INTERNATIONAL GRADUATE PROGRAM ON

CIVIL AND ENVIRONMENTAL ENGINEERING

Information on Application Form Submission
APPLICATION CHECKLIST
Name of Applicant: Nationality:

Submission of ensuing application forms involves two interlinked aspects, check-lists of which are provided here.
Please be advised to check the contents of this page carefully as it is applicants' responsibility to ensure that all the
required fields are addressed properly prior to the submission. For filling the forms, use the latest version of freely
available Adobe Acrobat Reader.

[A] Application forms

Application forms are required to be filled digitally, except for Form B. Before the submission, applicant is required to
check against the following check-list to ensure completeness. Do not remove this application checklist page as this
page is required to be sent together with the application forms.

Both pages of the application forms (Form A) are duly filled and signed.
Photo taken in the last 6 months is affixed on the first page of Form A.
Both the summary and the detailed form of essays under Form C have been included.
Concise resume under Form D is duly filled and signed.
Submission of application forms can be done either through email (link at top-right corner of the Form A | 1 of 2) or through
regular postal mail. For the latter, simply print the filled-in forms and send by post. To be noted, however, is that even in the
case of email submission, applicant is required to submit supporting documents (as below) through post.

[B] Supporting documents

Official copies of supporting documents for the application forms are required to be sent via postal mail (the postal
address is listed at the bottom of this page). Digital scan of document(s) and/or a simple photocopy will not be accepted.

Original or certified copies of academic transcripts of applicant's previous undergraduate and/or graduate programs
Certified copy of the certificate of graduation (undergraduate and/or graduate programs)
Two sealed letters of recommendation (Form B)
Certificate of English proficiency (an official score of TOEFL / IELTS / Equivalent)
Certificate of employment (must state the start and the end date of employment) and compensation (monthly or annual
income) issued by the company with company's letter head/logo (ADB-JSP only)
Certificate of family income issued by the company with company's letter head/logo (parent's annual/monthly income if
applicant is single or spouse's annual/monthly income if applicant is married or if status is unemployed, retired or
deceased, an authenticated supporting document must be submitted) (ADB-JSP only)
ADB-JSP information sheet (ADB-JSP only)
Evidence such as copy of bank account activity statements or salary payment statements showing that the applicant
is financially able to bear the expenses while pursuing his/her degree (applicants seeking for admission only)

Additional information
Please check from the list below on how you heard about this program:

Web search Program's website Poster Friend/former student Teacher Facebook Other

Other (please specify):

The postal mail should be addressed to

Foreign Student Office (FSO)
Department of Civil and Environmental Engineering
Saitama University
255 Shimo-Okubo, Sakura-ku, Saitama-shi
Saitama, Japan 338-8570
 Email to FSO

Form A | 1 of 2

attach your
Form Actions

Clear Photo
photo taken
Application for Admission to Print
within
The INTERNATIONAL GRADUATE PROGRAM RESET the past six
All Fields months
on CIVIL AND ENVIRONMENTAL ENGINEERING

1. Name:
family name given name middle name
2. Nationality: 3. Sex: male female

4. Age: 5. Date of Birth: 6. Marital Status: single married

7. Present Affiliation and Position:

employer or university position or status

8. Permanent Address:

9. Present Mailing Address:

Tel: Fax: Email:

10. Major Fields of Interest in Civil and Environmental Engineering:

(a) 　　 (b)
　
11. Degree Program applying for: Master of Engineering Doctor of Engineering / Ph.D.

12. Application for Admission and Scholarship:

Applying for Admission with Scholarships administered by the Department
Applying for Admission only, and have already obtained scholarship or financial support
(Please specify scholarship obtained: )
Monbukagakusho Scholarship through Japanese Embassy in home country: have applied

13. Professional Experience: (list starting with the most recent employment )
Current Annual Income (in US$)

Employer Position/Title Period Full Time Nature of Work

from to (year)

Total years of
full time job years
 Form A | 2 of 2
14. Educational Background:
(a) Bachelor’s Degree Major
University
Location Period: from to
Class Rank: Total Number of Students: Grade or G. P. A.
Awards, Honor, Scholarships received

(b) Master’s Degree Major

Institution
Location Period: from to
Class Rank: Total Number of Students: Grade or G. P. A.
Awards, Honor, Scholarships received

(c) Other Academic Training: Specialization

Institution
Location Period: from to
Class Rank: Total Number of Students: Grade or G. P. A.
Awards, Honor, Scholarships received

15. Rate your proficiency in the English Language:

Reading poor average good excellent
Writing poor average good excellent
Speaking poor average good excellent
Listening poor average good excellent

Certificate of English Proficiency (TOEFL, IELTS or equivalent):

TOEFL score date taken IELTS score date taken
others name of test: score: date taken:

16. Other comments (interests, achievements, skills, publications) which might be important to your application

17. List other universities or graduate schools (in Japan or other countries) that you are also applying to:

18. Name two persons who can give us critical evaluation of your qualifications:

(a) (b)

I , the undersigned, herewith certify that all of the above information is

true and correct at the time of completion.

Signature: Date:
 Form B | 1 of 2

Foreign Student Office, Dept. of Civil and Environmental Engineering

SAITAMA UNIVERSITY, Saitama, Japan 338-8570
LETTER OF RECOMMENDATION

Note to the applicant: Application for admission requires recommendations from two persons well acquainted with
your intellectual ability and personality. Fill in your name and give this form to the recommender.

Name of Applicant: Nationality:

Note to the recommender: Please complete this form, seal in an envelope and sign across the seal, and return to the applicant.
This letter will be held in the strictest confidence, and we would value very much your critical evaluation of the intellectual
ability and personality of the applicant with regard to pursuing advanced study and research. Thank you very much.

Name of recommender:

Position / Title:

Organization:

Address:

Email: Telephone No.: Facsimile No.:

How long (years, months) have you known the applicant?

Under what circumstances have you known the applicant?

How often have you observed him/her? Daily Weekly Monthly Rarely
In comparison with other students in the same field, how would you rate the applicant’s overall scholastic ability?
Truly exceptional --- One of the best you have known.
Outstanding --- Top 5% Average --- Upper 50%
Excellent --- Top 10% Below average --- Lower 50%, but recommended
Good --- Strong ability, but not in the top 10% Not recommended

Some gifted individuals may get mediocre scholastic records. In your opinion, is the applicant's scholastic record an accurate
index of his/her scholastic ability? yes no don't know
If you answer ‘no', please explain briefly:

Evaluate the applicant’s ability to work with others Outstanding Good Average Poor
Evaluate the applicant’s English proficiency (Writing) Outstanding Good Average Poor
English proficiency (Speaking) Outstanding Good Average Poor

Your overall evaluation of the applicant: Strongly recommended Recommended

Recommended with reservation Not recommended

Additional comments, if any: (Please use the back of this sheet)

Signature: Date:
 Form B | 2 of 2

Foreign Student Office, Dept. of Civil and Environmental Engineering

SAITAMA UNIVERSITY, Saitama, Japan 338-8570
LETTER OF RECOMMENDATION

Note to the applicant: Application for admission requires recommendations from two persons well acquainted with
your intellectual ability and personality. Fill in your name and give this form to the recommender.

Name of Applicant: Nationality:

Note to the recommender: Please complete this form, seal in an envelope and sign across the seal, and return to the applicant.
This letter will be held in the strictest confidence, and we would value very much your critical evaluation of the intellectual
ability and personality of the applicant with regard to pursuing advanced study and research. Thank you very much.

Name of recommender:

Position / Title:

Organization:

Address:

Email: Telephone No.: Facsimile No.:

How long (years, months) have you known the applicant?

Under what circumstances have you known the applicant?

How often have you observed him/her? Daily Weekly Monthly Rarely
In comparison with other students in the same field, how would you rate the applicant’s overall scholastic ability?
Truly exceptional --- One of the best you have known.
Outstanding --- Top 5% Average --- Upper 50%
Excellent --- Top 10% Below average --- Lower 50%, but recommended
Good --- Strong ability, but not in the top 10% Not recommended

Some gifted individuals may get mediocre scholastic records. In your opinion, is the applicant's scholastic record an accurate
index of his/her scholastic ability? yes no don't know
If you answer ‘no', please explain briefly:

Evaluate the applicant’s ability to work with others Outstanding Good Average Poor
Evaluate the applicant’s English proficiency (Writing) Outstanding Good Average Poor
English proficiency (Speaking) Outstanding Good Average Poor

Your overall evaluation of the applicant: Strongly recommended Recommended

Recommended with reservation Not recommended

Additional comments, if any: (Please use the back of this sheet)

Signature: Date:
 Form C | 1 of 4

Name of Applicant: Nationality:

Essay 1. Your Field of Study in the past :

(a) summarize (in less than 150 words) within the block space below
(b) write in detail (at least 600 words) under 'Form C | 2 of 4' Total words: 0

Essay 2. Your Proposed Plan of Study :

(a) summarize (in less than 150 words) within the block space below
(b) write in detail (at least 600 words) under 'Form C | 3 of 4' Total words: 0

Essay 3. In your opinion, what is the most important engineering (infrastructure or environmental related)
issue that should be addressed in your local community. Justify your choice and envision a role for yourself.
(a) summarize (in less than 150 words) within the block space below
(b) write in detail (at least 600 words) under 'Form C | 4 of 4' Total words: 0
 Form C | 2 of 4

Name of Applicant: Nationality:

Essay 1. Your Field of Study in the past

(write in detail - at least 600 words)
Total words: 0
 Form C | 3 of 4

Name of Applicant: Nationality:

Essay 2. Your Proposed Plan of Study

(write in detail - at least 600 words)
Total words: 0
 Form C | 4 of 4

Name of Applicant: Nationality:

Essay 3. In your opinion, what is the most important engineering (infrastructure or environmental related) issue
that should be addressed in your local community. Justify your choice and envision a role for yourself.
(write in detail - at least 600 words) Total words: 0
Form D | 1 of 2
 Form D | 2 of 2

8. Past Entry into/Stay in Japan:

Date of Arrival Date of Departure Status Purpose of Entry
1.

2.

3.

4.

5.

9. Reason for study in Japan:

10. Plan after you return to your home country:

I , the undersigned, herewith certify that all of the above information

is true and correct at the time of completion.

Year Month Day

Signature: