Eligibility(A)

TokyoInstituteofTechnology

GlobalScientistsandEngineersProgram(GSEP)

April2018ApplicationForm

-Pleasetypetheanswersorwritelegiblyinprint(blockletters).

-NumbersshouldbewritteninArabicnumerals.

-YearsshouldbewrittenusingtheA.D.(19YY,20YY)system.

-Acronymsandabbreviationsshouldbespelled-outthefirsttime.

-Personaldatainthisapplicationwillonlybeusedforadmissionspurposes.

1.Name:

(Family)(Given)(Middle)

Eligibility(A)

2.Nationality:

DateofBirth: (yyyy/mm/dd)

Eligibility(A)

3.IfyouknowaTokyoTechfacultyorTokyoTechAlumniAssociationmember,pleaseprovidehis/hercontactinformation.(Thisisnotmandatory,buthe/shemaybeconsultedandhis/hercommentstakenintoaccountduringtheapplicationscreening.)

Name:
Relationship:
Address:
Tel:
Fax:
Email:

4.Essays

A) WhydoyouwishtoentertheGlobalScientistandEngineersProgramattheTokyoInstituteofTechnology?Howwillcompletingthisdegreecontributetoyourcareerobjectives?(max.500words)

B) Pleasetellusaboutyourself,includingthefollowing(max.500words):

▪Whatareyouracademicstrengthsandgoals?

▪Whatkindsofactivitieshaveyouinitiatedortakenpartinasastudent?

▪Whatleadershipexperiencedoyouhave?

▪CommentonyourknowledgeregardingJapanesecultureandthelanguage.

▪Listanyawardsorcertificationsthatyouhavereceivedinsportsoracademia.

Eligibility(A)

Date:

Eligibility (A)

(yyyy/mm/dd)

Signature:

Eligibility (A)

[Questionnaire] Please type all your answers.

Admissionresultswillbesentbypostinmid-November2017.Pleasewritethe postaladdress,telephoneandfacsimilenumbers,andemailaddress atwhichyoucanbereachedatthistime.

Address:

Postalcode： Country:

Phonenumber:

Faxnumber:

Email address:

ApplicantswhointendtoapplyfortheJapaneseGovernment(MEXT)Scholarshiparerequestedtoprovidethefollowinginformation:

Japaneseembassyorconsulatenearesttoyourresidenceinyourhomecountry:

MEXTScholarshipstudentsarerequiredtoembassyorconsulatein theircountryofnationality.

Internationalairportin yourcountryofnationalitythatyou willusetotraveltoJapan:

Nameof Airport:

Location(City/Province/Country)of Airport:

InaccordancewithMEXTregulations,MEXT Scholarship studentswillbeprovidedaneconomyclassairticketfromtheinternationalairportclosesttotheirplaceofresidenceintheircountryofnationalitytoNaritaorHanedaInternationalAirport.

Pleaseprovideyour(expected)postaladdress,telephonenumber,andemailaddressin your home country asofApril,2018.

 Unchanged from November 2017

 Expected residence as of April 2018

Address:

Phonenumber:

Email:

If your address changes aftersubmission,pleaseinformtheTokyoInstituteofTechnologyAdmissionsDivision.

E-mail:

Eligibility (A)

TokyoInstituteofTechnology

GlobalScientistsandEngineersProgram(GSEP)2018

Application Check Sheet

Name in Full (FAMILY NAME, First Name) / Nationality
  1. Select the eligibility and conditions that correspondto your application to GSEP.

(a) Iwish to enroll in this program as a MEXT scholarship student. (Eligibility (A))

 (b) Iwish to enroll in this program as a privately-funded international student. I currently donot live in Japan. (Eligibility (B))

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

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

Among those admitted,thetoptenstudentswill be awardedMEXTscholarships.In the caseyouareNOTawardedaMEXT scholarship,areyouwillingtoenroll inthisprogramas a privately-funded international student? Please check the corresponding box.

 (a) No

 (b) Yes

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

Applicantswhodid not qualify for theJapaneseGovernment(MEXT)ScholarshipmayapplyfortheMonbukagakushoHonorsScholarshipforPrivatelyFinancedInternationalStudentsoffered bytheJapanStudentServicesOrganization(JASSO).

DoyouwishtoapplyfortheMonbukagakushoHonorsScholarshipforPrivatelyFinancedInternationalStudents?

Yes

No

Pleasenotethatthosewhoare alreadyrecipientsofascholarshipare not eligible toapply for the JASSOscholarship.Thescholarshipwillprovide amonthlystipendof¥48,000(JPY),and is subjecttochangein accordance with JASSO directives.ThescholarshipwillbeprovidedfromApril2018toMarch2019 (12months). Pleasenotethatrecipientsofthisscholarshiparestillrequiredtopayadmissionandthetuitionfees.

4. [Application Documents]

Eligibility / Pleasecheckthefollowingboxes（）andsubmittheseapplication documents bythedeadline.
(A) / (B)
 / (1)ApplicationFormforGSEPEligibility(A)
(Attachedform:original,nophotocopies)
 / (1)ApplicationFormforGSEPEligibility(B)
(Attachedform:original,nophotocopies)
 /  / (2)Questionnaire(Attachedform,shouldbetyped)
 /  / (3)CheckSheet(Attachedform, this form)
 / (4) ApplicationFormforMEXTscholarship(Attachedform:original,nophotocopies)
 /  / (5) Passportphotocopy(photocopyofthepage(s)thatshowtheapplicant’sname,nationality,dateofbirthandphoto)
*OnlyapplicantswhocurrentlyresideinJapanarerequiredtosubmittheCertificateofResidence(juminhyo)oraphotocopyofbothsidesoftheirResidence Card(zairyucard) toprove theirstatusofresidenceandauthorizedperiodofstay. Onlyoriginalcopiesof the CertificateofResidencewillbeaccepted.
 /  / (6)OfficialAcademicTranscripts(Originalorcertifiedtrue copy)
 /  / (7) CertificateofGraduationorExpectedGraduation(Originalorcertifiedcopy)
*If the applicant’shighschooldoesnotissuegraduation certificates, pleasecheck the following box.
I have submitted other notarizeddocuments that authenticate my graduation and/or expected graduation.
 /  / (8)TOEFL,TOEICorIELTStestscores
(Nophotocopies--onlyoriginaldocumentswillbeaccepted. TOEFL-ITP, TOEIC-ITP, TOEIC-IP willnotbeaccepted.)*Please be sure to check the following box(es), and provide the test dateif you have requested the ETS/British Council to directly send the official score sheet to the Admissions Division of Tokyo Tech.The institutional code number of the Tokyo Institute of Technologyfor TOEFL is 0215
If you have not requested the officialscoresheets to be directly deliveredtothe AdmissionsDivision of Tokyo Tech by the ETS/BritishCouncil,pleaseleave the boxes unchecked.
TOEFL (TestDate: . . )
IELTS (TestDate: . . )
Applicants who have requested anexemptionfrom the submission of English test scores,pleasecheck following box.
I have requestedfor anexemptionfrom submitting English testscores.
 / (9)The"PaymentVerification"page(printed copy)
Pleaseprintoutthe"PaymentVerification"pagethatappearedonthescreenattheendofthepaymentprocessandincludethesheetinyourapplicationpackage.
TokyoTechwillNOTacceptanypaymentsmadebycashorcheck.

[IndividualAssessment]

 / I have applied for the IndividualAssessmentofAdmissionEligibility.