CHIBA UNIVERSITY

GRADUATE SCHOOL OF NURSING

Curriculum Vitae and Goal Statement

Applicant
Name (as it appears
on your passport):
Department to which
you are applying:

Date of Birth:

Address (Home):

Phone (Home) :

Cell Phone:

E-mail Address

Educational Background:
List the full name and location of each college level school you have attended after high school, the dates of
attendance, your major, and the degree received.
Name and Location Dates Attended Degree
Major Field of
(Complete name, Specific campus, City, From - To Received or
Study
State, Country) (Mo/Yr) Expected

Professional Background:
List professional experience, laboratory work, or occupations you have had other than that of student.
Provide the names of your employers, the dates of the employment or work experience, and the
positions.
positions.
Dates
Employer/Institution Position
From - To
Publications and/or Inventions:
List articles, books, or any other material published, or any inventions patented.

Article Title, Name of Journals or Books, Pages, Publication Year

Academic Honors:
List academic honors, prizes, fellowships, scholarships, traineeships, or honorary scholarships you have
received, or honor societies to which you have been elected:

Date Honors/Prizes/Scholarships

Professional License:
List professional licenses and certificates you have obtained.

Date License, Registration Number

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Goal Statement:
Please describe your aptitude and motivation for graduate study in your area of specialization, including your
preparation for this field of study, your academic plans or research interests in your chosen area of study, your
future career goals, and your personal strength and weakness. Please also describe how your personal
background informs your decision to pursue a graduate degree. Please be specific about why Chiba University
Graduate School of Nursing would be a good intellectual fit for you.

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