Escolar Documentos
Profissional Documentos
Cultura Documentos
1. Name in full
, ,
(Family Name) (Given Name) (Middle Name)
, ,
(Family Name) (Given Name) (Middle Name)
2. Nationality
(b). Others
Paste a photograph of
yourself taken within the
3. Sex
past 6 months. Write your
Male Female name and nationality in
block letters on the back
4. Marital Status of the photo.
5. Date of Birth
9. Academic Background:
Location and
Elementary School To
months
Location and
Lower Secondary School To
months
*-1
Name From
years
Upper Secondary School Location and
To
months
years
Total number of years studied mentioned above
and
As of April 1, 2019
months
Japanese
English
Others ( )
11. Previous visits or stays in Japan. List from your most recent visit.
Date Purpose
From
To
From
To
13. If you know a Tokyo Tech faculty or alumni association member, please provide his/her
contact information. (This is not mandatory, but he/she may be consulted and his/her
comments taken into account during the application screening.)
Name:
Relationship:
Address:
Tel:
Fax:
E-mail:
14. Essays
a) Why do you wish to enroll in this degree program at Tokyo Institute of Technology?
How will completing this degree program contribute to achieving your career objectives?
(max. 500 words)
b) Please tell us about yourself, including the following:
Date:
(yyyy/mm/dd)
Signature:
[Questionnaire] Please type all your answers.
Admission results will be sent by post in mid-November 2019 Please write the postal address,
telephone and facsimile numbers, and email address through which you can be reached at this time.
Address:
Applicants who intend to apply for the Japanese Government (MEXT) Scholarship are requested to
provide the following information:
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, 2019.
Address:
Phone number:
Email:
If your address changes after submission, please inform the Tokyo Institute of Technology
Admissions Division.
E-mail: nyu.gak@jim.titech.ac.jp
Tokyo Institute of Technology
Global Scientists and Engineers Program (GSEP) 2019
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 privately-funded international student. I currently do not
live in Japan.
(b) I wish to enroll in this program as a privately-funded international student. I currently live in
Japan.
(c) I wish to enroll in this program as a privately-funded international student. However, I will
register as a MEXT scholarship student if I awarded the MEXT scholarship.
Do you wish to apply for the Monbukagakusho Honors Scholarship for Privately Financed
International Students?
Yes
No
Please note that those who are already recipients of a scholarship are not eligible to apply for the
JASSO scholarship. The scholarship will provide a monthly stipend of ¥48,000 (JPY), and is subject
to change in accordance with JASSO directives. The scholarship will be provided from April 2019 to
March 2020 (12 months). Please note that recipients of this scholarship are still required to pay
admission and the tuition fees.
4. [Application Documents]
Please check the following boxes()and submit these application documents by the
deadline.
(4) 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.
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.
(8) 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.
Tokyo Tech will NOT accept any payments made by cash or check.
[Individual Assessment]
I have applied for the Individual Assessment of Admission Eligibility.