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จาก: "Akane YOSHIDA (KIT)" <[email protected]> ถึง: [email protected]
ชื่อเรื่อง: Student Exchange Program AY 2010 (From KIT)
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ประกอบ: 2Query on Exchange Program AY2010.pdfapplication/pdf 38.40 KB
3Application Form_KIT.pdf application/pdf 521.47 KB
Dear exchange program counterparts, Greetings from Kyoto!
Thank you for your devoted assistance for our student exchange program.
I am Ms. Akane Yoshida of KIT International Affairs, and today I am writing to inform you of our schedule for student exchange in AY 2010.
Please find attached file for details.
Should you have any questions or concerns, please feel free to contact me.
Sincerely yours, Akane Yoshida(Ms.)
STUDENT EXCHANGE SERVICES INTERNATIONAL AFFIRS
KYOTO INSTITUTE OF TECHNOLOGY
address: Matsugasaki, Sakyo-ku, Kyoto 606-8585 JAPAN e-mail: [email protected] Tel: +81-75-724-7126 Fax: +81-75-724-7710
Page 1 of 1
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file://C:\DOCUME~1\ADMINI~1\LOCALS~1\Temp\V6DFCATO.htm
To exchange program counterparts in KIT partner institutions;
Re: Short-Term Exchange Program AY 2010
Greetings from Kyoto Institute of Technology.
I would like to express our sincere appreciation for your kind support of our exchange program.
Today I am writing to inform you of minor changes in our application form. Attached to this letter, please find the instruction concerning applicant names. This was added to Form A. The purpose of this change is to assist us with registering student names accurately. Thank you in advance for your understanding.
Furthermore, if you are planning to send your students to KIT as exchange students during the 2010 Japanese Academic Year (from April 2010 to March 2011), please contact the coordinator of KIT to let him/her know the number of students, the expected length of stay and when and how long they want to come. It would be appreciated if you could provide us with this information no later than December 1st, 2009.
Also, please note the application deadlines below:
-For admission in April 2010 (Spring semester):
Application for Admission: must reach us no later than December 11th, 2009 -For admission in October 2010 (Fall semester):
Application for Admission: must reach us no later than June 18th, 2010
If you would like to send your students in any other month, please note that the deadline for applications is 3 months prior the admission date.
Accommodations cannot be guaranteed for applications submitted after the dates indicated above.
Application forms are available on our website at:
http://www.kokusai.kit.ac.jp/english/category1/shortterm_abroad/index.html
For exchange program details, please contact the KIT exchange program coordinator or KIT International Affairs.
Contact:
Student Exchange Services International Affairs
Kyoto Institute of Technology Email: [email protected]
Application forms
for Short-term Exchange Program
at KYOTO INSTITUTE OF TECHNOLOGY
Application materials should be sent in a single package containing all the following documents:
1. Application for Admission (Form A)
(Completed in clear block letters. A passport photo should be pasted on the first page.) 2. Questionnaire for Application for Certificate of Eligibility (Form B)
3. Application for KIT International House (Marikouji Kaikan) (Form C)
! ! (If applicant desire to live in a dormitory for international students, please submit this application. Admission will be decided based on room availability.)
4. Recommendation Letter (Form D)
(Must be signed by the dean or the head of department in which the exchange student is currently enrolled.)
5. Recommendation Letter (Free Form)
(Preferably from a professor or professional person who can verify the applicant’s suitability and motivation for enrolling in KIT.)
6. Health Questionnaire (Form E) 7. Academic Transcript
8. Certificate of Enrollment
(which certifies that the applicant is registered as a regular student at home institution.) 9. Photocopy of Passport
(Personal details page. If unavailable at the time of application, submit reason and predicted date of submission.)
10. 4 copies of the same ID photo
(Width 3cm x height 4cm. Front view, no hat, upper half of body, plain background. Photos are must be of high quality.)
Should you have any questions or concerns, please do not hesitate to contact us.
Contact:
Student Exchange Services International Affairs
Kyoto Institute of Technology
Matsugasaki, Sakyo-ku, Kyoto 606-8585 JAPAN TEL: +81-75-724-7131
FAX: +81-75-724-7710 Email: [email protected]
!
!!
!
(Form A)Kyoto Institute of Technology
Application for Admission
INSTRUCTIONS:
1) Type or write in Roman block letters. 2) Write numbers in Arabic numerals. 3) Write years in the Anno Domini system. 4) Do not abbreviate proper nouns.
Name in full, in native script (same as in your passport) 1Ч
f f f
f f f f f f f f f f f Хf f f f f f f f f f f f f Хf f f f f f f f f f f f f f
(Family name)f f f f f f ! ! ! ! ! f (First name)f f f f f f ! ! ! f (All other names)
Name in full, in Roman block letters (same as in your passport)
f f f f f f f f f f f f f f Хf f f f f f f f f f f f f Хf f f f f f f f f f f f f f
(Family name)f f f f f f ! ! ! ! f (First name)f f f f f f f ! ! ! (All other names)
Name in Chinese characters, if applicable ____________________________
Note: Your name will be officially registered as written above. Spell it exac Note: Your name will be officially registered as written above. Spell it exac Note: Your name will be officially registered as written above. Spell it exac
Note: Your name will be officially registered as written above. Spell it exactly as it appears in your passport. tly as it appears in your passport. tly as it appears in your passport. tly as it appears in your passport. KIT follows ward office policy on Chinese character
KIT follows ward office policy on Chinese character KIT follows ward office policy on Chinese character
KIT follows ward office policy on Chinese character----use in registration. If you are from a country where Chinese use in registration. If you are from a country where Chinese use in registration. If you are from a country where Chinese use in registration. If you are from a country where Chinese characters are in official use, the official KIT registration of your name will use these characters.
characters are in official use, the official KIT registration of your name will use these characters. characters are in official use, the official KIT registration of your name will use these characters. characters are in official use, the official KIT registration of your name will use these characters.
2Ч Nationality 3. Date of birth 4. Sex 棄 Male 棄 Female f f f f f f ! ! ! ! ! ! f f f f ! f /f f f f /f f f f f f Agef f f f
Day Month Year
5Ч Present status at home institution:
i) Name of the home institution and department
________________________________________________________________________________ ii) academic program enrolled and school year (at the time of application)
(Check one)
□ Undergraduate Program ! ! ! ! ! ! ! ! Date of Enrollment: _______________________ □ Master’s Program
□ Doctoral Program ________ year Date of expected graduation: ____________________ iii) Major
f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f 6Ч Present address and phone number
f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f Phone: f f 7Ч
8.
Permanent address and phone number
f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f Phone:f f f f f f f f f f E-mail address ____________________________________________________
(An e-mail address that can be used before you come to Japan, during your stay in Japan and after you return home is preferred.)
Paste your Paste your Paste your Paste your p p p
photohotohotohoto here.here.here.here. -Write your name on the back of it. -Must be taken within the past 6 months.
9Ч Person to be notified in applicant’s home country in case of emergency i) Name in full (underline family name):
f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f ii) Address and phone number:
f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f iii) Occupation: iv) Relation to applicant
f
f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f f
10. Educational background:
Name and Address of School Year and Month of Entrance and Completion Period of schooling Qualification Primary Education Name Location From , To , Years and months Lower Secondary Education Name Location From , To , Years and months Upper Secondary Education Name Location From , To , Years and months У Higher Education (Undergraduate level) Name Location From , To , Years and months Higher Education (Graduate level) Name Location From , To , Years and months
Total years of education
Years and months
Notes:
1. Do not include kindergarten or nursery school education.
2. Include extra-curricular activities and additional university preparatory schooling under secondary education. 3. Where applicant has passed a qualifying examination for admission to a university, explain in the space marked *.
4. If you require additional space, you may attach separate sheets. When attaching separate sheets, you must put your full name and nationality on each sheet.
11. Employment Record:
Begin with the most recent employment, if applicable. Name and Address of Organization Period of
Employment Position Type of Work
from to from to 12ЧLanguage proficiency:
Circle a proficiency level. (Key to proficiency levels: 4 – Excellent, 3 – Good, 2 – Fair, 1 – Poor)
Reading Writing Speaking Listening
Japanese 4 3 2 1 4 3 2 1 4 3 2 1 4 3 2 1
English 4 3 2 1 4 3 2 1 4 3 2 1 4 3 2 1
Other languages studied and/or spoken
4 3 2 1 4 3 2 1 4 3 2 1 4 3 2 1 4 3 2 1 4 3 2 1 4 3 2 1 4 3 2 1
I hereby apply for Kyoto Institute of Technology (KIT) as an Exchange Student based on the agreement between my home institution and KIT and pledge to observe the following articles while I study at KIT:
(i) To refrain from violating any of the regulations of KIT, and to do my best in my studies in order to achieve the aims of the exchange program;
(ii) To accept responsibility for payment of any debts I may incur in Japan. Date of application:
Applicant's signature:
Applicant's name in Roman block letters:
--- 13. Recommendation of Coordinator of Exchange Program
Name
Signature! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Date
Questionnaire for Application for Certificate of Eligibility (Form B)
Issue of a Certificate of Eligibility, mandatory to a Japanese visa, requires completion of the following questionnaire. False, misleading, incorrect or incomplete information will result in unfavorable treatment at the Immigration Bureau in Japan.
I hereby declare that the information given above is true and correct.
Signature of applicant_______________________________ Date________________________
1. Name
Family name Given names
Name in Chinese character, if applicable:
2. Nationality 3. Sex 棄 Male 棄 Female
4. Date of Birth
Year ! Month ! Day
5. Place of Birth
6. Marital Status 棄Married 棄Single 7. Current town/city of residence
8. Passport No. Date of expiration Year Month Day
9. Accompanying persons, if any 棄 Yes 棄 No
10. Place applying for Japanese visa (city in your country)
11. Past entry into/ stay in Japan 棄 Yes, ___________time(s)
(Most recent stay in Japan: from ______________ to _______________)
棄 No
12. Criminal record (in Japan or overseas)
棄 Yes (Details: ) 棄 No
13. Family in Japan (Father, Mother, Spouse, Son, Daughter, Brother, Sister or others)
and/or any co-residents
Relationship Name Date of birth Nationality
Residing with applicant or not Place of employme nt / school Status of residence
14. Total period of education
(from elementary school to last institution of education) years
15. Date of expected graduation (from your home institution) Year Month Day
16. Method of financial support while in Japan
A. Average anticipated monthly support and method of payment (circle if applicable) (1) Money you bring with you: ______________ yen
(2) Money which will be sent from abroad: ___________ yen
(3) Money which someone brings you from abroad: ___________ yen (4) Money from guarantor in Japan supports you: ____________ yen
(5) Scholarship:
______________ yen
Organization providing scholarship:
棄Foreign government 棄Japanese government 棄Regional body 棄Public corporation
棄Other ( )
(6) Other: _____________ yen
B. Benefactor (If you circled (2), (3) or (4) in answer to above question, who supports you financially?)
Name: Relationship to applicant:
Address: Phone:
Occupation (Name of employer): Phone:
(Form C) Exchange Student
迩 鐶椹 琨珙Form 2珩!
静
攤
哢嶌楼
誓╂善
!INTERNATIONAL HOUSE- KYOTO INSTITUTE OF TECHNOLOGY
!渡悖賴㍈蟷
!APPLICATION FOR ADMISSION
!!
朮 蠻 荳 ! Date: year month day! 静 攤 哢嶌楼 誓╂善 鯏!
To: The Director-!
International House-!
Kyoto Institute of Technology!
賴 ㍈ 鞭!
Signature of Applicant ! !
静 攤 哢嶌楼 誓╂善 ⅓惚矼 貢康恒伍楼 誓╂善 香貢渡悖貢 壁惚真 貢膏抗酷賴㍈
浩合溝午!
In accordance with the Regulations of International House- Kyoto Institute of Technology- I hereby apply for the admission to the House/!
!
琨琚渡悖斷衽竆 箯 禘 簦 穭鳰鞭 琬琚 淤迩 棄 赶 Male!
! Name of Applicant ! ! ! ! S e x 棄 嚊 Female !
琯琚﨟 朮 蠻 荳! ! ! ! ! ! ! 琨瑋 朮 蠻 荳! Date of Birth year month day! !
琰琚楼! ! ! ! ! ! ! ! ! 琱/﨑 Ⓜ!
Nationality Occupation and Position ! !
琹琚創! ! ! ! ! ! !!盻
Home Address TEL/ ! !
瑄琚盻慍哢嶌伍 悄伍 薙 !
University- Institution- Department ! and Status in Japan Kyoto InstKyoto InstKyoto InstKyoto Institute of Technologyitute of Technologyitute of Technologyitute of Technology !
瑇琚渡悖斷衽彦薙 棄 豹 帷 棄 啌妍帷 棄 广茘帷! Type of Room desired single- researcher couple- researcher family- researcher! 棄鉧嶌﨟豹 帷 棄鉧嶌﨟啌妍帷 棄鉧嶌﨟广茘帷! single- student couple- student family- student! !
瑋琚八嶌弗購臙 貢袗 ! ! ! ! 朮! ! ! 蠻! ! ! 荳! ! ! ! ! 朮! ! ! 蠻! ! ! 荳! Period of stay at KIT From year month day through year month day!
! !
21/ 渡悖斷衽袗! ! ! ! ! ! ! ! ! ! ! 朮! ! ! 蠻! ! ! 荳! ! ! ! ! 朮! ! ! 蠻! ! ! 荳 ! Period desired at From year month day through year month day!
International House! ! 鳰 鞭! Name! 﨟 朮 蠻 荳 ! ! ! ! ! ! Date of birth! 淤迩! Sex! 諞 ! ! ! ! ! ! ! !! Family relationship! Ⓜ 釡! Occupation! ! 2: / / ! ! ! ! ! 2: / / ! ! ! ! 22琚弁 悖 广 茘! ! ! ! ! ! !! Accompanying Family! ! 2: / / ! ! ! !
(Form C) Exchange Student 迩 鐶椹 琬珙Form 3*! ! ! !
㌝
蟷
!PLEDGE
! ! ! ! ! 朮 蠻 荳! Date: year month day! !!
静 攤 哢嶌楼 誓╂善 鯏!
To: The Director-!
International House-!
Kyoto Institute of Technology! ! ! ! ! ! 鳰! ! ! 鞭 ! Name! ! 鞭! ! ! ! ! ! ! ! ! ! ! ! ! ! ! ! Signature ! ! ! 珙沸砿 貢弁悖广茘珩購伍静 攤 哢嶌楼 誓╂善 貢渡悖惚 壁江黒紅康恒購伍弁善 行抗 杭鵠渡悖 珙沸砿弁悖广茘珩貢 鳩惚㌨帑行惴 溝鵠梗膏惚㌝ 浩合溝午! ! !
Since I )and my family* am )are* admitted to stay at International House- Kyoto Institute of Technology- I )and my family* hereby pledge to observe faithfully the Rules and Regulations of the House/!
(Form C) Exchange Student ! ! ! !
胎
蟷
!LETTER OF GUARANTEE
! ! ! 琬琤琤! 朮 蠻 荳! ! Date: year month day! !!
静 攤 哢嶌楼 誓╂善 鯏!
To: The Director-!
International House-!
Kyoto Institute of Technology! ! ! 胎 斥創盻 ! Guarantor's Address ! 鳰! ! 鞭 , ! Name! ! ! ! 購伍 控静 攤 哢嶌楼 誓╂善 行抗杭鵠廛廏艷豪浩晃購苙 ! 珙 渡 悖! ! ! ! ! ! ! ! ! ! ! !鳰 鞭 珩 藻詹艷行拘拘鵠聴鳩伍渡悖 豪浩晃購稿貢弁悖 控疹 貢善 貢苙 伍 喋喋亦 惚 唸豪浩晃購綮脹 浩紅凅遍貢綮并↔諦行拘拘鵠聴鳩伍弗購疹 貢苙 惚譜◥行憐殱溝鵠貢行氣 荒 行拘拘鵠聴鳩行 考広肱伍渡悖 控征膣弗購 行国酷梗黒惚惴 頓襷荒広膏攻購伍渡悖 行千腰耕肱橲㌆聴鳩惚 祚 浩合溝午! !
I hereby assume all responsibility for ! ! ! ! ! ! in the case of any default of )name of resident*!
financial obligations caused by his/her accident or disease concerning the rent- the compensation for any loss or damage to the facilities- equipment- furnishings or other items provided )hereinafter referred to as facilities*- and the cost of restoring the facilities to their original condition- attributed to the above mentioned or his/her family at International House- Kyoto Institute of Technology/!
Form D
Kyoto Institute of Technology
Recommendation Letter
To the President of Kyoto Institute of Technology,
I hereby recommend as a candidate of
the student exchange program between our institution and KIT. I certify that
his/her academic capability, financial status, health and conduct are more than
adequate for the successful completion of this program.
Date / / Institution Title Name ( B l o c k L e t t e r s ) Signature
Form E
Kyoto Institute of Technology
HEALTH QUESTIONNAIRE
NOTE: All information offered below will be kept confidential and will not affect our admission decision in any way. (This information is collected and filed with your admission application but is not examined until your admission is finalized.)
1. Clinical history:
Circle the diseases below which you have contracted and where applicable, fill in the approximate age you were when diagnosed.
a. Tuberculosis (結核性疾患) Age: ( ) b. Asthma (気管支喘息) Age: ( ) c. Heart disease (心疾患) Age: ( ) d. Other ( ) Age: ( )
Please give details of any illness, injury, or operation you have had over the past three years. (use opposite side if necessary)
2. Present status:
Do you have the physical and mental stamina necessary to complete this exchange program?
( YES. / NO. )
If you answered NO, please write the reasons for your concern.
3. Personal information
Name: Sex: M ・ F Date of birth: Nationality:
