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/privacy.html

(1) Name【Required】

*Write your SURNAME (followed by your first name) in CAPITAL letters here.
*If your are Chinese,write your name in both English and Chinese.

(2) Nationality 【Required】

(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 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. masters' student, instructor)【Required】

*If your are Chinese,write your name in both English and Chinese.

Name of school or employment at present【Required】

(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 SSP project list and select the title of your preferred project and the name of the project leader. 【Required】

Name of project leader: Akihito NODA Akimitsu HATTA Akinori HARADA Akitaka ITO Chaoyang LI Eiichi INAMI Hideo KOHNO Hiroaki NISHIUCHI Hiroaki SHIGEMASU Hirokazu KOBAYASHI Hiroki NISHINO Hiroshi FRUSAWA Hiroshi FURUTA Hiroshi KADOTA Hisao MAKINO Keise IZUMA Keizo SHINOMORI Kiminori MATSUZAKI Kiyoshi NAKAHARA Koichi OKA Koji KOTANI Kojiro ISHII Kyoko SHIBATA Makoto IWATA Mamoru FURUTA Masahiro FUKUMOTO Masahiro OUCHI Masaki TAKEDA Masanori HAMAMURA Masataka OHTANI Masataka TAKAGI Masa-yuki YAMAMOTO Michikazu KOBAYASHI Mikifumi SHIKIDA Motomichi SONOBE Nagatoshi NISHIWAKI Noriko NITTA Sadao MOMOTA Seiji TANAKA Shinichi YOSHIDA Shinsaku IZUMI Shogo TAKEUCHI Shotaro HAYASHI Shuoyu WANG Suguru SUZUKI Takahiko MENDORI Takeshi FUJITA Tatsuro KOSAKA Tomohito TSUJI Toru KURIHARA Toshiyuki KAWAHARAMURA Wang LIAO Xiangshi REN Yoshiaki TAKATA Yousuke OGINO Yukinobu HOSHINO Yukio MITSUYAMA Yusuke KAMACHI Yutaka KOBAYASHI

Project title:

(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

Diploma/degree awarded, major subject

(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

Diploma/degree awarded, major subject

(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

Diploma/degree awarded, major subject

(D) Undergraduate Level

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

*If you are Chinese, 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:  

*If you are Chinese, 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:  

*If you are Chinese, 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 enter below all the schools that you have been enrolled in, including the schools in which you are now registered.

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 your preferred SSP project. 【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 (Writing score 17), a minimum score of IELTS5.5 (Writing score 5.5), 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 (Overall score:    , Writing 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 (Overall score:    , Writing score:    )

CET-6 *This test is only for Chinese applicants

WSK (PETS-5) *This test is only for Chinese applicants

I have taken/will take IELTS/TOEFL iBT and am waiting for the scores to be released.

Score will be released around ( 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 ) *If you are unable to submit proof of IELTS or TOEFL iBT score above the designated standard by the end of the month in which the application deadline falls,
  your eligibility to apply for SSP will not be recognized.

Check this box if you have any special reasons you cannot submit your English proficiency Test Score by the application deadline, and send e-mail to  international@ml.kochi-tech.ac.jp

Other

Japanese proficiency test   Level:  

(17) If you are applying for another institution’s scholarship, or if you have already received another institution’s scholarship, please give the name of the scholarship and its term.

Scholarship name:
Term of the scholarship:

(18) If you are applying to another university, give the details in the space below.

(19) 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 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 year )

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

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

No

Yes  (If yes, please provide the following information.)

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 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 year

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

(21) What is your plan after completing the doctoral program at KUT?【Required】

Return to your current occupation

Join an educational / research institute in your country

Work in a business enterprise in your country

Join an educational / research institute in Japan

Work in a business enterprise in Japan

Other