Application for Research Student, Auditor, or Others

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日本大学理工学部
情報教育研究センター
船橋
駿河台
Tel.047-469-5335
Tel.03-3259-0556
Fax.047-464-3033
Fax.03-3295-5138
form018-04
Application for Research Student, Auditor, or Others
Date
yyyy/m/d
Type
□New
□Change
Name
印
ID Number
Applicant
区分
□ 研究生
□ その他（
□ Auditor
□ 科目等履修生
）
□ 留学生
電話番号
E-Mail
・Funabashi Campus
□ cn Client
Service*1
□ cn UNIX
□ LAN Socket
□ Print on Demand
＊1 Multiple choice is available.
・Surugadai Campus
□ cn Client
□ cn UNIX
□ LAN Socket
□ Print on Demand
・Common
□ edu Mail
□ Campus Information
□ KYOUMU Information
When I take services provided by CN Center, I promise to observe the defined essential points strictly.
The Pledge
Name:
Seal
Entry column for a guarantor. (Faculty)
Name
Department
Ex. No.
（S ・ F ･ S2・8）
E-Mail
CN Center use only
Receipt No
Processed
Date
ID
Center Staff
Remarks：

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