Online Pre-Application Request Form

Online Pre-Application Request Form for CSC-KUT Scholarship Program
(Co-supervised Doctoral Study Students)


After inputting your information, please click the 'Preview' button to go to the confirmation page.

Note: please be sure to input information for all 【Required】 items.

Your personal information will be treated properly in accordance with KUT personal information protection policy, which is based on personal information protection laws, and it will never be used for any other purpose. For the full details of that policy, visit
https://www.kochi-tech.ac.jp/english/policy/privacy.html

IMPORTANT NOTE: *Incomplete applications will not be considered.
【Required】

When do you wish to start the program?
When do you wish to end the program?
Upload your recent photo.


*Only one pre-application request should be sent during a given enrollment period.

(1) Name【Required】
*Write your SURNAME (followed by your first name) in CAPITAL letters here.
*Write your name in both English and Chinese. (e.g. Li Chaoyang/李 朝陽)
(2) Nationality
(3) Date of birth【Required】
Year / Month / Day
(4) Age (at time of enrolment)【Required】
(5) Name of school at present【Required】
*Write name of school in both English and Chinese. (e.g. Kochi University of Technology/高知工科大学)
Name of your supervisor【Required】
E-mail of your supervisor【Required】
*You must obtain an approval from your supervisor in China before you apply for CSC-KUT Scholarship Program. (Co-supervised doctoral study students)
(6) E-mail address 1【Required】
E-mail address 2(*Optional)
(7) Present mailing address【Required】
Postal code【Required】
Country【Required】
Phone【Required】
(8) Refer to the Co-supervisor list and select the name of the Co-supervisor at KUT. 【Required】
Name of project leader:
(9) Educational background【Required】
*Please enter below all the schools that you have been enrolled in, including the schools in which you are now registered.
(A) Elementary School

School name:     City, Country:  

 / 
 / 

years and months
(B) Lower Secondary School

School name:     City, Country:  

 / 
 / 

years and months
(C) Upper Secondary School

School name:     City, Country:  

 / 
 / 
(D) Undergraduate Level

School name:     City, Country:  
*Write in both English & Chinese.

 / 
 / 

years and months

(E) Master's Level

School name:     City, Country:  
*Write in both English & Chinese.

 / 
 / 

years and months

(F) Level

School name:     City, Country:  
*Write in both English & Chinese.

 / 
 / 

years and months

Total years of schooling described above
(10) Employment record (if applicable) beginning with the most recent employment
*Please provide details of your two most recent employment records.
1.



 / 
 / 


2.



 / 
 / 


(11) List of publications (Provide the titles of books or papers, including graduation theses, with the publisher's name and date of publication. Write a summary, if possible.)【Required】
(12) Academic record: Average grade (CGPA, average grade)


*Please write the grades that you received and the maximum possible score. (e.g. CGPA 3.0 / 4.0)
(13) Academic honours and prizes, if any.
(14) Write a summary of your master's thesis below. 【Required】
(15) Write a brief research plan at KUT. 【Required】
(16) Language ability other than your native language. 【Required】


(score:    )

  *The TOEFL iBT test can be taken in three approved ways officially: test at a test center, test on paper or test at home. KUT accepts all three options.
(score:    )

  *IELTS is only accepted in the academic test format. KUT accepts scores from both test center-based exams and IELTS Online.




  Level:  
(17) Have you ever visited Japan?【Required】

*Purpose of stay (e.g. study at school, internship, work):
(18) Have you ever lived abroad?【Required】

From  month / year to month / year
*Purpose of stay (e.g. study at school, internship, work):

Send your completed pre-application request to your preferred co-supervisor via this online pre-application form. Only one pre-application request should be sent during a given application period. When you have obtained the permission of your preferred co-supervisor at KUT, please print the form and sign at the bottom. Then send all the required documents by post. The documents must reach at KUT by the deadline.

(Declaration and Agreement)
1. Missing or incomplete required documents will result in the rejection of my application.
2.Any false declaration, false information, or incomplete information on the application form or other application documents, including but not limited to omission of information regarding educational background, will result in the rejection of my admission or the cancellation of my acceptance by the university. If such a misrepresentation is detected after my enrolment, I will accept any disciplinary actions, such as expulsion from the university or reimbursement of exempted tuition fees, as decided by KUT.

Applicant's signature (hand-writing):  

Date submitted:
Year / / Month Day