zarTokyo Institute of Technology
Global Scientists and Engineers Program (GSEP)
April 2016 Application Form

* This application should be typed or neatly handwritten in block letters. * Numbers should be in Arabic numerals. * Years should be written using the A.D. (19YY, 20YY) system. * Proper nouns should be written in full and not abbreviated. * Personal data in this application will only be used for admissions purposes.

1. Name: (Family) (First) (Middle)

2. Nationality: Date of birth: (yyyy/mm/dd)

3. The top ten students will be enrolled in this degree program as MEXT scholarship students. If you are NOT awarded a scholarship, are you willing to join this program at your own expense? (Check one of the boxes below.)

 I will NOT join this program.
 I will join this program at my own expense.

4. If you know any Tokyo Tech faculty or alumni association members, please provide his/her contact information. (This is not mandatory, but he/she may be consulted and his/her comments may be taken into account during the application screening.) Name: | | Relationship: | | Address: | | Tel: | | Fax: | | Email: | |

5. Essays
A) Why do you wish to study at Tokyo Institute of Technology in this degree program? How will completing this degree program contribute to you achieving your career objectives?
(max 500 words)

B) Please tell us about yourself. For example,

* What are your academic strengths and challenges? * What type of activities have you participated in as a student in the past? * What leadership experience do you have? * Comment on your knowledge of Japan and/or Japanese language skills * What awards/certificates have you received which demonstrates academic and/or sports excellence?
(max 500 words)

Date:

(yyyy/mm/dd)