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Applicant No:

2025 RHEP_ENG(official use only)

2025 Refugee Higher Education Program Application for UNHCR Recommendation
Please use a black pen to fill in this form

Date of Application (dd/mm/yyyy):

Attach passport

Name:(Title) (First name)(Middle Name)photo here(Surname)

The photo must be a

Name in Japanese:photo taken within last
three months from the
D.O.B. (dd/mm/yyyy):

Sex：

ＭaleＦemale

Other

date of application

Age at time of application:

Present address (Japan):

Phone Number:

Email:

Mobile Phone:
Emergency Contact
Name:

Address:

Relationship to the Applicant:Email:

Phone Number:
Mobile Phone:
Online test
environment checklist

Quiet room

WIFI or LAN

Convention

Indochinese

RefugeeRefugee(Circle what you have)

PC or tablet-type device orsmartphone (with web camera and microphone)Country of Origin：

Legal Status: (Circle theappropriate category)ComplementaryProtection

Residency Status:

Resettlement

Humanitarian
Status*Please describe in detail

Other Categories*
Valid until: (dd/mm/yyyy)

Date of First Arrival to Japan: (dd/mm/yyyy)*Circle “other categories” if the applicant is not recognized as a refugee himself/herself, but instead has refugee status due tohis/her spouse’s or parents’ status (derivative status). Please indicate the relevant information of that family member in the section
below.

Name:

Date of recognition:

Relationship to the Applicant:Legal Status: (Circle theappropriate category)

Convention

Indochinese

Resettlement

Humanitarian

Complementary

Other

Protection

Categories

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University

Desired department

Desired Universityand department*（max. 3）*This application is for the schools and departments that are taught in English only. For more details, please visit the webpage of the relevant Universities.

1)

Academic Background (most recent first):
Status (e.g. graduated, current
School Name, Majors

Address (Including Country)

Durationmm/yy - mm/yy

study, discontinued)
Include details: year, location,degree obtained, etc.

2)Informal Education (most recent first):
Status (e.g. graduated,Educational Institute/Subject

Address

Duration(Including Country)

mm/yy - mm/yy

current study, discontinued)
Include details: year, location,
degree obtained etc.)

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3)English Language Proficiency:
Exams / English Language School

Certificate / points･GradeYears Attended / Duration
mm/yy - mm/yy

TOEIC/TOEFL

English Language School

Other English Education4) The Examination for Japanese University Admission for International Students (EJU):
Subject

Certificate / points･Gradedd/mm/yy
Date of examination

Japan and the World

Science（if applicable）
Physics

Chemistry
Mathematics (if applicable）
Course １

Course ２5) Professional Experiences (most recent first):
Note: Please list all work experiences including the positions held outside of Japan
EmployerType ofLocation

Employment PeriodOccupation(Including Country)

mm/yy - mm/yy

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6) Volunteer activities and other extracurricular activities/social activities:
Activity Details and Affiliated Organization(s)Location

Duration(Including Country)

mm/yy - mm/yy7）Please describe your financial plan covering your study period (i.e. savings, income, family support, scholarship, etc.,
excluding RHEP scholarships).

※Please indicate how much money you plan to spend on living expenses, and whether you are or will be working part-time.

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８）Reasons for Applying:
Please describe your objectives for applying to this program and related career aspirations.
e.g.：Why are you looking to continue your education? How would your university study experience help you reach your careergoals? How would it help you in your everyday life?
Note: Please limit your response to three pages (Max. 5,000 characters).

Name:

Essay Page 1

D.O.B:

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Name:

Essay Page 2

D.O.B:

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Name:

Essay Page 3

For official use only:

D.O.B: