Doctoral Thesis Specification
１． Text(1) The sheet is A4-size from the side.
・ free style and character
・ The margins are free-form.
(2) Attach the bibliography at the end of thesis.
２． Cover(1) Please check next sample and create it.
(2) Month and Year is the date of completion (Month ：September or March).
・ Make sure not to write the date of submission.
３． Inside Cover
Please don’t forget to attach an inside cover. Please check next sample pages and attach theinside cover to the first page of the thesis.
※ Example of a simple thesis (No binding required when submitting online)

４． Submission to thesis for publication to internet
After passing the final examination, please upload the final version of the thesis (PDF) to the
manaba.

Example（Cover）

Title

Month ２０＊＊Name

Month and Year in the dateof completion(Month:September or March)

Example（Inside Cover）

Title

Graduate School of Science and Technology
Degree Programs in Systems and Information Engineering
University of TsukubaMonth ２０＊＊Name
Month and Year in the date ofcompletion(Month:September or March)Request for Screening of the Thesis (Sample)(博甲)※オンライン提出のため省略
Omitted for online submission.

学位プログラムリーダー印

指導教員印

（※研究群長印省略）
Fill in the date ofsubmitting
Thesis

学 位 論 文 審 査 願Request for Screening of the Doctoral Thesis
令和
Date:

年
月
日
dd/ mm/ yyyy

理工情報生命学術院長
殿
To: Executive Dean of the Graduate School of Science and Technology

筑波大学大学院博士課程理工情報生命学術院
システム情報工学研究群
学位プログラム
Graduate School of Science and Technology in the University of Tsukuba
Degree Programs in Systems and Information Engineering
Doctoral Program in○○○○○○
Please sign or seal next to yourtyping name and submit by PDF
file to manaba.

XXXX 年度入学 学籍番号 20XXXXXXX
Admission Year Student ID Number
氏名
○○ ○○
印
Full Name
Seal/Signature

国立大学法人筑波大学学位規程第５条の規定により、博士（）の学位論文に下記の書類を添えて提出しますので、審査願います｡
In accordance with Article 5 of the University of Tsukuba Degree Regulations, I hereby apply foradmission to the examination of my doctoral thesis to earn a Doctor of Philosophy in( ○○○○○○ ) and submit my doctoral thesis along with the following documents.
Please fill in the name of the degree you plan to obtain:
記
Policy and Planning Sciences/Engineering/Bioinformatics/Human Informatics
１ 論文概要 Summary
２ 論文目録 Table of Title and References
３ 履歴書 Curriculum Vitae
４ インターネット公表に関する申出書
Request for Non-disclosure / Disclosure on the Internet
５ 論文公正に関する確認書 Statement of Research Ethics
筑波大学

受理番号

Do not fill in

１ 通
１ 通
１ 通
１
１

通
通

課程博士

the

Doctoral Thesis Summary（Sample）
Please fill in the name of the degree you plan to obtain:
Policy and Planning Sciences/Engineering/Bioinformatics/Human
Informatics

Doctor of Philosophy in (○○○)
Summary of the Doctoral Thesis

Title of the Doctoral Thesis（Title of Japanese translation）
Follow paragraph 1 of the Precautions

Doctoral program nameGraduate School of Science and Technology
Degree Programs in Systems and Information Engineering
Doctoral Program in ()

Name
Year and month of your completion

Month 20**
Precautions
1.
To English title, Japanese translation should be affixed in parentheses.
2.
Summary should be 5-10 pages in horizontally.
3.
Write the expected year and month (September or March) of the obtainment degree.

Table of Title and References (Sample)
論

文

目

（博甲）

録

Table of Title and References
筑

波 大 学

University of Tsukuba

博士課程理工情報生命学術院システム情報工学研究群

学位プログラム

Graduate School of Science and Technology
Degree Programs in Systems and Information Engineering
Doctoral Program in ○○○○○○○○

学籍番号Student ID No.

１．
【論文題目
Title of the Thesis】

氏

20XXXXXXX

名Name

Follow paragraph 1of the Precautions○○ ○○The Example of Thesis at the Graduate School of Systems and Information
Engineering(筑波大学大学院システム情報工学研究科における博士論文の書き方)

２．
【印刷公表の方法および時期 How and when the publication in print was made】(Example)
Follow paragraph 2, 6, 7of the Precautions
The essential part of this Thesis is already published / planned to be published in the papers listed in the “Reference
Papers”, and also is being contributed as the paper below.
(1) Taro Tsukuba and Hanako Tsuchiura, “Getting All Solutions to Constraint Satisfaction Problems in Polynomial
Time", Journal of the Japanese Society for Artificial Intelligence.

３．
【参考論文 Reference Papers】

Follow paragraph 3, 5, 6, 7of the Precautions(Example)
The essential part of this Thesis has been published as (1) of the following, and the paper of (2) is planned to be
published.
- Published Papers(1) Taro Tsukuba and Hanako Tsuchiura, “Behavior of Misfit Dislocations in GaAs Epilayers Grown on si as Low
Temperature by Molecular Beam Epitaxy”, Jpn. J. Appl. Phys., Vol.7, No.4, 2007, pp.23-30- Papers Accepted(2) Taro Tsukuba, “Implementation of Distributed Robot Control Systems with Transputers”, Trans. Of the SICE
(Transactions of the Society of Instrument and Control Engineers) (Accepted)

４．
【その他の論文 Other Papers】(Example)- Published Papers(1) Taro Tsukuba and Hanako Tsuchiura, “…….
- Papers Accepted(2) Taro Tsukuba, “…….
- Presented Papers Without Review

Follow paragraph 4, 5, 6, 7of the Precautions(3) Taro Tsukuba and Hanako Tsuchiura, “…….
Precautions:
1. To the titles in English, affix the Japanese translation enclosed in parentheses.
2. In the field of “How and when the publication in print was made”, fill out only the single or joint authorship paper related
to the Thesis, with review and which is being contributed.
3. In the field of “Reference Papers”, fill out the single or joint authorship paper related to the Thesis, with review andwhich have been published or accepted.
4. In the field of “Other Papers”, fill out the papers applicable to the following according to the “Reference Papers”.
(1) Single or joint authorship paper with review, unrelated to the Thesis.
(2) Papers presented without review at a lecture meeting, etc. in Japan.
5. In the field of “Reference Papers”, categorize the papers “published” or “accepted” distinctly. Furthermore, in the field of“Other Papers”, categorize the papers “without review” distinctly.
6. Underline the name of the applicant.
7. Create the Index referring to “The Points to Complete in the Index of the Thesis”.

（博甲）【The Points to Complete in the Index of the Thesis】
The Index of the Thesis is a list of the single or joint authorship papers of the applicant’s writings to which thefollowing apply, (a) to (d).
If you do not have any applicable papers, fill out – 1 “Subject of the Thesis”- only.
(a) Papers with review and have been published(b) Papers with review and have been accepted(c) Papers with review and is being submitted, but not accepted yet(d) Papers presented without review at a lecture meeting, etc. in Japan
１．【Subject of the Thesis】
Fill in the subject of the Thesis being submitted. To the titles in English, affix the Japanese translation enclosed inparentheses.
２．【How and when the publication in print was made】
Fill in the papers related to the Thesis being submitted and applicable to the above (c).
(Example)
The essential part of this Thesis is already published / planned to be published in the papers listed in the “Reference
Papers”, and also is being contributed as the paper below.
(1) Taro Tsukuba and Hanako Tsuchiura, “Getting All Solutions to Constraint Satisfaction Problems in Polynomial
Time", Journal of the Japanese Society for Artificial Intelligence.
３．【Reference Papers】
Fill in the Papers related to the Thesis being submitted and applicable to the above (a) and (b), categorizing them into(a) and (b).
(Example 1)
The essential part of this Thesis has been published as (1) and (2) in the following Reference Papers.
- Published Papers(1) Taro Tsukuba and Hanako Tsuchiura, “A Frequency Domain Repetitive Control Algorithm for Robot
Manipulators”, Proc. of the 2nd Motion and Vibration Control Conf. Yokohama, Aug. 2007, pp.12-20(2) Taro Tsukuba, “Research on XXXXX”, Journal of the Japanese Society for XXXXX, Vol.20, No.2, 2006,
pp.234-241(Example 2)
The essential part of this Thesis are planned to be published as the following papers- Papers Accepted(1) Taro Tsukuba, “Implementation of Distributed Robot Control Systems with Transputers”, Trans. Of the SICE
(Transactions of The Society of Instrument and Control Engineers) (Accepted and to be Published in Vol.7, No.4)(Example 3)
The essential part of this Thesis has been published as (1) of the following, and the paper of (2) is planned to be
published.
- Published Papers(1) Taro Tsukuba and Hanako Tsuchiura, “Behavior of Misfit Dislocations in GaAs Epilayers Grown on si as Low
Temperature by Molecular Beam Epitaxy”, Jpn. J. Appl. Phys., Vol.7, No.4, 2007, pp.23-30- Papers Accepted(2) Taro Tsukuba, “Implementation of Distributed Robot Control Systems with Transputers”, Trans. Of the SICE
(Transactions of the Society of Instrument and Control Engineers) (Accepted)
4. “Other Papers”
Fill in the Papers with review unrelated to the Thesis being submitted, categorizing them into above (a) and (b). Or,
fill in the presented papers without review at a lecture meeting, etc. in Japan as described in above (d), indicating thatinterest. To fill in the papers, refer to the way of filling in the papers in “Reference Papers”.

Curriculum Vitae (Sample)

履〔学位論文審査用〕
理工情報生命学術院様式

歴 書 （博士論文用）Curriculum Vitae

注１）学位記は、氏名欄の記載に基づき、作成します。手書する場合は、楷書ではっきりと記入してください。
また，英文学位記を併せて作成しますので，英字氏名もはっきりと記入してください。
注２）論文博士（乙）については、学籍番号の記入は不要です。
Note 1: The diploma will be written based on your Curriculum Vitae. Write your name in block letters clearly.
Note 2: Student ID is not required on doctoral degree by thesis only.

学籍番号Student ID No.

フリガナ

Katakana

氏

名

Name

（令和

Fill in the date of submitting the Thesis

20XXXXXXX

年

月

日現在）

Date of submitting the thesis: dd / mm / yyyy
本 籍アルベルト アインシュタイン（国籍）

Albert EinsteinCountry of

Switzerland

Nationality

Spell your name registered on TWINS.
英字氏名（学位記作成に使用）

現住所

If you needchangeyour nameName in English(Usedtofor
diploma)【Note】

registered on TWINS, please submit“Notice of Chang in Name”

31-xxx Ichinoya Your
Dormitorye-mail address and mobile phone number

University of Tsukuba
Tennoudai,
are needed to2-1
be askedsomething just in case.

Albert Einstein

Write them that are available until the completion
Tsukuba-shi,Ibaraki-ken,Japane-mail
生年月日

XXXX 年

Date of Birth

郵便番号 〒305 - 8573

Address

XX 月 XX 日生

自宅電話番号（ XXX ） XXX － XXXX

携帯電話番号（ XXX ） XXXX － XXXXHome Phone
Cell Phone

年月

学歴 (大学以上（高専修了者は高専以上）)

Date (from - to)Academic History (after high school)

XXXX 年 XX 月～
XXXX 年 XX 月
（ 卒業修了・退学・除籍・())
Graduation / Withdrawal / Dismissal / Other ()

Department of Physics,Swiss Federal Polytechnic School
Zurich,Switzerland)

Master's Program in Business Adminstration and Public Policy
Graduate School of Systems and Information Engineering
University of Tsukuba(Research Student)

XXXX 年 XX 月～
XXXX 年 XX 月
（ 卒業修了・退学・除籍・())
Graduation / Withdrawal / Dismissal / Other (XXXX 年 XX 月～
XXXX 年 XX 月
（ 卒業修了・退学・除籍・())
Graduation / Withdrawal / Dismissal / Other ()

XXXX 年 XX 月～
年 月（ 卒業修了・退学・除籍・())
Graduation / Withdrawal / Dismissal / Other (

)

年 月～
年 月
（ 卒業修了・退学・除籍・())
Graduation / Withdrawal / Dismissal / Other (年)

Master's Program in Business Adminstration and Public Policy
Graduate School of Systems and Information Engineering
University of Tsukuba
Doctoral Program in Policy and Planning Sciences
Degree Program in Systems and Information Engineering
Graduate School of Science and Technology
University of Tsukuba
If you do not have any job experience, just write "None".

月

職歴等
Job History

Date (from - to)
XXXX 年 XX 月～XXXX 年 XX 月
XXXX 年 XX 月～XXXX 年 XX 月 present
If you belong now, write"present"

ceremony.

xx@xxx.xx.xx

Technical Assistant,Swiss Patent Office Bern,Switzerland○○○○○○○○○○ Co. Ltd

Request for Non-disclosure or Disclosure on the Internet of My Doctoral Thesis (Sample)
インターネット公表に関する申出書
Request for Non-disclosure / Disclosure on the Internet of My Doctoral Thesis
令和年月日
Date: dd / mm / yyyy
筑波大学長 殿
To: President of the University of Tsukuba
筑波大学大学院博士課程システム情報工学研究科
専攻
所属
Degree Program（
学位プログラム）
Graduate School of Systems and Information Engineering
Doctoral Program in

入学年度
Admission Year

20XX

学籍番号
Student ID Number

2XXXXXXX

住所（論文博士のみ記載）
Address (*For the
candidate of the doctoral
degree by thesis only)
氏名Full NameTSUKUBA Taro

博士学位論文のインターネット公表に関して、下記のとおり申し出ます。
I hereby request that my doctoral thesis to be disclosed or not be disclosed on the Internet as
is stated below.

記
Details１

論文の全文をインターネット公表することについて
Regarding disclosure on the Internet of the full text of the doctoral thesis,□ 特に問題はない
There is no problem at all.
□
✔ やむを得ない事由があることから公表に支障があるため、論文の全文に代えて「論文の要約」の公表を希望する。
（チェックした者は以下の事項にも回答すること）
Choose one
I would like to publish my summary of doctoral thesis instead of the full text due toof them.
unavoidable reasons.
(Please answer the following, if you have any problem.)
２

論文の全文をインターネット公表できない事由
The full text of my doctoral thesis cannot be disclosed on the Internet due to the following
unavoidable reasons.
*Please tick the boxes below where appropriate.

※オンライン提出に用いるシステムの提出ログをもって本人証明とし、これを押印又は署名の代わりとする。
※Since the submission log of the online submission system will be treated as proof of your identity, your sealand signature can be omitted.

If you can’t publish the full text of your doctoral thesis,
select the reason from the following.

It contains:□ 立体形状による表現を含む等の理由のため
ideas such as expressions by three-dimensional shape.
✔ 出版刊行、多重公表を禁止する学術ジャーナルへの掲載を予定しているため□
ideas that schedule to be published in academic journals that prohibit multiple
publication and/or plan to be published in specialized books.
□ 特許の申請等による理由のため
ideas such as related to patent application.
□ 著作権保護、個人情報保護等の理由により 1 年を超えて公表することができないため
contents such as copyrighted materials belonging to others and/or personal information.
Therefore I cannot disclose it even one year later.
□ その他 Others３

上記理由の詳細
Give detailed explanations; include the corresponding pages, name of the publishers/magazines/journals, and date of issues/publications.
（該当するページや出版社、雑誌、ジャーナル等の名称とその発行または掲載時期などを含めて、詳細な理由を記載すること）(e.g.) I am planning to submit the contents of Chapter 0 of my doctoral dissertation to○○○○, an international academic journal. The publication date is planned to bearound October 20XX.

４

やむを得ない事由の解消（予定）時期(Estimated) Date of resolution of the unavoidable reason※学位論文の全文のインターネット公表を延期できる期間は、原則として学位論文の受理後 1 年を限度とする。
※In principal, the period of non-disclosure on the internet is limited to one year after receiving thedoctoral thesis.
※やむえない事由がある場合には、筑波大学の承認を得て、論文の要約文をインターネット公表する。大学はその論文の全文を求めに応じて閲覧に供する。
※In cases where there are unavoidable reason, an Summary of the thesis will be published on theInternet with the approval of the University of Tsukuba. The University will make the thesis available
for inspection upon request.

令和年月頃
It would be resolved by about dd / mm / yyyy
Supervisor
指導教員

上記の申出を確認しました。

※以下、学位プログラム記載

Signature or SealTSUKUBA Jiro

署名又は記名押印↓ The following are not required. ↓上記の申出を 適 ・ 否 と判断します。
令和
年 月 日

専攻長

署名又は記名押印

研究科長

署名又は記名押印※以下、大学記載

システム情報工学研究科運営委員会
上記の申出を承認します。
令和
年 月

日

※オンライン提出に用いるシステムの提出ログをもって本人証明とし、これを押印又は署名の代わりとする。
※Since the submission log of the online submission system will be treated as proof of your identity, your sealand signature can be omitted.

Statement of Research Ethics (Sample)

論文公正に関する確認書
Statement of Research Ethics

理工情報生命学術院長

殿

To: Executive Dean, Graduate School of Science and Technology

私は、提出した学位論文について、研究不正行為（捏造、改ざん及び盗用等）は行っておりません。

I confirm that there is absolutely no breach of research ethics (fabrication, falsification andplagiarism) on the submitted thesis.
Write Japanese equivalents in parentheses
after English title.

論文題目

Title of the thesis

The Example of Thesis at the Graduate School of Science andTechnology(筑波大学大学院理工情報生命学術院における論文の書き方)

指導教員
Supervisor
20XX 年TSUKUBA Jiro〇

月

Date: (Year, Month, Day)〇日

学位プログラム名
Graduate Program

学籍番号Student ID Number

氏名
Name

Doctoral Program in 〇〇〇20XXXXXXTSUKUBA Taro

当該学位論文を剽窃チェックツール（iThenticate）により調査しました。

指導教員(自署)

筑波次郎

Signature※オンライン提出に用いるシステムの提出ログをもって本人証明とし、これを押印又は署名の代わりとする。
※Since the submission log of the online submission system will be treated as proof of your identity, your sealand signature can be omitted.