Academic Year 2015 Chiba Institute of Technology Graduate School Fall Enrollment: September Examination International Student Admission Examination Application Guidelines Graduate School of Engineering Graduate School of Information and Computer Science Graduate School of Social Systems Science Master s Program Doctoral Program
Graduate Schools and Programs Chiba Institute of Technology Graduate School Graduate School Master s Program Doctoral Program Mechanical Science and Engineering Electrical, Electronics and Computer Engineering Graduate School of Engineering Life and Environmental Sciences Architecture and Civil Engineering Engineering Design Advanced Robotics Graduate School of Information and Computer Science Information and Computer Science Graduate School of Social Systems Science Management Science 2
Master s Program Application Guidelines 1 Master s Programs and Recruiting Capacity Graduate School Master s Program Recruitment Capacity Mechanical Science and Engineering Electrical, Electronics and Computer Engineering Graduate School of Engineering Life and Environmental Sciences Architecture and Civil Engineering Design A few students per program Advanced Robotics Graduate School of Information and Computer Science Graduate School of Social Systems Science Information and Computer Science Management Science 2 Enrollment Date September 18, 2015 3 Application Qualifications (applicants must meet one of the following criteria): 1) Individuals who have graduated from a university or expect to graduate from a university by September 17, 2015. 2) Individuals who have been awarded or expect to be awarded an undergraduate degree by September 17, 2015, pursuant to the stipulations of the School Education Act, Article 104, Clause 4. 3) Individuals who have completed or expect to complete 16 years of school education in a foreign country by September 17, 2015. 4) Individuals who have completed or expect to complete 16 years of school education by taking correspondence courses offered by a foreign school in Japan, by September 17, 2015. 5) Individuals who have completed a program recognized by the Ministry of Education, Culture, Sports, Science and Technology (MEXT) at an educational institution in Japan that is affiliated with the education system of a foreign country, and that has a university program in that foreign country (only if those who complete the program are treated as having completed 16 years of school education in that foreign country), or who expect to complete such a program by September 17, 2015. 6) Individuals who have completed a specialized program at a specialized training college (only those with a standard term of four years or longer, and that meet other standards established by MEXT) recognized by MEXT on or after the date determined by MEXT, or who expect to complete such a program by September 17, 2015. 7) Individuals recognized by MEXT. 8) Individuals who have been enrolled in a university for three or more years as of September 17, 2015, and who have been deemed by this Graduate School to have earned a prescribed number of credits and excellent grades. 9) Individuals who were enrolled in another graduate school pursuant to the stipulations of the School Education Act, Article 102, Clause 2, and who have been deemed to have academic ability suitable for receiving a graduate school education at this Graduate School. 10) Individuals who are recognized by this Graduate School as possessing academic skills equivalent to or greater than those of a university graduate based on an individual application qualification review, and who will be 22 years of age or older by September 17, 2015. Note: Individuals applying based on criteria 8 10 will be required to undergo a preliminary qualification review, and should contact the Admissions Office for more information before applying. (See p. 12 for information on the preliminary qualification review.) 3
Master s Program 4 Admission Examination Schedule Type of Examination Application Submission Period Academic Program Date of Examination Date of Notification of Acceptance Enrollment Deadline Mechanical Science and Engineering Electrical, Electronics and Computer Engineering Fall Enrollment September Examination International Student Admission Examination August 3 (Mon.) to August 21 (Fri.) (must be received by this date) Life and Environmental Sciences Architecture and Civil Engineering Design September 1 (Tue.) September 3 (Thu.) September 10 (Thu.) (All documents must be received, or at least postmarked, by this date.) Advanced Robotics Information and Computer Science Management Science Notes: All of the examinations will be held at the Chiba Institute of Technology s Tsudanuma Campus. Applications will be accepted weekdays, 10 a.m. to 4 p.m. (The office will be closed on weekends in August and from August 10 to 14 for summer holiday. ) 4
Master s Program International Student Admission Examination (1) Application Qualifications Applicants must be citizens of a country other than Japan, meet one of the application qualifications on p. 3, and have the consent of their prospective academic advisor. (2) Application Documents 1) Application Form: Obtained after registration for online application 2) Examination Admission Form/Photograph Form: Obtained after registration for online application 3) Letter of recommendation from a department head of the student s home school or their academic advisor (in Japanese or English): Any format 4) Acceptance consent form from the student s prospective academic advisor: University-prescribed form (Form 1) 5) Transcript from last school attended: one (1) original copy 6) Certificate of graduation or certificate of expected graduation from last school attended: one (1) original copy 7) Photograph: two (2) original copies of a photograph taken within three months prior to application, 4 cm high x 3 cm wide, affixed to the Application Form and Photograph Form 8) Copy of passport: Copies of pages (A4 size) showing the holder s name, date of birth, photograph, issuing institution, and expiration date (not required of international students already enrolled in this university) 9) Copy of the applicant s resident card (both front and back sides): Only required of those who have been in Japan for three months or longer 10) Additional documents: Life and Environmental Sciences Research plan Using about 2,000 characters on an A4-sized sheet of paper, describe the research topic you want to investigate (as well as your ambitions) upon your enrollment (in Japanese only, and in general should be made using wordprocessing software). Architecture and Civil Engineering Describe your personal history, reasons for applying, and post-enrollment ambitions on an A4-sized sheet of paper (one page) in the format prescribed by this guideline (see pp. 7 and 8). (May be in Japanese or English, and in general should be made using word-processing software.) Design Research plan Describe the background, purpose, methods, schedule and anticipated results of the research you want to pursue at this university in approximately 2,000 characters on A4-sized paper. Be sure to have your prospective academic advisor confirm the contents of your plan before you submit it. Advanced Robotics Research plan Using about 2,000 characters on an A4-sized sheet of paper, clearly explain your research background, purpose, methods, schedule, and anticipated results. Figures and tables may be used if needed. (May be in Japanese or English.) Information and Computer Science and Management Science Research plan Using about 2,000 characters on an A4-sized sheet of paper, describe the research topic you want to study (as well as your ambitions) upon your enrollment. (May be in Japanese or English, and in general should be made using wordprocessing software.) 11) International Student Confirmation Form: University-prescribed form (Form 2); please make sure to attach your 1) certificate of completion or certificate of expected completion, 2) academic transcript and 3) certificate of attendance records from a Japanese-language school or the like. Notes: The Acceptance Consent Form is provided at the end of these guidelines. Documents submitted in any language other than Japanese or English should be accompanied by a translated version verified by a public institution (e.g., an embassy or consulate) or a Japanese-language school, and have the institution s official signature or seal on it. 5
Master s Program (3) Examination Type and Schedule Program Mechanical Science and Engineering; Electrical, Electronics and Computer Engineering; Life and Environmental Sciences; Design; Information and Computer Science; Management Science Type Time Program Type Time Program Type Oral examination (Japanese) Starts at 1:00 p.m. Advanced Robotics Oral examination (Japanese or English) Starts at 1:00 p.m. Architecture and Civil Engineering Oral examination (As a rule, conducted in Japanese; however, administered in English as necessary) Time Starts at 1:00 p.m. Note: Be sure to arrive at least 10 minutes before the examination starts. 6
Format for Additional Documents for the Architecture and Civil Engineering Program 1. Overall structure Cover: Body: 2. Page settings Indicate your name in the lower area. Use the settings indicated below. 1)No. of characters and rows No. of characters, rows 48 rows, 50 characters each Font Body text titles, figure titles: MS Gothic Body text: MS Mincho Font size Body text titles: 11 pt. Figure titles: 10.5 pt. Body text: 10.5 pt. Columns 1 2)Margins Top, bottom, left, right 20, 20, 20, 15 (mm) Binding 0 mm 3)Paper Size and format A4, portrait 4)Other Word-processing software Microsoft Word is the standard Page numbers Centered at the bottom of the page MS Mincho, 10.5 pt. 3. Body text layout and structure See the next page (however, figures and tables in the body should be separated from the body by a blank line both above and below). Provisions regarding the use of section titles are also provided on the next page. 4. Text styles for numbers and English (1) Any katakana used should be full-width characters. (2) Single numbers and English characters should be full width. If there are two or more characters, they should be half width. (3) Units should be half width. Ex: m, mm, L/s, m/s, Pa, etc. (4) Numbers in figures and tables should be half width. (5) Footnotes used within the body text should be superscripted to 1/4. 5. Numbers and titles for figures and tables (1) Figures : Under the figure, use this format: Figure 1.1.1-1 (2) Tables: Above the table, use this format: Table 1.1.1-1 Title: 10.5 pt. Space No.: Half width Section (paragraph): Half width Title: 10.5 pt. Space No.: Half width Section (paragraph): Half width Continue to next page 7
The basic body layout is shown below. (Boxes indicate spaces, asterisks * indicate text.) Chapter 1 MS Gothic (11 pt.) MS Mincho (10.5 pt.) MS Gothic (11 pt.) MS Mincho (10.5 pt.) MS Gothic (11 pt.) MS Mincho (10.5 pt.) MS Gothic (11 pt.) MS Gothic (11 pt.) MS Mincho (10.5 pt.) (Blank line) MS Mincho (10.5 pt.) Table MS Gothic (10.5 pt.) MS Gothic (10.5 pt.) Figure 8
Doctoral Program Application Guidelines 1 Doctoral Programs and Recruiting Capacity Graduate School Doctoral Program Recruitment Capacity Graduate School of Engineering Graduate School of Information and Computer Science Graduate School of Social Systems Science Engineering Information and Computer Science Management Science A few students per program 2 Enrollment Date September 18, 2015 3 Application Qualifications (applicants must meet one of the following criteria): 1) Individuals who hold a master s degree or professional degree, or who expect to receive such a degree by September 17, 2015. 2) Individuals who have been awarded a degree equivalent to a master s degree or professional degree in a foreign country, or who expect to be awarded such a degree by September 17, 2015. 3) Individuals who have taken correspondence courses in Japan offered by a school in a foreign country and have been awarded a degree equivalent to a master s degree or professional degree, or who expect to be awarded such a degree by September 17, 2015. 4) Individuals who have completed a program recognized by MEXT at an educational institution that is affiliated with the education system of a foreign country, and that has a graduate school program in that foreign country, and who have been awarded a degree equivalent to a master s degree or professional degree, or who expect to be awarded such a degree by September 17, 2015. 5) Individuals recognized by MEXT. 6) Individuals who are recognized by this Graduate School as possessing academic skills equivalent to or greater than those of a master s degree holder based on an individual application qualification review, and who will be 24 years of age or older by September 17, 2015. Note: Individuals applying based on criteria 6 will be required to undergo a preliminary qualification review, and should contact the Admissions Office for more information before applying. (See p. 12 for information on the preliminary qualification review.) 9
Doctoral Program 4 Admission Examination Schedule Type of Examination Application Submission Period Program Date of Examination Date of Notification of Acceptance Enrollment Deadline Fall Enrollment: September Examination International Student Admission Examination August 3 (Mon.) to August 21 (Fri.) (must be received by this date) Engineering Information and Computer Science Management Science September 1 (Tue.) September 3 (Thu.) September 10 (Thu.) (All documents must be received, or at least postmarked, by this date.) Notes: (1) All of the examinations will be held at the Chiba Institute of Technology s Tsudanuma Campus. (2) Applications will be accepted weekdays, 10 a.m. to 4 p.m. (The office will be closed on weekends in August and from August 10 to 14 for summer holiday.) 10
Doctoral Program International Student Admission Examination (1) Application Qualifications Applicants must be citizens of a country other than Japan, meet one of the application qualifications on p. 9, and have the consent of their prospective academic advisor. (2) Application Documents 1) Application Form: Obtained after registration for online application 2) Examination Admission Form/Photograph Form: Obtained after registration for online application 3) Letter of recommendation from a department head at the student s home school or their academic advisor (in Japanese or English): Any format 4) Acceptance Consent Form from the student s prospective academic advisor: University-prescribed form (Form 1) 5) Transcript from last school attended: one (1) original copy 6) Certificate of course completion or certificate of expected course completion from last school attended: one (1) original copy 7) Photograph: two (2) original copies of a photograph taken within three months prior to application, 4 cm high x 3 cm wide, affixed to the Application Form and Photograph Form 8) Copy of passport: Copies of pages showing the holder s name, birth date, photograph, issuing institution, and expiration date (A4 size); not required of international students already enrolled in this university 9) Copy of the applicant s resident card or certificate of alien registration (both front and back sides): Only required of those who have been in Japan for three months or longer 10) Research plan for the doctoral program 11) International Student Confirmation Form: University prescribed form (form 2); please make sure to attach your 1) certificate of completion or certificate of expected completion, 2) academic transcript and 3) certificate of attendance records from a Japanese-language school or the like. Notes: The Acceptance Consent Form is provided at the end of these guidelines. Documents submitted in any language other than Japanese or English should be accompanied by a translated version verified by a public institution (e.g., an embassy or consulate) or a Japanese-language school, and have the institution s official signature or seal on it. (3) Examination Type and Schedule Academic Program Type Time Academic Program Type Engineering, Information and Computer Science Oral examination (Japanese or English) Starts at 10:00 a.m. Management Science Oral examination (Japanese or English) and other examinations (e.g., a presentation) (The presentation would include the applicant s research background, purpose, methods, and anticipated results.) Time Starts at 10:00 a.m. Note: Be sure to arrive at least 10 minutes before the examination starts. 11
Guidelines Relevant to Both the Master s and Doctoral Programs 1 Preliminary Qualification Review Master s program applicants applying under qualifications 8 10 on p. 3 and doctoral program applicants applying under qualification 6 on p. 9 must undergo a preliminary qualification review before applying. If you are subject to this review, be sure to contact the Admissions Office before the end of the application submission period. Application submission period: Must be submitted between July 6 (Mon.) and 17 (Fri.), 2015 Submission location:tsudanuma Campus, Admissions Office Application Materials: 1) Application Qualification Review Request Form: University-prescribed form (Form 3) 2) Certificate of graduation and a transcript from the last school attended (issued within the past three months, as a rule) 3) Master s program: Documentation verifying that the applicant has academic ability equivalent to that of a university graduate (documentation verifying the applicant s work history, training history, research history, or other practical experience, and performance) Doctoral program: Documentation verifying that the applicant has academic ability equivalent to that of a master s degree holder (documentation verifying the applicant s performance, including job description, outline of performance and experience, works created, presentations and essays, and patents). Note: Documents submitted in any language other than Japanese or English should be accompanied by a translated version verified by a public institution (e.g., an embassy or consulate) or a Japanese-language school, and have the institution s official signature or seal on it. Review Method: Document review Review Fee: Free Review Results: Results for the September admission exam will be sent to the applicant on July 28 (Tue.). 2 Application Fee: 30,000 JPY 3 Application Methods (1) Register your application information For information about registering your application information and the application procedure, refer to the online application guide on the following webpage. http://webentry.it-chiba.ac.jp/guide/it-chiba-g Note: If a family member or acquaintance is making the payment on behalf of the applicant, be sure to enter the information of the applicant. (2) Pay your application fee 1) After you apply online, pay the application fee at a convenience store (Lawson, FamilyMart, 7-Eleven, Circle K Sunkus, Three F, Ministop, Daily Yamazaki, or Seicomart), using Pay-easy (at any JP Bank or bank ATM with a Pay-easy mark or through Pay-easy-compatible net banking), or using a credit card (Visa, MasterCard, JCB, American Express or Diners Club) within the application submission period (from August 3 to 21). 2) When you pay the application fee, you will also have to pay a transaction fee in addition to the application fee. 3) You cannot pay the application fee in person at a financial institution. 4) You cannot pay the application fee in person at the university. 5) After an application fee has been paid, you will be allowed to print your application form. 6) You can make payments at convenience stores any time within store hours, including Saturdays, Sundays, and holidays. However, please note that applications are only accepted on the online application site until 4 p.m. on the last day of the application submission period. 12
Guidelines Relevant to Both the Master s and Doctoral Programs (3) Submit your application documents Prepare an envelope sized 240 mm 332 mm (an envelope that the designated A4 size forms will fit in without folding), affix an address sticker on the front of the envelope, and put the complete set of application documents in the envelope. Bring the complete set of application documents to the university. (The documents must arrive by the deadline.) Before you seal the envelope, make sure that the envelope includes all the necessary documents. Even if the application fee payment is completed within the application submission period, if the postmark on the application materials you send by mail is dated after the end of the application submission period, you will not be able to take the admission examination. Your examination admission number will be determined when your application documents are received by the Admissions Office. Bring the Examination Admission Form/Photograph Form with your examination admission number written on it on the day of the examination. Do not separate the Examination Admission Form and Photograph Form. Admissions Office, Chiba Institute of Technology 2-17-1 Tsudanuma, Narashino-shi, Chiba Prefecture 275-0016; Tel: 047-478-0222 4 Examination Venue Tsudanuma Campus: 2-17-1 Tsudanuma, Narashino-shi, Chiba Prefecture In front of Tsudanuma Station (south exit) on the JR Sobu Line You will receive a list of venues for the written and oral examinations when you submit your application in person to the Admissions Office. If you submit your application via postal mail, a copy of this list will be sent along with the Examination Admission Form/Photograph Form. 5 Notification of Acceptance 1) Mailing of Notifications of Acceptance Acceptance notifications and documents related to enrollment will be mailed to successful applicants at the same time they are posted on campus. Please be aware that notifications will not be sent to unsuccessful candidates. 2) Online Results For five days starting on the date of notification of acceptance, applicants can check their examination results online (in Japanese only). You can use a computer or cell phone/smartphone to see if you passed. https://www.go-hi.jp/cit/ (PC and mobile site) Any connection charges incurred to check this data are borne by the user. The university shall not bear any responsibility for any problems that arise related to incorrect operations or misreading of the online data. Hours September Examination September 3 (Thu.) 6:00 p.m. to September 7 (Mon.) end of day 3) Important Notes The examination results will not be posted on a bulletin board. If you confirm that you have passed the examination online but do not receive a notification of acceptance within four to five days, please contact the Admissions Office right away. Successful applicants should expect to receive information on student liability insurance from a university affiliate, the Chiba Institute of Technology Service. Results will not be given in response to telephone inquiries. 6 Enrollment Procedures To complete their enrollment, applicants must pay their student fees and miscellaneous dues and submit their enrollment documents by the enrollment deadline. For details, see the Enrollment Instructions enclosed with the notification of results. 13
Guidelines Relevant to Both the Master s and Doctoral Programs 7 Tuition and Fees Student fees and miscellaneous dues for the 2015 academic year are as follows. Information Relevant to Both the Master s and Doctoral Programs Item Graduates of Chiba Institute of Technology (including those who expect to graduate) Graduates of other universities (including those who expect to graduate) Student fees Admission fee 0 JPY 200,000 JPY Tuition 800,000 JPY 800,000 JPY Miscellaneous dues Student mutual aid association PPA Membership fee 0 JPY 2,000 JPY Annual dues 2,500 JPY 2,500 JPY Membership fee 0 JPY 10,000 JPY Annual dues 10,000 JPY 10,000 JPY Alumni association lifetime membership 0 JPY 20,000 JPY Total 812,500 JPY 1,044,500 JPY Notes: In the second year and beyond, tuition will increase annually by 30,000 JPY. Student fees are not taxable pursuant to the Consumption Tax Act. Tuition, student mutual aid association annual dues, PPA annual dues, and the alumni association lifetime membership fee can be paid in two installments, one in the fall semester and one in the spring semester. The second installment should be paid after enrollment (around March of the following year). 8 Declining an Offer of Admission If circumstances require a student to decline an offer of admission after having completed the enrollment procedures, all fees other than the admission fee will be refunded if the student completes the admission rejection procedures by Thursday, September 17, 2015. For details, please see the Enrollment Instructions enclosed with your notification of results. 9 Scholarship Programs 1) Loans We have established a program that grants loans to prospective graduate school students (Japanese citizens) to cover their student fees. (However, students who have received a loan from this university or from another program may not be eligible to apply for this loan, depending on their total debt load.) An annual administrative processing fee of 1 percent a year needs to be reimbursed along with repayment. 2) Teaching Assistant The teaching assistant program was established to help graduate students gain teaching experience and pay their expenses. 3) We facilitate scholarship programs offered by the Japan Student Services Organization (JASSO), other public organizations, private companies, etc. 10 Important Notes Students are not required to submit a health report, but everyone should undergo the health examinations that the university offers to them after enrollment. If you have a physical disability and require special considerations when taking the entrance examination, be sure to contact the Admissions Office before applying. Individuals who are concerned that a serious illness or injury could hinder their ability to take the entrance examination should likewise consult the Admissions Office. 11 Personal Information Management Personal information collected during the application process, such as your name and address, will only be used to send out materials and surveys related to your enrollment and to collect statistical data. Personal information shall be carefully managed. We will provide information such as your address to the Chiba Institute of Technology Service, a university affiliate, so that they can send insurance information to you. 14
5 1 ( 様 式 1) 秋 入 学 2 受 入 れ 同 意 書 3 専 攻 長 印 4 指 導 予 定 教 員 印 大 学 院 入 学 試 験 において 下 記 の 者 が 合 格 となった 場 合 に 受 入 れ することを 同 意 します 記 6 志 願 者 氏 名 7 志 望 課 程 名 修 士 博 士 後 期 課 程 (どちらかを で 囲 むこと) 8 志 望 専 攻 名 専 攻 9 志 望 研 究 分 野 名 1 (Form 1) Fall Enrollment 2 Acceptance Consent Form 3 Department Head Stamp 4 Prospective Academic Advisor Stamp 5 I consent to the acceptance of the following person upon his or her passing of the admission examination. 6 Name of applicant 7 Preferred program Master s / Doctoral (Circle one) 8 Preferred department 9 Preferred research field 15
( 様 式 2) 1 日 本 以 外 の 国 籍 を 有 する 者 のみ 提 出 する 事 平 成 27 年 度 千 葉 工 業 大 学 大 学 院 留 学 生 確 認 票 秋 入 学 2 3 日 本 以 外 の 国 籍 を 有 する 方 は 出 願 の 時 点 から 過 去 1 年 の 間 に 在 籍 していた 全 ての 日 本 語 学 校 専 門 学 校 等 における 次 の ( 1 ) から ( 3 ) の 書 類 を 提 出 してください ( 1 ) 修 了 証 明 書 ( 在 学 中 の 場 合 は 修 了 見 込 証 明 書 または 在 学 証 明 書 ) (2) 成 績 証 明 書 (3) 出 席 状 況 証 明 書 以 下 の 質 問 に 回 答 してください 日 本 語 学 習 歴 について 記 入 してください 4 学 校 名 5 所 在 地 ( 国 名 ) 6 期 間 7 年 月 ~ 年 月 8 年 月 ~ 年 月 9 年 月 ~ 年 月 10 日 本 留 学 の 目 的 および 本 学 大 学 院 を 志 望 した 理 由 を 記 載 してください 11 本 学 大 学 院 に 在 学 する 期 間 の 学 費 生 活 費 の 支 弁 方 法 を 明 記 してください 12 支 弁 方 法 13 金 額 ( 単 位 : 円 ) 14 本 人 の 貯 蓄 15 母 国 の 両 親 または 親 戚 ( 関 係 : ) 16 日 本 国 内 の 経 費 支 弁 者 ( 氏 名 : 関 係 : ) 17 政 府 または 各 種 団 体 の 奨 学 金 ( 名 称 : ) 18 その 他 ( 詳 細 : ) 計 20 上 記 の 記 載 内 容 に 相 違 ないことを 誓 います 21 受 験 者 氏 名 22 日 付 1 Form 2 Only individuals with non-japanese citizenship must submit this form 2015 Chiba Institute of Technology Graduate School International Student Confirmation Form (Fall Enrollment) Individuals with non-japanese citizenship should submit the following three documents from all of the Japanese-language schools or vocational schools that they were enrolled in during the year prior to applying to Chiba Institute of Technology. (1) Certificate(s) of completion (if currently enrolled, a certificate of expected completion or certificate of enrollment) (2) Academic transcript(s) (3) Attendance record certificate(s) 2 Please also provide the information requested below. 3 Describe your Japanese-language school experience. 4 School Name 5 Location (Country) 6 Period 7 From Yr. Mo. to Yr. Mo. 8 From Yr. Mo. to Yr. Mo. 9 From Yr. Mo. to Yr. Mo. 10 Please explain your purpose for studying in Japan and the reasons you are applying to this graduate school. 11 Please note all sources of funding available to you for paying your expenses (school fees and living expenses) while enrolled in this graduate school. 12 Source of Funds 13 Amount (Unit: yen) 14 Applicant s savings 15 Parents or relatives (Relationship to applicant: ) 16 Financial supporter in Japan Name: ) (Relationship to applicant: ) 17 Scholarships from the government or other organizations (Name: ) 18 Other (Details: ) Total 20 I hereby affirm that the above information is true and correct. 21 Applicant s Signature 22 Date 16
2 平 成 27 年 度 千 葉 工 業 大 学 大 学 院 入 学 試 験 出 願 資 格 認 定 申 請 書 1/2 1 ( 様 式 3-1) 秋 入 学 3 フ リ ガ ナ 5 6 4 生 年 月 日 年 月 日 氏 名 7 現 住 所 10 志 望 課 程 名 11 修 士 博 士 後 期 12 どちらか で 囲 むこと 13 志 望 専 攻 名 8 9 電 話 番 号 ( ) 携 帯 番 号 ( ) 14 課 程 専 攻 15 志 望 す る 研 究 分 野 名 16 学 歴 17 年 月 18 事 項 20 職 歴 17 年 月 18 事 項 21 2ページ 目 もあります 1 Form 3-1 Fall Enrollment 2 2015 Chiba Institute of Technology Graduate School Application Qualification Review Request Form 3 Furigana 4 Name 5 Date of birth 6 Year Month Day 7 Current address 8 Tel: 9 Mobile: 10 Preferred academic program 11 Master s Doctoral Program 12 Please circle one. 13 Preferred academic major 14 Major 15 Preferred research field 16 Academic history 17 Date (Western calendar) 18 Details Year Month 20 Work history 21 Continues on the second page 17
様 式 3-1) 入 学 日 4 4 2 平 成 27 年 度 千 葉 工 業 大 学 大 学 院 入 学 試 験 出 願 資 格 認 定 申 請 書 2/2 3 社 会 及 び 学 会 における 活 動 等 5 年 月 日 事 項 6 賞 罰 5 年 月 日 事 項 1 ( 様 式 3-2) 秋 入 学 1 Form 3-2 Fall Enrollment 2 2015 Chiba Institute of Technology Graduate School Application Qualification Review Request Form 3 Social and academic association activities 4 Date 5 Details 6 Rewards and punishments 18