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Tokyo Institute of Technology

Global Scientists and Engineers Program (GSEP)

April 2018 Application Form

- Please type the answers or write legibly in print (block letters).

- Numbers should be written in Arabic numerals.

- Years should be written using the A.D. (19YY, 20YY) system.

- Acronyms and abbreviations should be spelled-out the first time.

- Personal data in this application will only be used for admissions purposes. 1. Name:

(Family) (Given) (Middle)

2. Nationality: Date of Birth: (yyyy/mm/dd)

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4. Essays

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B) Please tell us about yourself, including the following (max. 500 words): ▪ What are your academic strengths and goals?

▪ What kinds of activities have you initiated or taken part in as a student?

▪ What leadership experience do you have?

▪ Comment on your knowledge regarding Japanese culture and the language.

▪ List any awards or certifications that you have received in sports or academia.

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Admission results will be sent by post in mid-November 2017. Please write the postal address, telephone and facsimile numbers, and email address at which you can be reached at this time.

Applicants who intend to apply for the Japanese Government (MEXT) Scholarship are requested to provide the following information:

Japanese embassy or consulate nearest to your residence in your home country:

MEXT Scholarship students are required to embassy or consulate in their

country of nationality.

International airport in your country of nationality that you will use to travel to Japan:

Name of Airport:

Location (City/Province/Country) of Airport:

In accordance with MEXT regulations, MEXT Scholarship students will be provided an economy class air ticket from the international airport closest to their place of

residence in their country of nationality to Narita or Haneda International Airport.

Please provide your (expected) postal address, telephone number, and email address in your home country as of April, 2018.

 Unchanged from November 2017

If your address changes after submission, please inform the Tokyo Institute of Technology Admissions Division.

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Tokyo Institute of Technology

Global Scientists and Engineers Program (GSEP) 2018

Application Check Sheet

Name in Full (FAMILY NAME, First Name) Nationality

1. Select the eligibility and conditions that correspond to your application to GSEP.

(a) I wish to enroll in this program as a MEXT scholarship student. (Eligibility (A))

(b) I wish to enroll in this program as a privately-funded international student. I currently do not live in Japan. (Eligibility (B))

(c) I wish to enroll in this program as a privately-funded international student. I currently live in Japan. (Eligibility (B))

2. This section only applies to those who selected 1(a).

Among those admitted, the top ten students will be awarded MEXT scholarships. In the case you are NOT awarded a MEXT scholarship, are you willing to enroll in this program as a privately-funded international student? Please check the

corresponding box.

(a) No

(b) Yes

3. This section applies for those who selected 1(b) or 2(b).

Applicants who did not qualify for the Japanese Government (MEXT) Scholarship may apply for the Monbukagakusho Honors Scholarship for Privately Financed International Students offered by the Japan Student Services Organization

(JASSO).

Do you wish to apply for the Monbukagakusho Honors Scholarship for Privately Financed International Students?

Yes

No

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Eligibility Please check the following boxes () and submit these application documents by the deadline.

(A) (B)

(1)Application Form for GSEP Eligibility (A) (Attached form: original, no photocopies)

(1)Application Form for GSEP Eligibility (B) (Attached form: original, no photocopies)

(2)Questionnaire (Attached form, should be typed)

(3)Check Sheet (Attached form, this form)

(4) Application Form for MEXT scholarshipphotocopies) (Attached form: original, no

(5) Passport photocopy (photocopy of the page(s) that show the applicant’s name, nationality, date of birth and photo)

*Only applicants who currently reside in Japan are required to submit the Certificate of Residence (juminhyo) or a photocopy of both sides of their Residence Card (zairyu card) to prove their status of residence and authorized period of stay. Only original copies of the Certificate of

Residence will be accepted.

(6) Official Academic Transcripts (Original or certified true copy)

(7) Certificate of Graduation or Expected Graduation (Original or certified copy)

*If the applicant’s high school does not issue graduation certificates, please check the following box.

I have submitted other notarized documents that authenticate my graduation and/or expected graduation.

(8) TOEFL, TOEIC or IELTS test scores

(No photocopies -- only original documents will be accepted. TOEFL-ITP, TOEIC-TOEFL-ITP, TOEIC-IP will not be accepted.)

If you have not requested the official score sheets to be directly delivered to the Admissions Division of Tokyo Tech by the ETS/British Council, please leave the boxes unchecked.

TOEFL (Test Date: . . )

IELTS (Test Date: . . )

Applicants who have requested an exemption from the submission of English test scores, please check following box.

I have requested for an exemption from submitting English test scores.

(9) The "Payment Verification" page(printed copy)

Please print out the "Payment Verification" page that appeared on the screen at the end of the payment process and include the sheet in your application package.

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[Individual Assessment]

Referensi

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