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

(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】

1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 Year / 1 2 3 4 5 6 7 8 9 10 11 12 Month / 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Day

(4) Age (at time of enrolment)【Required】

(5) Present occupation (e.g. doctoral student)【Required】

Name of school or employment at present【Required】

*Write name of school or employment in both English and Chinese. (e.g. Kochi University of Technology/高知工科大学)

(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 CSC-KUT Supervisor list and select your preferred Supervisor. 【Required】

Name of Supervisor: Akihito NODA Akitaka ITO Chaoyang LI Eiichi INAMI Hiroaki SHIGEMASU Hirokazu KOBAYASHI Hiroshi FURUTA Hiroshi KADOTA Keizo SHINOMORI Kiminori MATSUZAKI Kojiro ISHII Liao WANG Mamoru Furuta Masaki TAKEDA Motomichi SONOBE Nagatoshi NISHIWAKI Shinichi YOSHIDA Shinsaku IZUMI Shuji TAUE Suguru SUZUKI Takeshi FUJITA Toru KURIHARA Toshiyuki KAWAHARAMURA Wei Ting Han Xiangshi REN Yousuke OGINO Yusuke KAMACHI

(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
School name:     City, Country:  

Time of entrance and completion(month/year)
From: / 
To: / 

Length of schooling
years and months

(B) Lower Secondary School

School name, city, country
School name:     City, Country:  

Time of entrance and completion(month/year)
From: / 
To: / 

Length of schooling
years and months

(C) Upper Secondary School

School name, city, country
School name:     City, Country:  

Time of entrance and completion(month/year)
From: / 
To: / 

Length of schooling
years and months

(D) Undergraduate Level

School name, city, country
School name:     City, Country:  

*Write in both English & Chinese.

Time of entrance and completion(month/year)
From: / 
To: / 

Length of schooling
years and months

Diploma/degree awarded, major subject

(E) Graduate Level

School name, city, country
School name:     City, Country:  

*Write in both English & Chinese.

Time of entrance and completion(month/year)
From: / 
To: / 

Length of schooling
years and months

Diploma/degree awarded, major subject

(F) Level

School name, city, country
School name:     City, Country:  

*Write in both English & Chinese.

Time of entrance and completion(month/year)
From: / 
To: / 

Length of schooling
years and months

Diploma/degree awarded, major subject

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.

Employer, city, country
Employer:
City, Country:

Period of employment(month/year)
From: / 
To: / 

Position

Type of work

2.

Employer, city, country
Employer:
City, Country:

Period of employment(month/year)
From: / 
To: / 

Position

Type of work

(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)

Undergraduate level:

Graduate level:

*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. If you are still working towards your master's degree, provide a written description of the content of your master's thesis and of the progress of the research at this point. 【Required】

(15) Write a brief research plan based on the research field of your preferred Supervisor. 【Required】

(16) Language ability other than your native language. 【Required】

*Applicants must have one of the following score to apply: a minimum score of TOEFL iBT72, a minimum score of IELTS5.5, CET-6 or WSK(PETS-5).
*When you send your application documents (originals), a copy of an official document showing your score on one of the applicable English proficiency tests must be enclosed.

*TOEFL iBT (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.

IELTS (score:    )

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

CET-6

WSK (PETS-5)

Other

Japanese proficiency test   Level:  

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

No

Yes    ( Period of stay:  From 1 2 3 4 5 6 7 8 9 10 11 12 month / 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 year to 1 2 3 4 5 6 7 8 9 10 11 12 month / 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 year )

*Purpose of stay (e.g. study at school, internship, work):

(18) Have you ever lived abroad?【Required】

No

Yes  

Name of country: Period of stay:From  1 2 3 4 5 6 7 8 9 10 11 12 month / 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 year to 1 2 3 4 5 6 7 8 9 10 11 12 month / 1900 1901 1902 1903 1904 1905 1906 1907 1908 1909 1910 1911 1912 1913 1914 1915 1916 1917 1918 1919 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 year

*Purpose of stay (e.g. study at school, internship, work):