NOTE: This form is for an applicant who resides outside of Japan only.

sampleDo not use this form if an applicant who resides in Japan. The applicant who reisides in Japan should use aprescribed format; please refer to the admission guideline, "How to obtain a copy of the guidelines and application
forms for admission" for details and get the booklet version.

Application Form for Admission to the Master’s Program
Graduate School of Informatics, Kyoto University

Complete the fields enclosed by thick lines.
Enter Course
name you apply for(School use only)
Examinee's Number

Social Informatics Course

Current Status:

Family name

KYODAI

Name in English

Alphabet *1

Given nameName in Chinese

Family nameMiddle nameTaroGiven name京大 太郎

Characters *1 and *4

year/month/day

Date of Birth

Research Student

2001/6/18

OtherFemale

Enrolled inyear/month

Graduated inyear/month

Expected to graduate inyear/month2024/3At the timeof enrollment)

Provide all information
University name: XXXX University

Faculty: Computer Science

Non-university Institution name:Institution
Types of scholarship/funding

Nationality: Enter nationality here
Visa status:

Japanese public university
University outside Japan

Department: Faculty of Engineering

Check here if you are currently
enrolling in university, and provide
last month and year of enrollment

International Students

Japanese national university
Japanese private university

University

2020/4
Most Recent Check one
Education

Working Professional

Middle nameHandwrite your name in Chinese Character

Male

Undergraduate

A Japanese government (MEXT) scholarship student

most applicants would

Student fall into “Student” status
Check here if you have

AAInternational student sent by home government(privately funded international student)

status, and enter ) AAPrivately funded international student
Other ( specialname of Visa status

Your Name in Passport (provide your name as it appears on your passport)

KYODAI Taro
2

Order of Preference
Preferred Group *2oCourseeXe

Current Address *3-Country:

xxxxxxx(Parent's home, etc.)
Check here if
same as above

E-mail Address(School use only)
Result-SI - 2-SI - 3SI - 4-

1

11--

-

Room #101, XXX Apartment, 100 XXX Ave., Province Name
Postal code:

Contact Address *3

SI - 1Country name here

Cellular phone number

Telephone no.:000-000-0000

000-000-0000

Resident's name, Room #, XXX Apartment, 111 XXX Ave., Province Name
Postal code:

Country:xxxxxxx

Country name here

Telephone no.:000-000-0000

kyodaitaro@xxxxxxx.com
Passed/FailedApproval Seal by the Course Chair:(Notes)*1. Fill in your name as shown on your official family register. For an international student, fill in your name as shown on
your passport. Note that all the official documents to be issued for the School's administration purposes will be based on
the information stated here.
*2. Preferred application group:- Refer to the relevant Course information in the guidelines and enter the application groups in which you would liketo belong in the order of your preference.
- You will be regarded as having no interest in joining the application groups that are not listed on this form.
*3. Promptly notify the School of any change of addresses made after submission.
*4. If you have Chinese characters in your name, print this form and write your name legibly in this field.
Complete the other fields in this form first by typing before printing it out and handwriting your name.

※ Carefully read application
guideline and enter theapplication groups.

sampleNOTE: This form is for an applicant who resides outside of JapanDo not use this form if an applicant who resides in Japan. The applicant who reides inJapan should use a prescribed format; please refer to the admission guideline, "How toobtain a copy of the guidelines and application forms for admission" for details.

Admission to the Master’s Program

Graduate School of Informatics, Kyoto University

Curriculum Vitae
Name in English Alphabet

KYODAI TaroName in Chinese Characters*1

京大

Date of Birth (year/month/day)太郎

2001/6/18

Name of educational institution
Elementary education NameYears attended
From (year/month)

To (year/month)

Name

From (year/month)

To (year/month)

Secondary education Name

From (year/month)

To (year/month)

From (year/month)

To (year/month)

From (year/month)

To (year/month)

Name

Education *2

Higher education

2008/04

XXXX Jonior hign school

2014/03

2014/04

XXXX Hign school

2017/032017/04

Name(School/Department)* Please include yourschool/department
information.

XXXX elementary school

XXXX University, Faculty of Engineering

Department of Computer Sciences

2020/032020/042024/03

From (year/month)

To (year/month)

From (year/month)

To (year/month)

From (year/month)

To (year/month)

6 yearsyears

3 years
3 years
4 years
years
years
years

Total years of schooling(For undergraduate students)

Periods of absence from school

From (year/month/day)

To (year/month/day)From (year/month/day)

To (year/month/day)

Employer name

years

Period of employment

Employment

From (year/month)

To (year/month)

From (year/month)

To (year/month)

From (year/month)

To (year/month)

From (year/month)

To (year/month)

From (year/month)

To (year/month)

years
years
years
years
years

StatusCurrent Status

Undergraduate student
Master's Degree student
Working professional
Research student
OtherCurrent school (include laboratory) or employer( 4 year)(year)XXXX University, Faculty of Engineering,
Department of Computer Sciences, XXXX laboratory
Telephone number (laboratory, etc.) : XXX-XXXX-XXXX
If you do not belong to a laboratory, you can leave it blank.

(For current undergraduate students of Kyoto University)
Enter your student ID――(Notes)*1. If you have Chinese characters in your name, print this form and write your name legibly in this field.
Complete the other fields in this form first by typing before printing it out and handwriting your name.
*2 Applicants who have graduated or are expecting to graduate from a Japanese university need only enter
information from their secondary education onward. All others must enter information from their primaryeducation. Periods spent as a research student must also be entered in this section.