hokkaido University)□

９．パスポートのコピー（日本に在住の外国人については在留カードのコピー（両面）を提出すること）
A photocopy of passport（or photocopy of residence card (both faces) for international students living in Japan)□10．研究が個人的研究である旨の本人の確約書（入学時に民間会社等に所属している場合のみ提出）
Letter of commitment prepared by the applicant indicating the reason he/she wishes to conduct personal research(Required only for those who belong to a private company when he/she enrolls at Hokkaido University as a
research student.)□ 11．会社等の事業目的追求のために派遣するものではない旨の所属長の確約書及び在籍のまま研究生として入学することに差し支えない旨の所属長の承諾書（入学時に民間会社等に所属している場合のみ提出）
Letter of commitment prepared by your immediate supervisor confirming that you are not being sent by yourcompany to conduct research at the university for business purposes and a letter of approval prepared by yourimmediate supervisor indicating approval of your admission as a research student while being employed(Required only for those who belong to a private company when he/she enrolls at Hokkaido University as a
research student.)