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Student ID No.

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FY() Application for Admission for
Graduate School of Information Science and Technology, Osaka University
Doctor Course – Information Technology Special Course in English, Summer(Front upper body, nohats, single person
taken within the past 3months)

Please leave blank in the fields with *.
*Name of preferred supervisor*

Preferred major (Department)
GenderNameDay

Date of birth□ Japanese government
scholarship student

Application
qualification

For international students

Contact Addresses

MonthCitizenshipYear□ Foreign governmentsponsored student□ Unsponsoredinternational students(Select the corresponding number from “3. Admission Requirements” in Application Guideline.)
Last school attended
Date of graduation or expected graduation
Day/ Month

Current address/ YearAddress

zip code

Phone

MobileEmail address
Name
Home country(Note 1)

Relationship

Address

zip code

Phone

ResumePeriodAcademichistory (Note 2)

Professionalexperience(if applicable)

From

to

From

to

From

to

From

toFrom

to

From

to

From

to

From

to

TOEIC/TOEFL/IELTS score

TOEIC score
TOEFL score
IELTS score

For person in employment

I will [□resignNote

School/institution

Type(iBT, PBT)

Test date
Test date
Test date□not resign] after admission.

1) One additional contact information in the applicant’s home country requested.
2) In the academic history field, start entering with primary school entrance information. In addition, make sure to enter
information regarding research student or student of Japanese-language school if applicable.
Academic affairs*Check*Examination Admission Card ( FY)

Photograph

Major name
Examinee’s number

Attach the same photo file*with the application.

NameGraduate School of Information Science and Technology, Osaka University----------------------------------------------------------------------Do not detach. ----------------------------------------------------------------------

Photo Identification Card ( FY)

Photograph

Major name
Examinee’s number*

Name
Graduate School of Information Science and Technology, Osaka University

Please leave blank in the fields with *.

.

Attach the same photo filewith the application.

Graduate School of Information Science and Technology, Osaka University

Research Plan
Reception No.

*

Examinee’s No.

*

Preferred major
Name

Name of preferredsupervisor

Preferred research contents (Enter specifically.)(Note) (1) Please leave blank in the fields with *.
(2) Regarding the preferred course name, please refer to the Information Science and Technology website.
URL: https://www.ist.osaka-u.ac.jp/

Examinee’s No.

Name
Preferred major

Proof of Examination Fee Payment Form

Please attach a scanned copy of

Proof of Payment for Examination Fee(Note) Please leave blank in the fields with *.

*Dispatch Slip
Address is where applicant wishes to receive correspondence.
Notification of success and admission procedure will be sent to this address.

Address

Postal Code
Name
Preferred Major
Examinee’s Number *Address

Postal Code
Name
Preferred Major
Examinee’s Number *(Note) Please leave blank in the fields with *.