2025 April enrollment

2025 April enrollment

Graduate School of Sustainable Systems Science,
Komatsu University

Graduate School of Sustainable Systems Science,
Komatsu University(Doctoral Course)(Doctoral Course)

Photograph Slip

Examination Voucher
切り

Division

離Division

さな１

Admission
Category

２
３

Applicant with a
Master’s Degree
Employed /Professional
ApplicantInternational Applicant

Name

い１

でくだ
さ

Admission
Category

い２３。

Applicant with a
Master’s Degree
Employed/Professional
ApplicantInternational Applicant

Name

Attach the
Photo Here
（4 cm (length) X 3cm (width)）
Taken within the last 3
months prior to theapplication
Front, Upper Body, NoCap
No backgroundexaminee'sserialnumber※

Do not fill in the ※ mark column.

examinee's
serialnumber※Do not fill in the ※ mark column.

2025 Graduate School of Sustainable Systems Science, Komatsu University
Application Form
Admission TimeClassification（Circle the appropriatecategory）

April

examinee's number

１

Applicant with a Master's Degree

２

Employed/Professional Applicant

３International Applicant※Major of interest（Year/Month/Day）
BirthdayName(male〒・female)－Contact
mobile－－－landline－

Email AddressUniversityFaculty□graduation
date □expected tograduateMajor
Undergraduate andgraduate school

graduate school

graduate course□completion
date □expectedcompletion

major subject

Desired Research
ThemeFirst Choice
Faculty Advisor
that you expect

SecondChoiceNote 1: Do not fill in the ※ marked column.
2: Please enter the year, month and date using the Western calendar.
3: In the space for faculty advisors whom you wish to be supervised after admission, please selectand fill in the names from the list of faculty members in your field of study/teachers listed in
the Application Guidebook.

examinee's(seat) number※Name
Academic and Professional History（Fill in from high school or secondary schoolenrollment）
School's name（Department）

Secondary/High School

Year and month of admission andgraduation

April
Graduation DateAcademic

university (department)

Admission Date
Graduation Date

graduate school

Admission Datecompletion Date
Admission Datebackground

Graduation Date
Admission Date
Graduation Datecertificate of bank transfer payment（space for pasting）

Admission Date
Graduation Date
Admission Date
Graduation Date
Admission Date
Graduation Date
Name of Employer

Period of service～～Career～～～～

1.※Do not fill in the "※" column.
NotesonEntry

2.In the "Academic Background" section, please enter any non-degree student statuses such as credited
auditors, auditing students, research students, etc.
3.Please enter the year and month using the Western calendar.

Summary of Master's Thesis
Division

Name【Form 1-1】

Graduate School of Sustainable Systems Science, Komatsu
University（Doctoral Course）
Examinee's※Serial
NumberResearch Topics

Research results, etc.

Note1: Do not fill in the※ marked column.
2: If you need more space, please add additional A4 paper as appropriate.
You may prepare a similar form to this one, but it should contain no more than 2,000 words (no morethan 5 pages).

Summary of Bachelor's Thesis
Division

Division of Glocal Cultures

Name
Research Results, etc.

Note: Do not fill in the※ marked column.

【Form 1-２】

Graduate School of Sustainable Systems Science, Komatsu
University（Doctoral Course）
Examinee's※
SerialNumberSummary of Research or Development Work, etc. 【Form ２】
Division

Name

Graduate School of Sustainable Systems Science, Komatsu
University（Doctoral Course）
Examinee's※Serial
NumberNote1: Do not fill in the※ marked column.
2：If you need more space, please add A4 paper and write within 2,000 words (5 pages or less).

Research PlanMajormajor
subject【Form 3】

Graduate School of Sustainable Systems Science,Komatsu University（Doctoral Course）

furigana (kana)
Name
Desired research theme in the doctoral program

Future Research Plans

Note1: Do not fill in the ※ marked column.
2: If you need more space, please add A4 paper as appropriate.

examinee's※numberForm for Pre-Screening of Application Qualifications（ Enrollment for the Year of 2025）
Admission Time

Graduate School of Sustainable Systems Science,
Komatsu University（Doctoral Course）

April

Division

Category１２３

Applicant with a Master's Degree
Employed/Professional Applicant
International Applicant（Circle the appropriate category）

Komatsu University President
I wish to apply for the entrance examination for the Graduate School of Sustainable Systems Science (Doctoral Program) at Komatsu University .

DateName(Male・Female)(AgeBirthday〒)－

Current Address－

Mobile－Landline－－

Place ofemployment

Present
Occupation

Job Title〒－

Location
Phone：
Academic Background－－（Please fill in from high school or secondary school enrollment.）

Year of Admission/Graduation
Admission Date
Graduation Date
Admission Date
Graduation Date
Admission Date
Graduation Date
Admission Date
Graduation Date
Admission Date
Graduation Date

Career/Work Experience（Please fill out the form so that we can understand your working history.）/W

Period～～～～Activities in Academic Societies and Others

Period～～～～Note 1: If you are an international applicant applying for pre-screening of application qualifications,please enter your educational background from elementary school.
2: If there is insufficient space, please use more than one copy of this form and write your name on
the second and subsequent copies.

Research Activity and Publication Record

NameGraduate School of Sustainable Systems Science,Komatsu University（Doctoral Course）
１ Applicant
General Selection
with a Master's Degree

Division

Category

２ Employed/Professional
Socialist Special SelectionApplicant
３ International
Special Selection
for Foreign Students
Applicant（Circle the appropriate category）

Academic Papers, Publications, andResearch Presentations・

Publisher, Journal, etc.
Date of Issue,Publication, etc.

Title of Graduation Thesis, etc.

Name of Conference, etc.

Note 1: If there is insufficient space, please use multiple copies of this form and enter your nameon the second and subsequent pages.
2: Please enter volume and pages of publication if available.

Co-author or coauthor
Presenter NameApplication for Special Exception for Educational Programs underArticle 14 of the Standards for the Establishment of Graduate Schools
Dean, Graduate School of Sustainable Systems Science, Komatsu University

major Graduate School of Sustainable Systems Science, Komatsu（Doctoral Course）
subject University

Major

examinee's※numberName

I am applying for a special exception to the educational programs based on Article 14 of theStandards for the Establishment of Graduate Schools, as I consider this necessary for mystudies for the reasons stated below.
※2 Long-term enrollment（Reasons for Application）

yes□no□Note1: Do not fill in the※1 marked column.
2:※2For details of the Long-term Enrollment System, please refer to page 19 of these Guidelines. Please be sure
to check the box regardless of whether you wish to apply or not.

examinee's※
numberPermission for Entrance Examination
Dean, Graduate School of Sustainable Systems Science, Komatsu University

We hereby give permission for
Sustainable Systems Science,

to apply to the Graduate School ofDivision (Doctoral Course) of youruniversity.
If the applicant enrolls in the Graduate School of Sustainable Systems Science of youruniversity, he/she will be allowed to remain in his/her current position in our company ororganijation.

（Affiliation / Position）（Name）

Note: Do not fill in the ※ marked column.