Ritsumeikan University Graduate Admissions Application
Procedures (September 2018 Enrollment)
1. Documents to be submitted
Please refer to the checklist on the next page and ensure ALL required documents are submitted. Some of the required documents are included in this PDF.
* Please fill in all forms electronically in this PDF, where possible, and print single-sided. * Documents 1, 2, 3, 4, 5 and 8 listed on the next page must be original versions.
* If you cannot submit your original document, you may submit a copy that is certified by the issuing organization as being a "certified true copy" and identical to the original in all respects. Please note that a certified copy must contain the original signature or seal of the university. Photocopied seals will not be accepted.
* All signatures and seals must be original. 2. Important points for application
(1) All application documents must be in English and, to the maximum extent possible, should be typed in word processing-type software and printed on A4-sized paper. Documents in any language other than English must be accompanied by a certified English translation.
(2) Be sure to enter your name and birth date exactly as it appears in your passport on all forms.
(3) All application documents must be sent together, by registered express mail to the address in number 4, “Application Mailing Address,” below.
(4) Once accepted by the university, submitted documents cannot be returned for any reason.
(5) If it is determined that your application documents contain any deliberate falsifications or forgeries, your application will not pass the examination
In addition to completing this application for Ritsumeikan University Admissions, applicants must also complete a separate application for JJ/WBGSP scholarship with the World Bank. Information can be
found at the World Bank’s Scholarship Homepage at the URL below. www.worldbank.org/scholarships
3. Ritsumeikan University Admissions Application Period: Thu, Feb 1 - Mon, Feb 19, 2018
- All documents must be sent by express post (EMS, FedEx, DHL, etc) - All documents must arrive by the deadline.
- Only posted applications will be accepted.
- No applications by email, fax, or walk-in will be accepted.
- * If you are concerned that your application may not arrive by the deadline, you must contact the Ritsumeikan University International Center at BKC by email at [email protected] before the application deadline to inform us of your intention to apply. In the email, you must include a PDF copy of your entire application along with proof that you delivered your application via express postal mail before the deadline (please provide the tracking number, etc.). Your application may be formally accepted upon the arrival of your original application documents via post, only.
4. Application Mailing Address
Ritsumeikan University International Center at BKC 1-1-1 Noji-Higashi, Kusatsu, Shiga, Japan 525-8577 Phone: +81 (0)77-561-3946
5. Notification of Results: Friday, March 16, 2018 (via email and post)
Joint Japan/World Bank Graduate
Scholarship Program (JJ/WBGSP) 2018
Application Documents (September 2018 Enrollment)
Document Checklist:(Forms 1, 2 and 8 are included in this PDF). Please print all forms single-sided.
1. Ritsumeikan University Graduate Application Sheet (University designated form)
2. Field of Study and Study Program (University-designated JJ/WBGSP Application-use form)
*Applicants to the Graduate Schools of Science and Engineering, Information Science and Engineering, or Life Sciences must enter their desired supervising professor's name in this form
3. Letter of Recommendation (optional, freeform) Original documents only
4. Certificate of graduation from most recent academic institution
*Only original documents or certified true copies will be accepted
5 Certificate of grades from most recent academic institution.
*Certificate must explain grading system: ie. Excellent, Good, Satisfactory, Fail, etc. (Only original documents or certified true copies will be accepted)
6. Copy of photo and personal identification page from passport (for applicants in possession of a valid passport) or copy of birth certificate
7. Copy of documentation showing objective proof of level of linguistic ability
・Submit a grade certificate from an English Language Ability Test (Score reports must be from one of the following: TOEIC® LISTENING AND READING, TOEFL iBT®, or IELTS TM. Copies are acceptable). *Document must have been issued no more than 2 years before the application deadline
8. Certificate of Health (University-designated form or form with identical contents)
9. PDF copy of 教育部学歴証書電子注冊備案表 (Graduates of Chinese Universities, only) or PDF copy
of 教育部学籍在線験証報告(Current Students at Chinese Universities, only) (*Students who attended or
are attending universities in Taiwan, Hong Kong or Macau need not submit these forms.)
10. Three photographs (must have been taken no more than 3 months prior, be 4.5 cm high by 3.5 cm wide, be taken head-on, and show applicant from the chest up, with no hat. All photos should have the applicant's name and nationality written on the reverse).
Application period: Thursday, February 1, 2018 - Monday, February 19, 2018
All documents must arrive by express mail before the deadline. Please allow sufficient time for delivery.
Joint Japan/World Bank Graduate
Scholarship Program (JJ/WBGSP) 2018
様式GS 1/3 Form GS 1/3
立命館大学大学院 入学試験志願票 ＊印記載のところは記入不要
Areas with an ＊ are for university use.
RITSUMEIKAN UNIVERSITY GRADUATE SCHOOL APPLICATION SHEET
提出日
Filing Date 年/Year 月/Month 日/Date
志願受付番号 Registration Number ＊ 受験番号Application Number ＊ 入学年度 Year of Enrollment 年 Year 入学時期 Semester of Enrollment 入試方式名称 Admission Method 学生証番号(本学出身者・在籍者のみ) Student ID Number (Current/former Ritsumeikan University students only)
性別 Sex
生年月日 Date of Birth
(YYYY/MM/DD) 年/Year 月/Month 日/Date
フリガナ/Name in Katakana
氏名/Name
国籍/Nationality 日本国 日本以外
Japan Other 取得(予定)在留資格 *外国籍の方のみ
(Scheduled) Residence Status
留学 その他
Student Other 出願研究科
Intended Graduate School 課程 Intended Degree Level
出願専攻 Major 出願コース・プログラム Course/Program 現住所 Current Address 〒Postal Code:
自宅電話番号/Home Telephone Number 携帯電話番号/Mobile Telephone Number
E-mail 保証人氏名 Guarantor's Name
続柄
Relationship with Applicant 保証人住所 Guarantor's Address 〒Postal Code: 保証人電話番号 Guarantor's Phone 自由記述欄 Notes (Ex. Another Address)
写真貼付欄 3cm×2.4cm の カラー写真を 貼付してください。 Attach a photo here
(3cm×2.4cm)
19
Last Name (Surname) First Name (Given Name), Middle Name
2018
2018 Fall Semester (September)
Joint Japan/World Bank Graduate Scholarship Program (JJ/WBGSP) based Admissions
✔
Form GS 2/3 ＊印は記入不要 / Areas with an ＊ are for university use.
① 大学学歴 / University (Undergraduate Level)
▼大学卒業(卒業見込)の場合、出身大学を記入してください。
If you have graduated (are going to graduate) university, please enter the name of that university.
学歴区分/Academic Standing ＊大学卒業 / University Graduate
終了区分/Graduation Status 卒業 卒業見込 その他
Graduated Expected to graduate Other 出身大学名/University
学部学科名/College・Department
学位名/Degree 大学卒業（見込）年月/
(Estimated) Graduation Date 年/Year 月/Month 日/Date
② 大学院学歴 / Graduate school
▼大学院修了(修了見込)の場合、出身大学院を記入してください。
If you have completed (are going to complete) graduate school, please enter the name of that graduate school.
学歴区分/Academic Standing ＊大学院修了 / Completed aGraduate school
終了区分/Graduation Status 卒業 卒業見込 その他
Graduated Expected to graduate Other 出身大学院名/Graduate school
研究科専攻課程名/ Department・Major・Course
学位名/Degree 大学院修了（見込）年月/ (Estimated) Graduation Date
年/Year 月/Month 日/Date
③ その他学歴 / Other schools attended
▼大学、大学院の学歴が複数ある場合、専門学校等を卒業している場合など、以下の項目に記入してください。
If you have attended more than one university or graduate school, or if you have graduated from professional school, please enter below.
学歴区分/Academic Standing 修了区分/Graduation Status
出身大学/大学院名 University/ Graduate school
研究科専攻課程名 Graduate school・Major・Course
学位名/Degree 大学/大学院修了（見込）年月
様式GS 3/3 Form GS 3/3
■留学生情報 / International Student Information
氏名
Name(Alphabet) 国籍
Nationality 在留資格
Residence Status in Japan
なし 留学 その他:
None Student Other:
在留期間満了日 Expiry Date （年月日） (YYYY/MM/DD) 留学費用区分 Financial Aid 国費(文部科学省) 私費
MEXT Scholarship Privately Financed
来日（予定）日
(Scheduled) Date of Arrival
（年月） (YYYY/MM)
■国費留学生実績情報 / Japanese Government Scholarship History
過去の国費留学生実績 Have You Received Japanese Government Scholarship (MEXT) in the Past
あり なし
Yes No
「あり」の場合以下を入力 / If yes, please answer the following questions.
留学生期間：開始
Study Abroad Period : FROM
（年月日） (YYYY/MM/DD) 留学生期間：終了
Study Abroad Period : TO
（年月日） (YYYY/MM/DD) 受入大学
University
If you are currently in Japan, please enter your current Residence Status (otherwise, check "none", and leave the Expiry Date below blank)
✔
2018/ 9
*Please type responses into this form or handwrite in clear, block letters. (Do not type in block letters)
Name:______________________________________________________________________________ Family Name(s) Given Name(s)
- Applicants for this scholarship should, to the maximum extent possible, have a detailed,
development-related research plan, based on their professional, development experience and/or the development needs of their country. This section will be one of the most important references for selection.
1. Describe in detail the specific topic or problem you plan to study at Ritsumeikan University as well as a timeline of concrete steps you will take to accomplish your research. (Additional sheets of paper may be attached if necessary.)
2. Describe how you will put your studies to use in your home country after graduation. (Please limit answer to one page)
□ 男 Male □ 女 Female 糖 glucose ⾚沈 貧⾎ ESR Anemia GPT （ALT) ３．現在治療中の病気
Disease currently being treated □ 無 No □ 有 Yes ： 病名 Disease
４．既往症 Past illness/disorder 該当するものにチェックと完治時期 /治療中を記⼊、いずれも該当し ない場合は「無し」にチェックするこ と。
Please check and fill in the date of recovery/under treatment. If NOT contracted any of them in the past, please check “None”.
病名Name 病名Name ✔ 結核 □ はい Yes □ いいえ No (1) 尿検査 Urinalysis: ⽩⾎球数 WBC count Tuberculosis その他感染症
Other communicable disease
腎疾患 Kidney disease 糖尿病 Diabetes １．⾝体検査 cm
Family name 姓 Given name 名 Middle name ミドルネーム
kg Year Month Day 年 ⽉ ⽇ (2)体重 Weight □ 正常 Normal □ 異常 Impaired □ 正常 Normal □ 異常 Impaired
mmHg〜 mmHg (4)⾎液型 Blood type □A □B □AB □O □RH＋□RH－
(8)聴⼒ Hearing □ 正常 Normal □ 異常 Impaired □ 正常 Normal □ 異常 Impaired □ 正常 Normal □ 異常 Impaired □ 正常 Normal □ 異常 Impaired (1)肺Film No. 異常がある場合⇒⼼電図 If impaired⇒Electrocardiograph 年 ⽉ ⽇ Year Month Day
(2)⼼臓 Cardiomegaly Lungs てんかん Epilepsy 完治時期/治療中 /under treatment マラリア Malaria 完治時期/治療中
/under treatment ✔ Date of recovery Date of recovery 薬剤アレルギー Drug allergy ⼼疾患 Heart disease ５．検 査 四肢機能障害 無し None 潜⾎ occult blood 蛋⽩ protein Laboratory tests
Functional disorder in the extremities
✔ 精神疾患
Psychosis
７. 志願者の既往歴、診察・検査の結果から判断して、現在の健康の状況は充分に留学に耐えうるものと思われますか？
In view of the applicant's history and the above findings, is it your observation that his/her health status is adequate to pursue studies in Japan?
gm/dl (3)肝機能検査 mm/Hr /cmm LFT （AST)GOT ６．医師の診断・意⾒ 継続的治療・投薬、その他問題がない場合も、その 旨ご記⼊ください。
Physician's impression of the applicant’s health
Please write if the applicant needs regular medication or treatment. If you do not have a particular opinion, please write as such.
⾎⾊素量 Hemoglobin
（IU/ｌ） （IU/ｌ） γ-GTP （IU/ｌ） (2) 貧⾎検査
Anemia test
（医師に記⼊してもらうこと） (to be completed by the examining physician) ⽇本語⼜は英語により明瞭に記載すること。 Please fill out (PRINT/TYPE) in Japanese or English.
(7)⾊覚異常の有無 Color blindness 性別 Sex (1)⾝⻑ Height (3)⾎圧 Blood pressure ⽣年⽉⽇ Date of Birth Physical examination (5)脈拍
Pulse □ 整 Regular□ 不整 Irregular ⽒名 Name (6) 視⼒ Eyesight 裸眼 (右) (左) Without glasses (R) (L) 矯正 (右) (左) With glasses or contact lenses (R) (L)
撮影年⽉⽇ Date of X-ray フィルム番号 (9)⾔語 Speech 胸部X線所⾒
Describe the condition of lungs.
２．胸部聴診及びＸ線検査 （６ヶ⽉以内）
Physical and X-ray examinations of the chest (within six months)
⽇付 Date 検査施設名 Office/Institution
年 ⽉ ⽇ Year Month Day
医師署名 Physician's Signature
所在地 Address
