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1 Tsuru University Application Form for UC/2009 Spring 2012 Fall 1/6 都留文科大学 / カリフォルニア大学短期交換プログラム申請出願書類チェックリスト Tsuru University / University of California Exchange Program Application Check List 志願者氏名 (Student Name) : 所属大学 (Home University): 参加希望プログラム (Term of Attendance): (Circle year) Fall 2009 / 2010 / 2011 / 2012 申請出願書類チェックリスト (Application Check List) 都留文科大学短期交換プログラム申請書 (Application for Tsuru University JAST Program) 在留資格認定証明書交付申請書 (Application for Certificate of Eligibility) 経費支弁財政能力を証明するもの (Financial Statement/Documentation of funds in bank account) 日本語能力評価 (Self-evaluation of the Japanese Language Proficiency) EAP 推薦状 (EAP Letters of Recommendation) 所属大学の在学証明書 (Registration Certificate: To whom It May Concern) 所属大学の成績証明書 (Transcript of Academic Records) 研究計画書 (Statement of Purpose/Independent Study Plan ) 写真 4 枚 (Four copies of photos 4 x 3 cm Print your name on the back of each copy) パスポートの写し (Copy of passport, if available) ホストファミリー申請書 (EAP Host Family Program Application) Name of applicant (This document contains six pages.) 1

2 Tsuru University Application Form for UC/2009 Spring 2012 Fall 2/6 都留文科大短期交換プログラム申請書 Application For Tsuru University JAST Program (Japanese Studies in Tsuru 2009 Spring Fall) 1. 姓名 (Name in full: in native language),, (Family name) (First name) (Middle name) (Name in full: in Roman block capitals),, (Family name) (First name) (Middle name) 2. 国籍 (Nationality) 出生地 (Place of birth) 3. 性別男 (Male) 4. 既婚未婚未婚 (Single) (Sex) 女 (Female) (Marital status) 既婚 (Married) 5. 生年月日,, 6. 年齢 (Date of birth) Year Month Day (Age) 7. 現住所及び電話番号 (Present address and telephone number) (TEL) ( ) 8. 緊急時の母国の連絡先 (Person to be notified in applicant s home country, in case of emergency) (1) 氏名 (2) 本人との関係 Name in full Relationship (3) 住所電話番号 Address TEL Name of applicant (This document contains six pages.) 2

3 Tsuru University Application Form for UC/2009 Spring 2012 Fall 3/6 9. 所属大学名等 (Home university) 大学学部学科 (University) (Faculty) (Department) Entered, College year (Year) (Month) 10. 学歴 (Educational background) 学校名及び所在地 (Name & address of school) 大学 (University) 入学及び卒業年月 (Year of entrance & completion) 専攻科目 (Major subject) 高校 (High School) 中学 (Junior High School) 初等教育 (Elementary School) 11. 職歴 (Employment record. Begin with the most recent employment) 勤務先及び所在地勤務期間職務内容 (Name & address of employer) (Period of employment) (Type of work) 12. 家族構成 (Family background) 氏名 (Name) 続柄 (Relationship) 父 (Father) 年齢 (Age) 職業 (Occupation) 住所 (Address) 母 (Mother) Name of applicant (This document contains six pages.) 3

4 Tsuru University Application Form for UC/2009 Spring 2012 Fall 4/6 13. 留学希望期間 (Period you are studying at Tsuru University) from 20, to 20, (year)(month) (year) (month) 14. 過去の出入国の記録 (Past entry into/stay in Japan) from 19 to 19 ( days/weeks) Purpose from 19 to 19 ( days/weeks) Purpose from 19 to 19 ( days/weeks) Purpose from 20 to 20 ( days/weeks) Purpose 申請年月日,, (Date of application) (month) (day) (year) 申請者氏名 (Applicant s name: print) 申請者署名 (Applicant s signature) 研究計画書 (Statement of Purpose / Independent Study Plan) 日本語あるいは日本文化に関するあなたの学問的関心それがどのように培われてきたかについて論じなさいまた都留で独自に研究したい分野について述べなさい Attach a two-page essay (typewritten, double-spaced) on the subject below: Discuss your interest in Japanese language and culture, how that interest developed, and the field of interest that you wish to pursue as Independent Study while your stay in Tsuru. (Attach your essay) Name of applicant (This document contains six pages.) 4

5 Tsuru University Application Form for UC/2009 Spring 2012 Fall 5/6 Tsuru University / University of California Exchange Program Japanese Studies in Tsuru 2009 Spring 2012 Fall Self-Evaluation of the Japanese Language Proficiency Name of the Applicants in full: Print in alphabet in Katakana Home Campus: This document should be attached to Application For Tsuru University JAST Program (Japanese Studies in Tsuru) Please evaluate your language proficiency as follows. Check the number. 1. Reading Comprehension (1) Not able to read Japanese language at all. (2) Able to read Hiragana. (3) Able to read Hiragana, Katakana, 100 Kanji characters and some simple sentences. (4) Able to read and comprehend basic text books. (5) Able to comprehend essays and manuals by using dictionaries (6) Able to comprehend research papers and newspapers. 2. Written Japanese (1) Not able to write in Japanese at all. (2) Able to write in Hiragana. (3) Able to write simple sentences in Hiragana, Katakana and 100 Kanjis. (4) Able to write an essay to introduce yourself in Japanese using some Kanjis. (5) Able to write simple passages regarding your research subject. (6) Able to write research papers and essays. 3. Listening Comprehension (1) Not able to understand any spoken Japanese. (2) Able to understand simple questions about yourself. (3) Able to understand daily conversation if spoken slowly. (4) Able to understand daily conversation without any problem. Name of applicant (This document contains six pages.) 5

6 Tsuru University Application Form for UC/2009 Spring 2012 Fall 6/6 (5) Able to understand when the subject concerns your major. (6) Able to fully understand lectures and talks. 4. Speaking (1) Not able to speak the language at all. (2) Manage simple greetings and simple questions. (3) Manage daily conversation. (4) Able to express yourself, though maybe broken. (5) Able to conduct talks concerning your interests. (6) Able to take part in discussions, and able to manage Keigo 5. History of Japanese Language Studying Name of the Institution: Duration: Instructor s name: Name of the Institution: Duration: Instructor s name: Textbooks used: Applicant s Signature: Applicant s Name in Full (Print): Date: (end of document) Name of applicant (This document contains six pages.) 6

APPLICATION FORM FOR ADMISSION

APPLICATION FORM FOR ADMISSION APPLICATION FORM ADMISSION FOR INTERNATIONAL STUDENTS TOYOTA TECHNOLOGICAL INSTITUTE GRADUATE SCHOOL OF ENGINEERING DOCTORAL COURSE 留学生入学志願書豊田工業大学大学院工学研究科博士後期課程 Instruction 記