(Form 1)

International Course in Management of Civil Infrastructure in Department of Civil

and Earth Resources Engineering
and
International Course in Urban and Regional Development in Department of Urban
Management
Graduate School of Engineering, Kyoto University

Application Form for Admission, 2021

1. NAME

In native language: , ,
(Family name) (First name) (Middle name)

In Roman block capitals: , ,

(Family name) (First name) (Middle name)

Please paste
2. NATIONALITY Photograph
(taken within the
Nationality: last six months)

Width: 3 cm
Height: 4 cm
3. DATE OF BIRTH

19
(Year) 　 (Month)　　 　(Day)　 (Age: as of April 1, 2021)

4. CURRENT CONTACT DETAILS

Address:

E-mail address:

Telephone number:

Fax number:

Form 1-1
 (Form 1)
5. NAME OF UNIVERSITY AND DEPARTMENT

University:

Department:

 Graduated in
 Will graduate in
(Year) (Month)

6. NAME OF GRADUATE SCHOOL AND DEPARTMENT

　　　Graduate school:

　　　Department:

 Graduated in
Will graduate in
(Year) (Month)

Form 1-2
 (Form 2)
International Course in Management of Civil Infrastructure in Department of Civil
and Earth Resources Engineering
and
International Course in Urban and Regional Development in Department of Urban
Management
Graduate School of Engineering, Kyoto University

Educational and Vocational Background

For Admission in 2021

Name of Applicant:
1. Education (list in order, from elementary school to the last school you attended. Periods of absence from school and
periods of military service should also be indicated, if applicable.)

Year and Month of entrance and Standard years required for

Years attended Name of institution
completion graduation/completion
Enrolled in
Year Month
years years
Graduated / Completed / Left in
Year Month
Enrolled in
Year Month
years years
Graduated / Completed / Left in
Year Month
Enrolled in
Year Month
years years
Graduated / Completed / Left in
Year Month
Enrolled in
Year Month
years years
Graduated / Completed / Left in
Year Month
Enrolled in
Year Month
years years
Graduated / Completed / Left in
Year Month
Enrolled in
Year Month
years years
Graduated / Completed / Left in
Year Month

Form 2
2. Employment History (include companies/organizations from which you retired, from which you
are temporarily absent or in which you are currently working)
Period of employment Name of company/organization Position or job duties
From

Year Month
To

Year Month
From

Year Month
To

Year Month

Note: Please list complete educational and employment history, without omission.

Form 2
 (Form 3)

International Course in Management of Civil Infrastructure in Department of Civil

and Earth Resources Engineering
and
International Course in Urban and Regional Development in Department of Urban
Management
Graduate School of Engineering, Kyoto University

Letter of Recommendation for Admission, 2021

TO BE COMPLETED BY THE APPLICANT

Application for admission requires recommendation from a person well acquainted with your intellectual
ability and personality. Please fill in the upper portion of this page (your name, address and e-mail) and give
it to the person who will be recommending you.

Name of applicant:

(Family) (First) (Middle)

Address:

E-mail:

TO BE COMPLETED BY THE RECOMMENDING PARTY

Upon completion, please return this form to the applicant in a sealed envelope, signed across the envelope seal.

Familiarity with the applicant

 What is your relationship with the applicant?  Teacher/Professor  Other
 How long have you known the applicant? years months
 How often do you meet the applicant?  Daily  Weekly  Monthly  Rarely
 What was the nature of your interactions with the applicant?

Form 3-1
  Please provide a description of the applicant’s qualifications for graduate study. In this regard, please include
assessment of how this applicant compares to others whom you have taught.

 Please comment on the applicant’s aptitudes and/or inadequacies and any other remarks that you may feel are
important and relevant to his graduate school study.

(If necessary, please write on a separate sheet and attach to this form)

Appraisal
Please make an appraisal of the applicant in terms of the qualities listed below. Rate the applicant in comparison with
other students in the same field whom you have known or taught.

Outstanding Excellent Good Fair Poor Unable to

(Top 5%) (Top10%) (Top Third) (Middle (Bottom judge
Third) Third)
Intellectual Ability
Analytical Ability
Ability in Oral Expression
Ability in Written Expression
Ability to Work with Others
Persistence/ Drive
Originality/ Creativity

Overall Recommendations:
 Strongly recommended  Recommended  Recommended with reservations  Not recommended

Name of recommending party: ____________________________________________

Position/Title:

Affiliation:

Address:

Telephone Number: Fax Number:

E-mail Address:

Signature Date

Form 3-2
 (Form 4)

International Course in Management of Civil Infrastructure in Department of Civil

and Earth Resources Engineering
and
International Course in Urban and Regional Development in Department of Urban
Management
Graduate School of Engineering, Kyoto University

Remittance Certificate of Application Fee for Admission, 2021

Name of applicant: 　　　　　 　　　　　　　　　　　　　　　　　　　　　　

Please paste the printed “Result” page for

application fees here.

Form 4
 (Form 5a)
(Name of Applicant)

(Address & postal code as of early July 2020)

(Form 5b)
(Name of Applicant)

(Address & postal code as of early September 2020)

(Form 5c)
(Name of Applicant)

(Address & postal code as of early March 2021)

Form 5
 (Form 6)

International Course in Management of Civil Infrastructure in Department of Civil

and Earth Resources Engineering
and
International Course in Urban and Regional Development in Department of Urban
Management
Graduate School of Engineering, Kyoto University

Questionnaire for Submission of English Test Scores

for Admission in 2021

Name of applicant:

Please check and fill in the appropriate sections below.

TOEFL-iBT Date of examination: 　 Score:

I (the applicant) have attached a copy of my Test Taker (Examinee) Score Report to Form 6 and
ordered that the official Score Report be sent to Kyoto University by the following method.
Online at the time of Registration
Online Order date:
Fax or Postal Mail Order date:

IELTS Date of examination: 　 Score:

I (applicant) have ordered that the official score report be sent to Kyoto University
on (order date).

TOEFL-PBT Date of examination: 　 Score:

I (the applicant) have ordered that the official Score Report be sent to Kyoto University by the
following method.
Ordered at the Examination Site
Telephone or Postal Mail Order date:

TOEIC Listening and Reading Test Date of examination: Score:

Note:
 Applicants who have taken TOEFL must submit Test Taker (Examinee) Score Report
attaching to this form, while ordering Official Score Report well in advance so that Kyoto
University can confirm their official score by “View Score Online” system
 IELTS official score reports must reach Kyoto University by July 31, 2020. Applicants must
therefore make a request to the test center to send the official score report to Kyoto University

Form 6
well in advance.

Form 6
 (Form 7)

International Course in Management of Civil Infrastructure in Department of Civil

and Earth Resources Engineering
and
International Course in Urban and Regional Development in Department of Urban
Management
Graduate School of Engineering, Kyoto University

Letter of English Proficiency Statement

Chair, Department of Civil and Earth Resources Engineering,

Chair, Department of Urban Management,
Graduate School of Engineering
Kyoto University

I, the undersigned, hereby state that I am a native English speaker.

Year Month Date

Nationality

Family Name First Name

Signature

Form 7
 (Form 8)

International Course in Management of Civil Infrastructure in Department of Civil

and Earth Resources Engineering
and
International Course in Urban and Regional Development in Department of Urban
Management
Graduate School of Engineering, Kyoto University

Preferred Study Area and Supervisor,

and Specialized Subject of Oral Exam I
for Admission in 2021

 Preferred Study Area and Supervisor

Enter the number (1 to 45) of the area in which you wish to study and the name of the supervisor
from whom you wish to receive supervision by referring to the table in section II. Study areas in the
guidelines.

Study area Name of

No. supervisor

 Specialized Subject of Oral Exam I

Select one specialized subject from the following five specialized subjects by referring to section
VII. Selection Method, i) Subjects, in the guidelines. Note that you are not allowed to take any other
specialized subjects once you select one specialized subject in this form.

□ Structural Mechanics □ Hydraulics □ Soil Mechanics

□ Planning and Management □ Earth Resources Engineering

Prior to submitting the application documents, applicants should contact their chosen supervisor and
the form must be signed by the supervisor.

Date 　　　　　　　　　　　Name of applicant 　　　　　　　　　　　　　 　　

　Signature of supervisor 　　　　　　　 　　　　　　　　

Form 8