Online Application

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Personal Data

Full Name:
(Last, First Middle)

Sex:

Male Female

Date of Birth:

(Month/Day/Year)

Mailing Address:
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Phone Number:

Fax Number:

Email:

Citizenship:

Native Language:

Type of Visa

Date of Expiration: (Month/Day/Year)

Martial Status:

Single Married Spouse's Name: Children:

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Contact Information

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(Last, First Middle)

Relationship:

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Employer/Duties:

Academic Information

Starting Term:

Program:

Associate Degree Undergraduate Degree Japanese Studies Program/Other

Current Status:

Other:

Major of Interest:

Career Goals:

Academic Record

Name of School	City	Date of Last Attendance	Year of Graduation

TOEFL Score:

(for Non-English speaker only)

Date: (Month/Day/Year)

TOEIC Score:

(for Non-English speaker only)

Date: (Month/Day/Year)

STEP Grade:

(for Non-English speaker only)

Date: (Month/Day/Year)

SAT Score:

(Math) (Verbal)

Date: (Month/Day/Year)

Personal Statement:

In the space below , provide a brief statement outlining your goals in your educational program at Kyoto International University. If there is not enough space, please email your full response to info@kyotoiu.ac.jp after submitting this application.

By clicking this checkbox, I verify that the above information in this application is true and accurate.