26 10 受入・理研IPA募集案内作業用_MK

Saitama University-RIKEN International Joint Graduate School
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SAITAMA UNIVERSITY
Graduate School of Science and Engineering
Saitama University-RIKEN International Joint Graduate School
1. General overview
Saitama University and RIKEN (http://www.riken.jp/en/), one of Japan’s leading advanced
research institutes began the Saitama University-RIKEN International Joint Graduate School on
October 1, 2008. This school offers Saitama University students from overseas the opportunity to
enroll in a doctoral program at Saitama University’s Graduate School of Science and Engineering,
and to pursue their studies under the supervision of faculty with concurrent appointments at
RIKEN and Saitama University. RIKEN will provide its research resources covering the fields of
physics, chemistry, biology, medicine and engineering, and financial support for a part of the
student’s living and accommodation costs. Enrollment is once per year in the autumn. The seventh
year of this program will begin in October, 2014.
2. Program
The Saitama University-RIKEN International Joint Graduate School is a part of RIKEN’s Joint
Graduate School Program. Graduate students from abroad participating in the Saitama
University-RIKEN International Joint Graduate School are supervised by faculty in the six
departments of Saitama University’s Graduate School of Science and Engineering and the
Saitama University Brain Science Institute. The six departments include the Department of
Bioscience; the Department of Material Sciences; the Department of Mathematics; Electronics and
Informatics; the Department of Human Support and Production Sciences; the Department of Civil
and Environmental Engineering; and the Department of Advanced Collaborative Research. The
faculty members listed on the table at the end of this program description hold concurrent
appointments with RIKEN and Saitama University and have their research laboratory at RIKEN’s
Wako campus. Successful candidates will pursue their PhD study at RIKEN as Saitama University
student and will receive some financial support in the form of a living and accommodation
allowance.
3. Eligibility
Non-Japanese students who satisfy the qualifications to apply for the PhD courses of the six
departments and one institute listed above are eligible to apply.
Applicants must also have the following qualifications:
• A Master’s Degree or equivalent research experience
• A high TOEFL or IELTS score（indicative minimum scores are 550（PBT）and 5.5, respectively）
Note: International applicants whose original language of instruction is not English must take TOEFL.
• Be in good mental and physical health
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Saitama University-RIKEN International Joint Graduate School
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If admitted, the applicant must be able to come to Saitama University by October 3, 2014.
4. How to Apply
Applicants for this program should first contact by email the faculty member who they would like to
have as the supervisor of their studies. Application must be made through one of the faculty listed
on the table at the end of this program description.
• Evaluation of applications will be based on the candidate’s scholastic ability and research
potential assessed from previous credentials, recommendation letters and essays on selected
topics. A screening committee will review all applications and the faculty member who has been
contacted will inform the applicant of the screening results. Successful applicants must have an
internet or telephone interview with one of the six departments and one institute listed above
according to a pre-determined time schedule. The details of this interview will be sent out to
short-listed candidates．The final selection is based on the performance at the interview and the
successful candidate must be accepted as a regular PhD course student at Saitama University.
Applicants who fail to meet these criteria will not be accepted.
• Schedule of applications for October 2014 admissions
April 4, 2014
Application deadline
April 7- May 8, 2014
Screening of applicants
June 20, 2014
Notification of results to applicants
September 29-October 3, 2014 Arrival date for international students enrolling in 2014
• Required documents (refer to the following Saitama University’s application forms )
(a) Completed application form: Form 1 (pdf:103kb)(word:103kb)(4 pages)
(Concise resume and certificates of degrees (BSc & MSc) including official copies
of academic records and grades obtained during previous undergraduate and
graduate studies as well as list of publications and copies of refereed papers, if
any.)
(b) Completed application form: Form 2 (pdf:41kb) (word:41kb)(1 page)
(c) Completed application form: Form 3 (pdf:41kb) (word:41kb)(2 pages or more)
(Including essays on field of study and study program in Japan)
(d) Two letters of recommendation including one from the dean of your Master’s
course
(e) Certificate of English proficiency: Official score of TOEFL, IELTS or equivalent
(f) Statement of source of funding
(If you receive scholarship, please submit certificate as evidence.)
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5. Financial Support
The successful applicant will hold the position of International Program Associate (IPA) at RIKEN;
RIKEN shall be paid the following for IPA:
1. JPY 5,200 per day for living expenses
2. Accommodation costs: If campus housing is unavailable, up to JPY 70,000 per month (utilities
and telephone not included)
Note: If RIKEN campus housing is available, rent is not charged
3. Discounted economy round-trip airfare from home country
6. Application, Admission, and Tuition Fees
Applicants to Saitama University’s PhD course are required to pay JPY 30,000 application fee. An
additional JPY 282,000 admission fee must be paid upon acceptance. One-half of the annual
tuition fee (JPY 535,800) for the PhD course must be paid prior to enrollment.
Contacts
Saitama University Graduate School of Science and Engineering
Address: 255 Shimo-okubo, Sakura-ku, Saitama, 338-8570 Japan
URL
http://www.saitama-u.ac.jp/rikogaku/english/index.html
TEL
+8148-858-3951
FAX
+8148-858-3698
+8148-858-3430
RIKEN Global Relations Office
[email protected]
URL：http://www.riken.jp/en/careers/programs/ipa/
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Graduate School of Science and Engineering departments and faculty with concurrent
appointments for Saitama University-RIKEN International Joint Graduate School
(as of January 2013)
Department
Type of Degree
Bioscience
Doctor of Philosophy
or
Doctor of Science
Faculty
Email
Hiroyuki Osada
hisyo(at)riken.jp
Naoko Imamoto
Toshihide Kobayashi
Department Outline
Chemical biology, recombinant DNA in
eukaryotes, molecular cell biology relating to
nucleocytoplasmic exchange, the growth and
differentiation of insects, the physiology of the cell
cycle and posttranslational modification
http://www.saitama-u.ac.jp/rikogaku/english/educa
tion/doctor/life.html
Key words & comments
Chemical Biology, Drug Discovery
Our research starts from the discovery of the
bioactive compounds that regulate the mammalian
cell function. Then, the research will be
expanded to the following subjects.
1) Biosynthesis of microbial metabolites.
2) Identification of molecular targets of bioactive
compounds.
3) Mining and functional analysis of molecular
targets of bioactive compounds.
http://www.riken.jp/en/research/labs/chief/antibioti
cs/
In eukaryotic cells, most of genomic information is
stored in the cell nucleus. The main subject of our
laboratory is to understand the nucleocytoplasmic
transport and organization of cell nucleus to
uncover new aspects and principles on regulation
and maintenance of nuclear function. Our current
effort has been focused on dissecting the dynamic
behavior
of
nucleocytoplasmic
transport
machinery, transport pathways, and functional
relation between nuclear envelope and chromatin
structure in the context of live cells and cell-free
reconstituted systems. We are taking cell
biological, molecular biological, and biochemical
approaches coupled with newly developed
imaging techniques.
nimamoto(at)riken.jp
http://www.riken.jp/engn/r-world/research/lab/wako
/cell-dyna/index.html
Lipid Biology Laboratory focuses on the elucidation
of molecular organization of lipids and lipid
domains that are involved in cellular signaling.
Our strategy is to visualize cellular lipids in vivo
and reconstitute the lipid membranes in vitro.
In order to visualize lipids, we develop proteins,
peptides and small molecules that recognize
specific lipids. The reconstituted membranes are
evaluated by a variety of biophysical techniques.
Those who have background in biochemistry, cell
biology, molecular biology, biophysics and organic
chemistry are encouraged to apply to the
laboratory.
kobayasi(at)riken.jp
http://www.riken.jp/lbl/mainpagelbl.html
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Tadashi Suzuki
Naoshi Dohmae
Minoru Yoshida
Yoichi Shinkai
Research Subjects: (1) studies on mechanism of
novel catabolic pathway for glycans; (2) functional
role and evolutional diversion of the cytoplasmic
PNGase.
Research Background Desired: Biochemistry; Cell
Biology; Genetics; Mammalian Genomics.
tsuzuki_gm(at)riken.jp
http://www.riken.jp/en/research/labs/grc/riken_max
_planck/sys_glycobiol/glycometabolome/
Biomolecular characterization. We develop high
quality structural characterization methods to the
biological science, aiming to further understand the
mechanism and action of biological molecules.
dohmae(at)riken.jp
http://www.riken.jp/BiomolChar/index_en.html
Chemical genetics, a new approach to drug and
drug target discovery in the post-genomic era. In
our laboratory, biological functions of a number of
proteins targeted by small molecules are studied
by chemical genetics, functional genomics and
proteomics. In particular, we focus on protein
subcellular localization and protein modifications
and their interplays such as acetylation,
methylation ubiquitination, and sumoylation, which
are regulated by small molecules.
yoshidam(at)riken.jp
http://www.riken.jp/en/research/labs/chief/chem_g
enet/
This laboratory’s principal objective is to
understand the molecular mechanism of
epigenetic gene regulation and roles of epigenetics
in health and disease. To address above
questions, we take multidisciplinary approaches
toward this goal, including molecular biology,
biochemistry, cell biology, structural biology and
mouse molecular genetics.
yshinkai(at)riken.jp
http://www.asi.riken.jp/en/laboratories/chieflabs/c
ml/index.html
Noncoding RNAs, Nuclear Structures, Epigenetics,
Evolution.
Shinichi Nakagawa
We are interested in the function of non protein
coding RNAs (ncRNAs) that are transcribed from a
wide region of the mammalian genomes. These
ncRNAs regulate a variety of cellular processes
including epigenetic regulation of gene expression,
post-transctiptional control of gene expression,
and formation of nuclear bodies. Many of these
ncRNAs are species-specific, raising an intriguing
possibility that emergence of particular ncRNAs
delineated the course of evolution of certain
species.
[email protected]
http://www.riken.jp/lab-www/nakagawa/index_e.ht
ml
Department
Type of Degree
Department Outline
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Saitama University-RIKEN International Joint Graduate School
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Material Sciences
Doctor of Philosophy
or
Doctor of Science
or
Doctor of Engineering
Faculty
Email
Zhaomin Hou
houz(at)riken.jp
Satoshi Kamiguchi
Kamigu(at)riken.jp
Tahei Tahara
tahei(at)riken.jp
Reizo Kato
Mikiko Sodeoka
http://www.saitama-u.ac.jp/rikogaku/english/educa
tion/doctor/material.html
Key words & comments
Organometallic Chemistry, Molecular Catalysis,
Polymer Chemistry. Our research interest includes
development of more efficient, selective catalysts
for olefin polymerization and organic synthesis,
organometallic complexes having novel structures
or properties, and organic functional materials.
http://www.riken.jp/lab-www/organometallic/engl/in
dex_e.html
Inorganic chemistry and catalytic chemistry. Our
research interest is synthesis of multi-nuclear
transition metal cluster complexes and their
application to functional materials. Recent study is
especially focused on utilization of sulfide cluster
complexes as catalysts.
Ultrafast Spectroscopy, Nonlinear Spectroscopy,
and Single Molecule & Correlation Spectroscopy.
We study ‘complicated systems’ in the condensed
phase using advanced molecular spectroscopy.
Especially, we now focus on (1) elucidation and
control of ultrafast phenomena using advanced
time-resolved spectroscopy, (2) study of soft
interfaces using new nonlinear spectroscopy, and
(3) study of the dynamics of complex systems in
the femtosecond - millisecond time region. In the
course of these researches, we develop new
methods in molecular spectroscopy.
http://www.riken.jp/lab-www/spectroscopy/index-e.
htmlhttp://www.riken.go.jp/lab-www/spectroscopy/
en/index.html
Chemistry and physics of molecular materials,
especially molecular conductors. The basic
concept of our science is organization of electrons,
molecules, and crystals. In order to reveal its
mechanisms and develop methods for its control,
we are carrying out basic studies on organization
of electrons in strongly correlated electron
systems, self assembling of molecules through
supramolecular interactions, and fabrication of
micro/nano-scaled crystals in the molecular
device.
reizo(at)riken.jp
http://www.riken.jp/lab-www/molecule/index-e.html
Synthetic Organic Chemistry and Chemical
Biology. Our research interests cover from
transition metal-catalyzed enantioselective
reactions to design and synthesis of intracellular
signal transduction modulators and their
application to the cell biology research.
sodeoka(at)riken.jp
http://www.riken.jp/en/research/labs/chief/synth_or
g_chem/http://www.riken.jp/engn/r-world/research/
lab/wako/organic/index.html
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Yousoo Kim
Takuo Tanaka
Katsunori Tanaka
Hiroshi Abe
Our research focuses on describing details of the
energy transport and conversion at the solid
surfaces and interfaces in the nanoscale regime.
In order to understand their basic mechanism at a
single molecule/atom level, we carry out combined
study of scanning probe
microscopy/spectroscopy and density functional
theory calculation on the well-defined surfaces
under ultra-high vacuum condition.
ykim(at)riken.jp
http://www.riken.jp/Kimlab/
In this research laboratory, we are intensively
investigating breakthrough science and techniques
that can artificially control the electro-magnetic /
optical properties of materials by using metal
nano-structures. We collectively call these
artificial materials “metamaterials.” Metamaterial
technology can control the permittivity and
permeability of the materials and can create
unprecedented optical materials such that its
refractive index can be zero, negative or
gargantuan. We also intensively extend the
application of metamaterials to develop novel and
functional photonic devices. In addition, other
active studies for the development of peta-byte
optical data storage or the development of laser
nano 3D fabrication technology are also running.
t-tanaka(at)riken.jp
http://metamaterials.riken.jp/
Synthetic organic chemistry and reaction-based
chemical biology. Our research focuses on
exploring the new reactivity of unsaturated imines
and their utilization in discovering the new
biological phenomena, establishing the innovative
PET imaging, and synthesizing the bioactive
natural products in living animals.
kotzenori(at)riken.jp
http://www.riken.jp/en/research/labs/associate/bio
funct_synth_chem/http://www.riken.jp/engn/r-world
/research/lab/asi/biofunc/
Development of medicine and diagnosis method
based on organic chemistry. We create new
functional molecule inspired from natural system.
Especially, artificial nucleic acids are designed and
synthesized. Specific subjects are: RNA
interference technology for RNA medicine,
bio-probe for imaging RNA or protein in living cells,
new fluorescent compound, bio-molecular catalyst
for organic chemical reaction.
Students can learn organic chemistry, synthetic
chemistry and molecular biology through the
h-abe(at)riken.jp
research.
Department
Type of Degree
Department Outline
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Saitama University-RIKEN International Joint Graduate School
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Mathematics,
Electronics and
Informatics
Doctor of Philosophy
or
Doctor of Engineering
Faculty
Email
Katsumi Midorikawa
kmidori(at)riken.jp
Hideki Hirayama
This course takes the harmony of humanity,
science, and technology as its theme and deals
comprehensively with education and research on
underlying theoretical concepts, hardware and
software.
http://www.saitama-u.ac.jp/rikogaku/english/educa
tion/doctor/mathematic.html
Key words & comments
Laser Physics and Engineering.
Novel nonlinear phenomena caused by interaction
of ultrashort intense laser pulses with matters are
investigated for creation of coherent x-ray sources.
Nonlinear optical phenomena in the soft x-ray
region and generation of attosecond pulses are
also pursued by use of high-order harmonics. In
addition, applications of short wavelength and
ultrashort laser pulses to material processing are
studied.
http://www.riken.jp/en/research/labs/chief/laser_te
ch/
We are studying on terahertz (THz) quantum
devices and deep-UV emitting devices. Especially,
we recently aim to develop 1-10 THz-band
quantum cascade laser (QCL) and THz photo
detector using semiconductor superlattices (SLs)
and also 230-350nm-band deep-ultraviolet (UV)
light-emitting diodes (LEDs) and laser diodes
(LDs) using group III nitride semiconductors.
hirayama(at)riken.jp
Tetsuya Aoyama
taoyama(at)riken.jp
Keiji Ono
k-ono(at)riken.jp
Tomohiro Yamaguchi
tyamag(at)riken.jp
Department
Type of Degree
Human Support and
Production
Sciences
Doctor of Philosophy
or
Doctor of Engineering
http://www.riken.jp/en/research/labs/chief/qtm_opt
odevice/
Organic semiconductor devices such as
transistors, photovoltaic devices and
light-electroluminescenceemitting diodes. The
influence of the molecular packing on device
performances are investigated.
Soft-optoelectronics with aggregated, aligned, or
organized organic materials, which takes
advantage of softness and flexibility in organic
materials.
Low temperature electron transport experiments
on semiconductor nanostructures, especially
quantum dots. Recently, we focus on electron-spin
and nuclear-spin related effects in quantum dots.
Physics and engineering of quantum nanoscale
devices. Our main interest involves a search for
novel phenomana in nanoscale devices based on
carbon nanotubes, semiconductor nanowires or
superconducting materials and its application to
quantum functional devices.
Department Outline
This course is divided into the two areas of
manufacturing science and human support
engineering. The area of manufacturing science
deals mostly with materials science, manufacturing
science, and thermal-fluid science, and the area of
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human support engineering deals with robotics
and mechatronics, and mechanics and design.
http://www.saitama-u.ac.jp/rikogaku/english/educa
tion/doctor/mechanical.html
Faculty
Hitoshi Ohmori
Email
Key words & comments
Tuelid(at)mvd.biglobe.ne
jp
Micro-mechanical fabrication, micro-mechanics, IT
assisted fabrication
http://www.riken.jp/en/research/labs/chief/mater_f
ab/
Chemistry and physics of nanocomposite
materials. We utilize the so called
“nano-integration” approach for the construction of
progressive composite materials from conventional
materials and functionalized nanocarbons.
Yusuke Tajima
tajima(at)riken.jp
Department
Type of Degree
Department Outline
Advanced
Collaborative
Research
Doctor of Philosophy
or
Doctor of Engineering
http://www.saitama-u.ac.jp/rikogaku/content/dept_
002_07_coll.html
Faculty
Particle Physics
Email
Key words & comments
Tohru Motobayashi
motobaya(at)riken.jp
Experimental
astrophysics
nuclear
physics
and
nuclear
Tomohiro Uesaka
uesaka(at)ribf.riken.jp
Experimental nuclear physics at RI-beam factory,
RIKEN: Weak responses of unstable nuclei, Shell
structure, Nuclear matter properties, and
Spin-related phenomena
Yuko Motizuki
motizuki(at)riken.jp
Theoretical nuclear astrophysics; computer
simulations of element synthesis and supernova
explosions.
Institute
Type of Degree
Department Outline
Saitama University
Brain Science
Institute
Doctor of Philosophy
or
Doctor of Science
http://www.saitama-u.ac.jp/iron/hP-kenkyo/shinko
u/nou.htm
Faculty
E-mail
Kazuhiro Yamakawa
yamakawa(at)brain.riken.j
p
Key Words & Comments
Molecular Genetics of Neurological diseases. The
laboratory is focusing on the researches of
epilepsy and Down syndrome by using genetics,
molecular biology, histology, mouse disease
models.
http://www.riken.jp/en/research/labs/bsi/neurogen/
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Yasunori Hayashi
yhayashi(at)brain.riken.jp
Tomomi Shimogori
tshimogori(at)brain.riken.j
p
Kang Cheng
Hajime Hirase
kcheng(at)riken.jp
My laboratory is interested in the mechanism of
hippocampal learning and memory in both in vitro
and in vivo preparation. The student will have
opportunity to learn state-of-art two-photon
microscopic imaging, probe designing, behavior
analysis, etc. Please refer to our laboratory
webpage
http://www.riken.jp/en/research/labs/bsi/mem_mec
h/ for accomplishments and ongoing research.
Neural Circuit Development, Thalamus-Cortex
connectivity, Evolution.
http://www.riken.jp/en/research/labs/bsi/mol_mech
_thal_dev/
Neuro Imaging, Functional Magnetic Resonance
Imaging (fMRI), Neurophysiology, Cognition,
Vision
http://www.riken.jp/en/research/labs/bsi/rrc/funct_
magn_reson_img/
Neuron-glia communication; in vivo
electrophysiology and imaging to investigate glial
role in neural processing. astrocytes, synapses
hirase(at)brain.riken.jp
http://www.riken.jp/en/research/labs/bsi/neur_glia_
circ/
*Replace (at) with @
10
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ＳＣＨＯＯＬ
ＩＮＳＴＲＵＣＴＩＯＮＳ（記入上の注意）
１．The application should be typed if possible, or neatly handwritten in block letters. （明瞭に記入すること｡)
２．Numbers should be in Arabic numerals.（数字は算用数字を用いること｡)
３．Years should be written using the Anno Domini system. （年号はすべて西暦とすること｡)
４．Proper nouns should be written in full and not abbreviated. （固有名詞はすべて正式な名称とし，一切省略しないこと｡)
* Personal data entered in this application will only be used for scholarship selection purposes, and contact information such as e-mail addresses
will only be used for forming related human networks after the student returns home and for sending of information by the Japanese Government.)
(本申請書に記載された個人情報については，本奨学金の選考のために使用するほかは，特に E-mail アドレス等の連絡先については，
帰国後における関係者のネットワークを作ること及び必要に応じ日本政府より各種情報を送信する以外には使用しない。
）
(Sex)
１．Name in full in native language
（姓名（自国語))
(Family name)
In Roman block capitals
（ローマ字）
(Family name)
，
，
□Male（男）
(First name)
(Middle name)
(First name)
(Middle name)
□Female（女）
(Marital Status)
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３．Date of birth(生年月日）
19
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）
６．Field of specialization studied in the past（Be as detailed and specific as possible.)
（過去に専攻した専門分野（できるだけ具体的に詳細に書くこと｡）
）
－1－
７．Educational background （学歴）
Name and Address of School
（学校名及び所在地）
Year and Month
of Entrance and
Completion
(入学及び卒業年月)
Amount of time
spent at the
school attended
（修学年数）
Name
(学校名)
From
（入学）
years
（年）
Location
(所在地)
To
（卒業）
and
months
（月）
Name
(学校名)
From
（入学）
years
（年）
Location
(所在地)
To
（卒業）
and
months
（月）
Name
(学校名)
From
（入学）
years
（年）
Location
(所在地)
To
（卒業）
and
months
（月）
Name
(学校名)
From
（入学）
years
（年）
Location
(所在地)
To
（卒業）
and
months
（月）
Name
(学校名)
From
（入学）
years
（年）
Location
(所在地)
To
（卒業）
and
months
（月）
Diploma or Degree awarded,
Major subject
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Elementary Education
(初等教育)
Elementary School
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Secondary Education
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Upper Secondary School
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（高等教育）
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years
（年）
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((注) 上欄に書ききれない場合には，適当な別紙に記入して添付すること｡)
８．State the titles or subjects of books or papers (including master thesis authored by the applicant), if any, with the name and address of the publisher and the
date of publication.
（著書，論文（修士論文を含む｡）があればその題名，出版社名，出版年月日，出版場所を記すこと｡）
* Please attach abstracts of those papers to this application.
（(注)論文の概要を添付のこと｡）
－2－
９．Employment Record: Begin with the most recent employment, if applicable.（職歴）
Name and address of organization
Period of employment
Position
Type of work
（勤務先及び所在地）
（勤務期間）
（役職名）
（職務内容）
From
To
From
To
10.Foreign language proficiency: Evaluate your level and insert an X where appropriate in the following blank space.
（英語能力等を自己評価のうえ，該当欄に×印を記入すること｡）
Excellent
（優）
Good
（良）
Fair
（可）
Poor
（不可）
Fair
（可）
Poor
（不可）
English
（英語）
French
（仏語）
German
（独語）
Spanish
（西語）
11．Japanese language proficiency: Evaluate your level and insert an X where appropriate in the following blank space.
（日本語能力を自己評価のうえ，該当欄に×印を記入すること｡）
Excellent
（優）
Good
（良）
Reading
（読む能力）
Writing
（書く能力）
Speaking
（話す能力）
12．Accompanying Dependents (Provide the following information if you plan to bring any family members to Japan.)
同伴家族欄（渡日する場合，同伴予定の家族がいる場合に記入すること。）
* All expenses incurred by the presence of dependents must be borne by the grantee. He/She is advised to take into consideration various difficulties and
the great expense that will be involved in finding living quarters. Therefore, those who wish to be accompanied by their families are advised to come alone
first and let their dependents come after suitable accommodation has been found.
(
（注）なお同伴者に必要な経費はすべて留学生の負担であるが，家族用の宿舎をみつけることは相当困難であり賃貸料も非常に割高になるの
であらかじめ承知されたい。このため，留学生はまず単身で来日し，適当な宿舎をみつけた後，家族を呼び寄せること。
Name
（氏名）
Relationship
(続柄)
13. Person to be notified in applicant's home country in case of emergency:
(緊急の際の母国の連絡先)
ⅰ） Name in full:
（氏名）
ⅱ） Address: with telephone number, facsimile number, e-mail address
（住所：電話番号，ファックス番号及び E-mail アドレスを記入のこと｡）
－3－
Age
（年齢）
)
現住所(Present address)：
電話番号/FAX 番号(Telephone/Facsimile number）：
E-mail address：
ⅲ） Occupation:
（職業）
ⅳ） Relationship:
（本人との関係）
14.Immigration Records to Japan（日本への渡航記録）
Date（日付）
Purpose（渡航目的）
From
To
From
To
Date of application:
（申請年月日）
Applicant's signature:
（申請者署名）
Applicant's name
（in Roman block capitals）：
（申請者氏名）
－4－
Ａｐｐｌｉｃａｔｉｏｎ
Ｆｏｒｍ
２
ＲＩＫＥＮＩｎｔｅｒｎａｔｉｏｎａｌＧｒａｄｕａｔｅＰｒｏｇｒａｍ
ＧｒａｄｕａｔｅＳｃｈｏｏｌｏｆ
Ｓａｉｔａｍａ
Ｓｃｉｅｎｃｅ
ａｎｄＥｎｇｉｎｅｅｒｉｎｇ
Ｕｎｉｖｅｒｓｉｔｙ
[ ＲＩＫＥＮ－ＳＡＩＴＡＭＡＵＮＩＶ．ＩＮＴＥＲＮＡＴＩＯＮＡＬ
２０１４ＡＵＴＵＭＮＰＲＯＧＲＡＭ ]
ＳＣＨＯＯＬ
１．Full name in Roman block capitals（姓名を記入，ローマ字で表記）
,
(Sex)
(Family name)
(First name)
(Middle name)
□Male（男）
□Female（女）
２．Date of birth（生年月日）
19
Year（年）
Month（月） Day（日）
Age As of Ｏｃｔｏｂｅｒ 1, 20１4 （2014 年 10 月１日現在の年齢）
Paste your passport size
photograph of your taken
３．Nationality （国籍）
within the past 6 months.
Write your name and
nationality in block letters
on the back of the photo.
４．Present address, telephone and facsimile number, E-mail address
（写真（６×４㎝））
（現住所及び電話，ファクシミリ番号，E メールアドレス）
５．The institution you have graduated/will graduate.（卒業した，あるいは卒業予定の機関）
Institution（機関）
Conferred Degree：
（取得学位）
Year（年）
Month（月）
a) Master’s Degree
（修士）
６．Field of study in Japan（日本での専攻希望）
７．If you are applying for other scholarships, state the name of sponsor, duration, amount, etc.
（もし他の奨学金に応募している場合は，その名前，期間，金額等を記すこと｡)
－1－
Ａｐｐｌｉｃａｔｉｏｎ
Ｆｏｒｍ
３
ＲＩＫＥＮＩｎｔｅｒｎａｔｉｏｎａｌＧｒａｄｕａｔｅＰｒｏｇｒａｍ
ＧｒａｄｕａｔｅＳｃｈｏｏｌｏｆ
Ｓｃｉｅｎｃｅ
Ｓａｉｔａｍａ
ａｎｄＥｎｇｉｎｅｅｒｉｎｇ
Ｕｎｉｖｅｒｓｉｔｙ
[ ＲＩＫＥＮ－ＳＡＩＴＡＭＡＵＮＩＶ．ＩＮＴＥＲＮＡＴＩＯＮＡＬ
２０１４ＡＵＴＵＭＮＰＲＯＧＲＡＭ ]
ＳＣＨＯＯＬ
専攻分野及び研究計画
Field of Study and Study Program
Full name in native language
（姓名（自国語）
）
(Family name)
，
(First name)
(Middle name)
Nationality
（国籍）
Proposed study program in Japan (State the outline of your major field of study on this side and the details of your study program on the backside of this
sheet. This section will be used as one of the most important references for selection. Statement must be typewritten or written in block letters. Additional
sheets of paper may be attached if necessary.)
)
(
日本での研究計画；この研究計画は，選考の重要な参考となるので，表面に専攻分野の概要を，裏面に研究計画の詳細を記入すること。記入は
楷書によるものとし，必要な場合は別紙を追加してもよい。
If you have Japanese language ability, write in Japanese.
（相当の日本語能力を有する者は，日本語により記入すること｡）
１
Field of study（専攻分野）
－1－
２
Study program in Japan in detail（研究計画：詳細に記入すること｡）
－2－

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