For International Students
April/September 2015 Enrollment
http://admissions.apu.ac.jp
(Note) Please confirm your appropriate admissions category using the chart below.
Do you possess Japanese nationality,
(including dual nationality)?
Are you currently residing in Japan, excluding
those on temporary visitor visas?
Do you have a
“permanent resident”status?
*1 Admissions for Japanese/Domestic Applicants applies to those who possess Japanese nationality or Japanese permanent
residency even if they are residing outside Japan.
*2 Individuals who will obtain a student visa before enrollment are eligible to apply for the APU Tuition Reduction Scholarship at the
time of application. APU offers support in obtaining a student visa if successful applicants do not possess Japanese nationality, are
residing out side of Japan, and have completed all required procedures before enrollment.
*3 Please send your inquiries directly to the Immigration Bureau of Japan regarding whether you can change your status of residence
to “student”.
Admissions for Japanese/
Domestic Applicants *1
Admissions for International
Applicants Residing in Japan
Admissions for International
Applicants Residing Outside
Japan
Do you have a
“student visa”or will you change
your status of residence to“student”
before enrollment? *3
Please contact the Admissions
Office before application.
No
Yes
Yes
Yes
No
No
No
*2
Yes
Admissions for Japanese/Domestic Applicants
Admissions Office(Domestic)
TEL: +81-977-78-1120 Hours: 9:00~17:30(Japan Time)
FAX: +81-977-78-1199
Email: apumate@apu.ac.jp
URL: http//www.apumate.net/
Admissions for International Applicants
Admissions Office(International)
TEL: +81-977-78-1119 Hours: 9:00~17:30(Japan Time)
FAX: +81-977-78-1121
Email: welcome@apu.ac.jp
URL: http//admissions.apu.ac.jp/
Contact
1. First Year Student Application
( i ) Applicants who possess language proficiency test scores 	 A + B
(ii) Applicants who do not possess language proficiency test scores 	 A + C
(iii) Applicants who are native speakers of English or Japanese 	 A only
(iv) Applicants residing in Japan	 A + B
2. Transfer Student Application
Current university students or university graduates who wish to apply to APU as second year or third year transfer students
are obliged to submit additional documents: D Transfer Eligibility Documents
See the Admissions Handbook for a list of documents which must be submitted with this form.
A Required Documents for All Applicants
□ 1. Undergraduate application form
□ 2. Application essay
□ 3. Certificate of Eligibility / Resident Status Questionnaire
□ 4. Application fee payment
  ◦Bank transfer → Send in proof of payment  ◦Bank check → Send in bank check
  ◦Credit card → Must register on My APU 2015 Admissions Office website
□ 5. Academic transcripts for most recent 3 years (if you are currently in high school, the most recent 2-2.5 years are acceptable)
□ 6. Mandatory or standarized national test results to enter university/standardized test result certificates (only for those
who have taken them)
□ 7. Letter of Recommendation
□ 8. Passport copy (if available)
□ 9. Two identical photographs (4cm X 3cm) or (1.57 inches X 1.18 inches)
B Language Proficiency Test Scores
□ English-basis students: TOEFL® (iBT) /TOEFL® (PBT) / IELTS / TOEIC® / The EIKEN Test in Practical English Proficiency
(The following test scores are not accepted: TOEFL® -ITP, IELTS (General Training Module), TOEIC® -IP)
□ Japanese-basis students: JLPT/ EJU (Japanese-not including the writing section)
C Language Proficiency Forms (Only if you do not have a language proficiency test score)
□ English Proficiency Evaluation/日本語能力認定書
D Transfer Eligibility Documents
□ 1. Higher institution (e.g., university) academic transcripts
□ 2. List of classes currently attending
□ 3. Credit requirements for graduation
□ 4. Higher institution (e.g., university) graduation certificate (in the case for graduates)
* If you have graduated from a higher educational institution (e.g., university), items 2 and 3 are not required.
E □ APU Tuition Reduction Scholarship Application
In addition to the above, applicants who wish to apply for the APU Tuition Reduction Scholarship must submit APU
Tuition Reduction Scholarship Application.
F □ Extracurricular Activities Report
In addition to the above, applicants who wish to show their experiences, awards or certificates of participation, which
indicate exemplary performance in extracurricular activities undertaken at the higher secondary school (or equivalent)
level or above, can submit the Extracurricular Activities Report.
Admissions handbooks and application forms are also available for download from the Admissions Office website.
Application Categories
Application Document Checklist
General Notes
Please type or hand-write the application forms in black or blue ink. (Applications written in pencil will not be accepted.)
For questions with a □, please mark your choice with a checkmark . You may only choose one box per question.
Family Name / Given Names in English
Please write your family name and given names in English separately as printed in or will be printed in your passport.
Email
Please write your email address accurately. (Please write in English clearly.)
Current Address
Please write in English if you are applying from outside Japan and in Japanese if you are applying from within Japan.
You must also include your phone number.
Mailing Address
Please fill in this information only in the case that the address listed as your current address is different to the address at which
you wish to receive your admission result and other information. (Current school and company, etc.) You must also include a
contactable phone number. If your mailing address is the same as your current address, please check the appropriate box.
Please write in English if you are applying from outside Japan and in Japanese if you are applying from within Japan.
APU Tuition Reduction Scholarship
Only applicants who do not possess Japanese nationality and will obtain a student visa before enrollment are eligible to apply
for the APU Tuition Reduction Scholarship.
Documents to be returned
Diplomas and other original documents that cannot be reissued will only be returned upon request. If you wish for an original
document to be returned, please check yes.
* Documents such as academic transcripts and English proficiency test score reports cannot be returned.
Notes for Completing the Undergraduate Application Form
1
2015
A
International Students
Undergraduate Application Form
I. Applicant Information
II. Undergraduate Program of Study and Other Information
Please fill in 1 to 5 as shown on or will be shown on your passport.
1. Family Name in English: 	
2. Given Name(s) in English: 	
3. Name in Chinese Characters (if applicable): 	
4. Date of Birth: 	 Year      Month      Date	 5. Gender:  □ Male  □ Female
6. Nationality: 	
	 Do you or your parents possess any form of Japanese nationality? □ Yes □ No
7. Native Language: □ English  □ Japanese  □ Other than English/Japanese
8. Email:
(Please write clearly, as this email will be used as the primary contact.) Skype ID:
For 9 and 10, fill in this information in English if you are applying from outside Japan and in Japanese if you are applying from inside Japan.
9. Current Address: 	
	 City/State: 	  Country: 	  Postal Code: 	
Phone: 	    Mobile: 	
10. Mailing Address: □ Same as above
	
	 City/State: 	  Country: 	  Postal Code: 	
Phone: 	    Mobile: 	
* As important documents, such as your screening result, will be sent to this mailing address, fill in this information accurately.
11. Emergency Contact:
Relationship with Applicant:	 □ Father	 □ Mother	 □ Other (Please specify) 	
Family Name: 		 Given Name(s): 	
Phone: 	
Email:
Please check only one box per question.
1. Semester of Enrollment:	 □ Spring (April)	 □ Fall (September)
2. College:	 □ College of Asia Pacific Studies (APS)     □ College of International Management (APM)
3. Enrollment Status:	 □ First Year Student	 □ Second Year Transfer	 □ Third Year Transfer
4. Language Basis:	 □ English	 □ Japanese
5. Type of Application:	 □ Residing Outside Japan	 □ Residing in Japan
6. Scholarship:
Do you wish to apply for the APU Tuition Reduction Scholarship? □  Yes    □ No
	 □ Applied for scholarship offered by other organizations (Organizations: )
Only applicants who do not possess Japanese nationality and will obtain a student visa before enrollment are eligible to apply for the
APU Tuition Reduction Scholarship.
7.Interview Location: Please confirm the date and place of interview in the Admissions Handbook.
  * Please fill in only if you reside in China.
    □ Shanghai  □ Wuhan  □ Shijiazhuang  □ Chongqing  □ Changchun
  * Please fill in only if you reside in India.
    □ Chennai  □ New Delhi
  * Please fill in only if you reside in Viet Nam.
    □ Hanoi  □ Ho Chi Minh
  * Please fill in only if you reside in Japan.
    □ Tokyo  □ Osaka  □ Fukuoka  □ Beppu
Please affix a photograph
(4 cm X 3 cm)
or
(1.57 in X 1.18 in)
taken within the last
3 months on a white
background.
No cap or hat is allowed.
FOR UNIVERSITY USE 大学使用欄
□ 新入生   □ 編入生   □ 転入生 □ 推薦  □ 一般
検定料納入方法
□ 小切手    □ 海外送金 □ 国内送金 □ CD
(小切手番号                    )
FOR UNIVERSITY USE 大学使用欄
願書受付日 受験番号
□ A(                       )
2
2015
III. Education History
In chronological order, please list all schools in English that you have attended from elementary school level to the last or current school
you are attending. (Nursery, kindergarten and language schools are not to be included.) Please write the school name in English. (If the
school is located in Japan, in Japanese.) Please note that 12 years of official education (or scheduled completion) is required for first
year student applications.
Please fill in your education history as written in the example below.
School name
Location
(City/country)
Year and month
of entrance and completion
Current status
Enrollment
YYYY/MM
Graduation
YYYY/MM
(Elementary Education)
AAAA Elementary School Ottawa, Canada 2003/03 2009/02
Elementary School
(Secondary Education)
BBB Middle School
CCC Junior High School
Boston, USA
Montreal, Canada
2009/03
2011/09
2011/07
2012/02
Lower Secondary School
Upper Secondary School
DDD High School
EEE High School
Montreal, Canada
Ottawa, Canada
2012/03
2014/03
2014/03
2015/02
□ Graduated
Currently attending
□ Other:      
(Higher Education) □ Graduated
□ Currently attending
□ Other:      Undergraduate Level
School name
Location
(City/country)
Year and month
of entrance and completion
Current status
Enrollment
YYYY/MM
Graduation
YYYY/MM
(Elementary Education)
Elementary School
(Secondary Education)
Lower Secondary School
Upper Secondary School
□ Graduated
□ Currently attending
□ Other:      
(Higher Education) □ Graduated
□ Currently attending
□ Other:      
Undergraduate Level
  * If the blank spaces above are not sufficient for the information required, please attach a separate sheet.
  * If you are applying as a transfer student and are currently enrolled in college or university, you must submit a document stating the
number of credits required for graduation from your institution. If you have already graduated, you must submit your graduation
certificate/diploma.
The institution name where you completed (or are scheduled to complete) 12 years of official education:               
Date of Completion:       (Year)    (Month)
 If you will not complete 12 years of education by the time of enrollment at APU (due to skipping a grade or for another reason), please
include an explanation on a separate sheet.
If you have attended other schools, e.g. language schools or specialized institutions, please fill in the information below.
Institution Name	   City/Country	   Started (yy/mm)	  Completed (yy/mm)	  Course/Award
	   	   	   	   	
	   	   	   	   	
SAMPLE
3
2015
V. Language Proficiency
If you have taken any language proficiency tests in the list below, please fill in your test details and attach the original score report with
your application. Photocopies or certified copies of the test score reports will not be accepted.
Test Name	 Test Date (Year, Month)	   Test Score		
TOEFL®(iBT)	 	  	 Registration Number: 	
TOEFL®(PBT)	 	  	 Registration Number: 	
IELTS	 	  	  Test Report Form Number: 	
TOEIC®	 	  	
The EIKEN Test in
Practical English Proficiency	
	  	
JLPT	 	  	  □ N1   □ N2
EJU	 	  	
* Test results are valid for two years from the date of the test up until the date of application. The date of application is the postmark
date of your submitted application or, if applying online, the recorded date of your complete online application.
* TOEFL® and IELTS: Please request the test center to send the score reports to APU directly. The institution code of APU is 2791.
VI. Documents to be returned
Please note that APU will only return original documents that cannot be reissued upon request.
I request for document(s) to be returned.  □ Yes  □ No
  Document name(s): 	
IV. Application Fee
A non-refundable application fee is compulsory for the application. Applications will not be evaluated without the application fee. Cash
payments will not be accepted. Payment methods for the application fee are as follows:
□ Bank Transfer (Overseas)	 Payment Date: 	 	 Payer’s Name: 	
□ Bank Transfer (in Japan)	 Payment Date: 	 	 Payer’s Name: 	
□ Bank Check* 	 Bank Name: 	 	 Check Number: 	
□ Credit Card	 My APU Login ID:
* Payment by bank check is not applicable for applicants residing in Japan.
* Student Certification: I certify that all information on this application and on all required documents is
complete and accurate to the best of my knowledge. Failure to report all institutions attended will invalidate
my application and may result in dismissal if admitted.
I agree to the“Personal Information Policy”included at the end of this application.
                                 
Signature (required)             Date
   We strongly recommend you keep a copy of all submitted materials for your records.
(This is a blank page.)
5
2015
Please answer the following two essay questions using legible characters in your own words. Both handwritten and typed versions will
be accepted. The length of each essay should be approximately 600 words. Please include the word count at the end of each answer.
Application Essay
Name Nationality
A
1. Please write the reason(s) why you wish to attend APU and how you intend to approach your studies within your choice of college
(APM/APS).
( words)
6
2015
2. Please write about any previous commendable experiences, any extracurricular activities you hope to pursue after you have entered
the university, and your plans after graduation from APU.
( words)
7
2015
International Students
Certificate of Eligibility / Resident Status Questionnaire
I. Applicant Information
II. Immigration-Related Issues
Applicant’s Name:
1. Family name: 		   Given name(s): 	
2. Current Status: 	 □ Student	       Name of School: 	
	 □ Employed (Excluding part-time jobs)  Name of Company: 	
		       Occupation: 	
	 □ Other (Please specify): 		
3. Have you entered Japan previously?	 □ No  □ Yes, number of times: 	
	 If your answer to Question 3 is“Yes”, please fill in the following:
	 Date of Entry: 	 yy/mm/dd	 Date of Departure: 	 yy/mm/dd
4. Have you ever applied for the“Certificate of Eligibility for Status of Residence”in Japan?	 □ No  □ Yes, number of times: 	
	 If your answer to Question 4 is“Yes”, please fill in the following:
	 Application Date: 	 yy/mm/dd	 Place of Application: 	
	 Applied Status:	 □ Pre-College	 □ Student	 □ Dependent	 □ Temporary	 □ Other
	 Issued/Denied:	 □ Denied	 □ Date of Issue: 	 yy/mm/dd
* You must fill in the above information if you have ever applied for a “Certificate of Eligibility for Status of Residence”. Please fill in this
information even if your “Certificate of Eligibility for Status of Residence”was not accepted or you did not enter Japan.
* You must submit photocopies of all passport pages with immigration stamps showing your arrivals and departures into Japan.
FOR UNIVERSITY USE 大学使用欄
受験番号
会 場 名
A
III. Financial Information
5. Relationship with Financial Sponsor	 □ Father  □ Mother  □ Other (Please specify): 	
Please fill in the following information about your financial sponsor.
Family name: 	   Given name(s): 	
Home Address: 	  Home Phone: 	
Company Name: 	  Occupation: 	
Company Address: (city/country)	  Company Phone:
(This is a blank page.)
9
2015
A
推 薦 書 / Letter of Recommendation
最終出身学校の教員もしくは勤務先の上司・雇用主などで、志願者を最低1年以上知っている人物に記入を依頼してください。
Please ask an instructor from the last school/institute you attended or employer/supervisor from the company you worked for to write
this recommendation letter. This must be a person whom you have known for at least a year or more.
志願者氏名 Applicant's Name :
姓 Family Name: 	   名 Given Name(s): 	
*できるだけ詳しく書いてください。
*英語または日本語で明確に記入してください。
*記入後は全ての書類を厳封し志願者に渡すか、アドミッション
ズ・オフィスに直送してください。
書類送付先:立命館アジア太平洋大学 アドミッションズ・オフィス(国際)
〒 874-8577 日本国大分県別府市十文字原 1 丁目 1 番
*記載事項に不明な点がある場合は、推薦者に直接問い合わせを
することがあります。必ず電話番号をご記入ください。
* Please make your recommendations as detailed as possible.
* ‌Please write your recommendation clearly in English or
Japanese.
* You may then either return the sealed envelope to the
applicant or mail it to us at: Ritsumeikan Asia Pacific
University, Admissions Office(International),
1-1 Jumonjibaru, Beppu, Oita, 874-8577 Japan
* Please write your phone number as we may contact you
directly if there are any unclear statements on this form.
1. 他の一般的な学生との比較において、本志願者をどのように評価されますか。あてはまると思われるレベルに を記入してください。
  How does the applicant compare in the following areas with other students in general? Please check( )the appropriate box.
非常に優秀
Truly
Exceptional
優秀
Excellent
とても良い
Very Good
良い
Good
平均以下
Below Average
評価不可能
Unable to
Assess
学力
Academic Ability
分析力
Analytical Ability
独創性・創造性
Originality / Creativity
柔軟性
Flexibility
口頭表現能力
Ability in Oral Expression
文章表現能力
Ability in Written Expression
協調性
Ability to Work with Others
指導力
Leadership
志願者へ To the Applicant
推薦者へ To the individual writing this Letter of Recommendation
10
2015
A
2.可能であれば、志願者の学業におけるおおよその順位のあてはまるレベルに をつけてください。
	 If possible, please indicate the approximate academic rank of the applicant by checking the appropriate box.
	 □ Top 5% □ Top 10% □ Top 25% □ Middle 50% □ Lower 25%
3.志願者の成績証明書にあらわれない面、例えば特技や素質などをできるだけ詳しく記入してください。また長所だけでなく、志願者の短
所もあわせて記入してください。
	Please include any other comments about the applicant's character/personality that may not be reflected on his/her academic transcripts.
4.不明な点がある場合は、記入者に直接問い合わせることがありますので、以下にご記入ください。
Please fill in the following information as we may contact you directly if there are any unclear statements
①推薦者の氏名 	 ②職業 	
Name of person writing the recommendation	 Occupation	
③所属機関 	 ④役職 	
Name of institution	 Job title 	
⑤Email 	 	 ⑥電話番号 	
		 Phone 	
⑦署名 	 	 ⑧日付	
Signature 	 	 Date	
①志願者の得意分野や特技、他の者より優れている素質・特徴は何ですか(学内および学外における活動などを含む)。
 What talents or unique character traits does the applicant possess (including school-related or independent activities)?
③ 立命館アジア太平洋大学での経験を、志願者は将来どのように役立てていくと思いますか。
 In what way do you feel that the applicant’s experiences at Ritsumeikan Asia Pacific University will benefit him/her in the future?
②志願者が、今後努力しなければいけないと思う分野は何ですか。
 What area or field do you feel the applicant needs to concentrate more on?
11
2015
English Proficiency Evaluation
To the Applicant
C
Please write your comments about the applicant’s language abilities.
Excellent
TOEFL(iBT)>100
Good
100≧TOEFL(iBT) 80
Average
80≧TOEFL(iBT) ≧61
Below Average
61TOEFL(iBT)
Speaking □ □ □ □
Listening □ □ □ □
Writing □ □ □ □
Reading □ □ □ □
Please ask your English teacher to write this evaluation. If possible, the teacher should have taught you for at least a year or more.
Applicant's Name:
Family Name: 	    Given Name(s): 	
* Please make your recommendation as detailed as possible.
* Please write your recommendation clearly in English or Japanese.
* You may then either return the sealed envelope to the applicant, or mail it to us at: Ritsumeikan Asia Pacific University,
Admissions Office(International), 1-1 Jumonjibaru, Beppu, Oita, 874-8577 Japan
* Please write your phone number as we may contact you directly if there are any unclear statements on this form.
To the evaluator
Please fill in the following information as we may contact you directly if there are any unclear statements.
①Name of person writing the evaluation 	 ②Occupation 	
③Name of institution 	 ④Job title 	
⑤Time period that you have taught the applicant	 	 /	 ―	 /	
	   YY  /  MM	   YY  /  MM
⑥Email 	 	 ⑦Phone 	
⑧Signature 	 	 ⑨Date
12
2015
日本語能力認定書
志願者へ
C
志願者の言語能力についてご意見を聞かせてください。
優
JLPT N1144
良
144≧JLPT N199
JLPT N2135
可
99≧JLPT N189
135≧JLPT N2>99
不可
99≧JLPT N2
話す力 □ □ □ □
聞く力 □ □ □ □
書く力 □ □ □ □
読む力 □ □ □ □
あなたの日本語指導教員に渡してください。可能な限り、最低 1 年以上あなたを指導した教員に依頼してください。
志願者氏名
姓 : 	    名 : 	
*できるだけ詳しく書いてください。
*英語または日本語で明確に記入してください。
*記入後は全ての書類を厳封し志願者に渡すか、アドミッションズ・オフィスに直送してください。
 書類送付先:立命館アジア太平洋大学 アドミッションズ・オフィス(国際)
       〒 874-8577 日本国大分県別府市十文字原 1 丁目 1 番
*記載事項に不明な点がある場合は、認定者に直接問い合わせをすることがあります。必ず電話番号をご記入ください。
認定者へ
不明な点がある場合は、記入者に直接問い合わせることがありますので、以下にご記入ください。
①認定者の氏名 	 ②職業 	
③所属機関 	 ④役職 	
⑤志願者を指導した期間	 	 /	 ―	 /	
	    年  /  月 	    年  /  月
⑥Email 	 	 ⑦電話番号 	
⑧署名	 	 ⑨日付
13
2015
Name Nationality
E
Only individuals who will obtain a student visa before enrollment are eligible to apply for the APU Tuition Reduction Scholarship at the
time of application. Those who would like to apply for the APU Tuition Reduction Scholarship must answer the following two questions.
APU Tuition Reduction Scholarship Application
1. How would the APU Tuition Reduction Scholarship assist you in reaching your educational and career goals?(approximately 300 words)
( words)
2.  Please check the appropriate box for your annual household income situation.
A B C D E
Below 1,500,000JPY /
Below 19,000USD
Between 1,500,000JPY
and 3,000,000JPY /
Between 19,000USD and
38,000USD
Between 3,000,000JPY
and 4,500,000JPY /
Between 38,000USD and
57,000USD
Between 4,500,000JPY
and 6,000,000JPY /
Between 57,000USD and
76,000USD
Above 6,000,000JPY /
Above 76,000USD
□ □ □ □ □
(This is a blank page.)
15
2015
F
活動実績報告書 / Extracurricular Activities Report
氏名
Name
国籍
Nationality
 あなたの高校時代もしくはそれに相当する課程(Grade 10)以降の活動実績について、その詳細を下欄に記入してください。
この報告書に記入されていないものは評価の対象となりません。記入欄が不足する場合には、同じ様式の別紙に記入して提出
しても構いません。
 なお、下欄(B)~(E)に記入した実績については、それを証明する資料・合格証書・成績証明書等のコピーに資料番号「B - 1」「B
- 2」「C - 1」などのように番号を記入し提出してください(言語証明書は原本提出)。英語または日本語以外で作成された証
明書等は、英語または日本語の翻訳を添付してください。
Fill in details of your activities, qualifications, licenses, achievements, etc. from high school grade 10 and above (or
equivalent of high school grade 10 and above). Please note that any activities, qualifications, licenses, achievements, etc.
not listed on this form will not be considered in your application's evaluation. If you need more space, please attach a
separate sheet.
Please attach the copies (A4 size) of awards or certificates which prove the result/grade/score/etc. written on sections
(B) to (E) below. However, for language proficiency test scores, you must submit the original score report. Please also
include a reference number written as B - 1, B - 2, C - 1, etc. on each copy. For documents that are not written in
English or Japanese, please attach an official translation.
団体名 Organization’s Name 所属期間 From, to 役職 Your Post/Role
年Y   月M~   年Y   月M
年Y   月M~   年Y   月M
年Y   月M~   年Y   月M
(A)高校時代もしくはそれ以降に所属した部・クラブなど
   Fill in any clubs, groups, organizations, etc. that you participated in during grade 10 and later.
資料番号
Attached
document’s
number
開催年月日
Year/month/day
主催団体名
Name of
sponsor/
organizer
大会等の名称
Name of
tournament/
contest/
competition
種 目 名
Name of event
大会の規模
Type of event
参加者・団体数
Number of
participants/
groups
順位等
Rank,
etc.
B–1
□ 全国/National
□ 地域/Regional
□ 学内/School
B–2
□ 全国/National
□ 地域/Regional
□ 学内/School
B–3
□ 全国/National
□ 地域/Regional
□ 学内/School
B–4
□ 全国/National
□ 地域/Regional
□ 学内/School
B–5
□ 全国/National
□ 地域/Regional
□ 学内/School
(B)大会・競技会・コンテスト等の実績 Fill in the results of tournaments/contests, etc. that you participated in.
16
2015
資料番号
Attached
document’s
number
取得年月日
Date of
completion
(Year/month/day)
資格・検定等の名称
Name of qualification/
standardized test, etc.
認定機関の名称
Name of
issuing authority
取得段位・スコア・成績等
Level of
attainment/score/results
D–1
D–2
D–3
資料番号
Attached
document’s
number
滞在期間・滞在年数
Duration
From, to
滞在国・地域名
Country/region/city
滞在目的・理由、在籍学校名、滞在期間中の活動概要など
Reasons for residing abroad, name of school attended,
type of activities involved in, etc.
E–1
  年    月
  Y    M
  〜
  年    月
  Y    M
E–2
  年    月
  Y    M
  〜
  年    月
  Y    M
(D)資格・検定・段位・スコア等 Fill in your results of qualifications/standardized tests, etc.
(E)海外滞在経験(滞在期間が1ヵ月以上にわたる場合のみ記入)
   Fill in any experience you have living abroad (only if the duration was for one month or longer).
(C)その他の活動実績があれば記入してください。
   Fill in the details of any other activities, etc. that you would like to include in addition to those listed on the previous page.
資料番号
Attached
document’s
number
活動の概要
Details of additional activities
期間
From, to
年Y/月M 〜 年Y/月M
C–1
C–2
C–3
C–4
C–5
C–6
employment rate
⑬⑫⑪⑩⑨⑧⑦⑥⑤④③②①
3. Which of the following factors from Question 2 influenced your decision to apply to APU? (Please choose only 1 option.)
4. Which of the following criteria were the most influential in your choice of university? (Up to 3 answers are allowed.)
Thank you for answering this survey.
FOR UNIVERSITY USE
2. How did you obtain information about APU? (Multiple answers allowed.)
We would appreciate your kind cooperation in filling out this survey. Answers will not affect your application in any manner and
will be used to improve our admissions process.
(at high school)
Other
(non-school venue)
Other
scholarships.
content
APU Survey
1. When did you start to think about applying to APU?
Please check the boxes as shown below.
Example:
More than 6 months ago
3 to 6 months ago
2 to 3 months ago
About a month ago
Recently (Less than a month)
① Internet
③ Government Embassy
⑤ APU Information Session (at high school)
⑦ APU Overseas Office
⑨ Family Member/Friends
⑪ APU Student/Graduate
⑬ Other 			
① International recognition
③ Curriculum content
⑤ Language education
⑦ Tuition fees/scholarships
⑨ Cultural diversity
⑪ Teacher recommendation
② Newspaper/Magazine
④ College Fair
⑥ APU Information Session (non-school venue)
⑧ APU Staff/Faculty Member
⑩ School Teacher/Counselor
⑫ APU Prospectus
② Reputation in home country
④ Strength of faculty/research
⑥ University location
⑧ Graduate employment rate
⑩ Parent encouragement
⑫ Other 			
Name:	 Name:	
Name:
Personal Information Policy
Personal information collected from individuals during the admissions process will be handled in accordance
with the following:
(1)	 Purpose of Use of Personal Information
①	To carry out the admissions process, such as screening, etc.
②	To notify results
③	To send enrollment-related documents
④	To complete the procedures to attain the Certificate of Eligibility to issue a student visa
⑤	To send the orientation guide for International students
⑥To send information on pre-enrollment education
⑦To send information on post-enrollment living matters (accommodation services, personal injury
insurance, university co-op, etc.)
⑧To send various questionnaires after admission
(2)	 Management of Personal Information
  Ritsumeikan Asia Pacific University will manage the personal information of application in compliance
with relevant laws and regulations. Information will be managed securely to prevent loss, destruction or
divulgence.
(3)	 Outsourcing of Handling of Personal Information
  Ritsumeikan Asia Pacific University may outsource part of the handling of the personal information of
applicants when necessary, such as the receipt of applications or the data entry of personal details. In
such cases, Ritsumeikan Asia Pacific University and the external organization will sign a contract regarding
the appropriate management of personal information.
(4)	 Statistical Use of Personal Information
  Ritsumeikan Asia Pacific University may use data extracted from applicants’ personal information to
conduct various statistical analysis to be used for surveys and research relating to the admissions process.
This data may also be provided to students interested in applying to Ritsumeikan Asia Pacific University.
However, the university shall ensure that any information made public cannot be used to identify specific
individuals.
E02
Not For Sale

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2015 application form_e

  • 1. For International Students April/September 2015 Enrollment http://admissions.apu.ac.jp
  • 2. (Note) Please confirm your appropriate admissions category using the chart below. Do you possess Japanese nationality, (including dual nationality)? Are you currently residing in Japan, excluding those on temporary visitor visas? Do you have a “permanent resident”status? *1 Admissions for Japanese/Domestic Applicants applies to those who possess Japanese nationality or Japanese permanent residency even if they are residing outside Japan. *2 Individuals who will obtain a student visa before enrollment are eligible to apply for the APU Tuition Reduction Scholarship at the time of application. APU offers support in obtaining a student visa if successful applicants do not possess Japanese nationality, are residing out side of Japan, and have completed all required procedures before enrollment. *3 Please send your inquiries directly to the Immigration Bureau of Japan regarding whether you can change your status of residence to “student”. Admissions for Japanese/ Domestic Applicants *1 Admissions for International Applicants Residing in Japan Admissions for International Applicants Residing Outside Japan Do you have a “student visa”or will you change your status of residence to“student” before enrollment? *3 Please contact the Admissions Office before application. No Yes Yes Yes No No No *2 Yes Admissions for Japanese/Domestic Applicants Admissions Office(Domestic) TEL: +81-977-78-1120 Hours: 9:00~17:30(Japan Time) FAX: +81-977-78-1199 Email: apumate@apu.ac.jp URL: http//www.apumate.net/ Admissions for International Applicants Admissions Office(International) TEL: +81-977-78-1119 Hours: 9:00~17:30(Japan Time) FAX: +81-977-78-1121 Email: welcome@apu.ac.jp URL: http//admissions.apu.ac.jp/ Contact
  • 3. 1. First Year Student Application ( i ) Applicants who possess language proficiency test scores A + B (ii) Applicants who do not possess language proficiency test scores A + C (iii) Applicants who are native speakers of English or Japanese A only (iv) Applicants residing in Japan A + B 2. Transfer Student Application Current university students or university graduates who wish to apply to APU as second year or third year transfer students are obliged to submit additional documents: D Transfer Eligibility Documents See the Admissions Handbook for a list of documents which must be submitted with this form. A Required Documents for All Applicants □ 1. Undergraduate application form □ 2. Application essay □ 3. Certificate of Eligibility / Resident Status Questionnaire □ 4. Application fee payment   ◦Bank transfer → Send in proof of payment  ◦Bank check → Send in bank check   ◦Credit card → Must register on My APU 2015 Admissions Office website □ 5. Academic transcripts for most recent 3 years (if you are currently in high school, the most recent 2-2.5 years are acceptable) □ 6. Mandatory or standarized national test results to enter university/standardized test result certificates (only for those who have taken them) □ 7. Letter of Recommendation □ 8. Passport copy (if available) □ 9. Two identical photographs (4cm X 3cm) or (1.57 inches X 1.18 inches) B Language Proficiency Test Scores □ English-basis students: TOEFL® (iBT) /TOEFL® (PBT) / IELTS / TOEIC® / The EIKEN Test in Practical English Proficiency (The following test scores are not accepted: TOEFL® -ITP, IELTS (General Training Module), TOEIC® -IP) □ Japanese-basis students: JLPT/ EJU (Japanese-not including the writing section) C Language Proficiency Forms (Only if you do not have a language proficiency test score) □ English Proficiency Evaluation/日本語能力認定書 D Transfer Eligibility Documents □ 1. Higher institution (e.g., university) academic transcripts □ 2. List of classes currently attending □ 3. Credit requirements for graduation □ 4. Higher institution (e.g., university) graduation certificate (in the case for graduates) * If you have graduated from a higher educational institution (e.g., university), items 2 and 3 are not required. E □ APU Tuition Reduction Scholarship Application In addition to the above, applicants who wish to apply for the APU Tuition Reduction Scholarship must submit APU Tuition Reduction Scholarship Application. F □ Extracurricular Activities Report In addition to the above, applicants who wish to show their experiences, awards or certificates of participation, which indicate exemplary performance in extracurricular activities undertaken at the higher secondary school (or equivalent) level or above, can submit the Extracurricular Activities Report. Admissions handbooks and application forms are also available for download from the Admissions Office website. Application Categories Application Document Checklist
  • 4. General Notes Please type or hand-write the application forms in black or blue ink. (Applications written in pencil will not be accepted.) For questions with a □, please mark your choice with a checkmark . You may only choose one box per question. Family Name / Given Names in English Please write your family name and given names in English separately as printed in or will be printed in your passport. Email Please write your email address accurately. (Please write in English clearly.) Current Address Please write in English if you are applying from outside Japan and in Japanese if you are applying from within Japan. You must also include your phone number. Mailing Address Please fill in this information only in the case that the address listed as your current address is different to the address at which you wish to receive your admission result and other information. (Current school and company, etc.) You must also include a contactable phone number. If your mailing address is the same as your current address, please check the appropriate box. Please write in English if you are applying from outside Japan and in Japanese if you are applying from within Japan. APU Tuition Reduction Scholarship Only applicants who do not possess Japanese nationality and will obtain a student visa before enrollment are eligible to apply for the APU Tuition Reduction Scholarship. Documents to be returned Diplomas and other original documents that cannot be reissued will only be returned upon request. If you wish for an original document to be returned, please check yes. * Documents such as academic transcripts and English proficiency test score reports cannot be returned. Notes for Completing the Undergraduate Application Form
  • 5. 1 2015 A International Students Undergraduate Application Form I. Applicant Information II. Undergraduate Program of Study and Other Information Please fill in 1 to 5 as shown on or will be shown on your passport. 1. Family Name in English: 2. Given Name(s) in English: 3. Name in Chinese Characters (if applicable): 4. Date of Birth: Year      Month      Date 5. Gender:  □ Male  □ Female 6. Nationality: Do you or your parents possess any form of Japanese nationality? □ Yes □ No 7. Native Language: □ English  □ Japanese  □ Other than English/Japanese 8. Email: (Please write clearly, as this email will be used as the primary contact.) Skype ID: For 9 and 10, fill in this information in English if you are applying from outside Japan and in Japanese if you are applying from inside Japan. 9. Current Address: City/State:  Country:  Postal Code: Phone:    Mobile: 10. Mailing Address: □ Same as above City/State:  Country:  Postal Code: Phone:    Mobile: * As important documents, such as your screening result, will be sent to this mailing address, fill in this information accurately. 11. Emergency Contact: Relationship with Applicant: □ Father □ Mother □ Other (Please specify) Family Name: Given Name(s): Phone: Email: Please check only one box per question. 1. Semester of Enrollment: □ Spring (April) □ Fall (September) 2. College: □ College of Asia Pacific Studies (APS)     □ College of International Management (APM) 3. Enrollment Status: □ First Year Student □ Second Year Transfer □ Third Year Transfer 4. Language Basis: □ English □ Japanese 5. Type of Application: □ Residing Outside Japan □ Residing in Japan 6. Scholarship: Do you wish to apply for the APU Tuition Reduction Scholarship? □  Yes    □ No □ Applied for scholarship offered by other organizations (Organizations: ) Only applicants who do not possess Japanese nationality and will obtain a student visa before enrollment are eligible to apply for the APU Tuition Reduction Scholarship. 7.Interview Location: Please confirm the date and place of interview in the Admissions Handbook.   * Please fill in only if you reside in China.     □ Shanghai  □ Wuhan  □ Shijiazhuang  □ Chongqing  □ Changchun   * Please fill in only if you reside in India.     □ Chennai  □ New Delhi   * Please fill in only if you reside in Viet Nam.     □ Hanoi  □ Ho Chi Minh   * Please fill in only if you reside in Japan.     □ Tokyo  □ Osaka  □ Fukuoka  □ Beppu Please affix a photograph (4 cm X 3 cm) or (1.57 in X 1.18 in) taken within the last 3 months on a white background. No cap or hat is allowed. FOR UNIVERSITY USE 大学使用欄 □ 新入生   □ 編入生   □ 転入生 □ 推薦  □ 一般 検定料納入方法 □ 小切手    □ 海外送金 □ 国内送金 □ CD (小切手番号                    ) FOR UNIVERSITY USE 大学使用欄 願書受付日 受験番号 □ A(                       )
  • 6. 2 2015 III. Education History In chronological order, please list all schools in English that you have attended from elementary school level to the last or current school you are attending. (Nursery, kindergarten and language schools are not to be included.) Please write the school name in English. (If the school is located in Japan, in Japanese.) Please note that 12 years of official education (or scheduled completion) is required for first year student applications. Please fill in your education history as written in the example below. School name Location (City/country) Year and month of entrance and completion Current status Enrollment YYYY/MM Graduation YYYY/MM (Elementary Education) AAAA Elementary School Ottawa, Canada 2003/03 2009/02 Elementary School (Secondary Education) BBB Middle School CCC Junior High School Boston, USA Montreal, Canada 2009/03 2011/09 2011/07 2012/02 Lower Secondary School Upper Secondary School DDD High School EEE High School Montreal, Canada Ottawa, Canada 2012/03 2014/03 2014/03 2015/02 □ Graduated Currently attending □ Other:       (Higher Education) □ Graduated □ Currently attending □ Other:      Undergraduate Level School name Location (City/country) Year and month of entrance and completion Current status Enrollment YYYY/MM Graduation YYYY/MM (Elementary Education) Elementary School (Secondary Education) Lower Secondary School Upper Secondary School □ Graduated □ Currently attending □ Other:       (Higher Education) □ Graduated □ Currently attending □ Other:       Undergraduate Level   * If the blank spaces above are not sufficient for the information required, please attach a separate sheet.   * If you are applying as a transfer student and are currently enrolled in college or university, you must submit a document stating the number of credits required for graduation from your institution. If you have already graduated, you must submit your graduation certificate/diploma. The institution name where you completed (or are scheduled to complete) 12 years of official education:                Date of Completion:       (Year)    (Month)  If you will not complete 12 years of education by the time of enrollment at APU (due to skipping a grade or for another reason), please include an explanation on a separate sheet. If you have attended other schools, e.g. language schools or specialized institutions, please fill in the information below. Institution Name   City/Country   Started (yy/mm)   Completed (yy/mm)   Course/Award                         SAMPLE
  • 7. 3 2015 V. Language Proficiency If you have taken any language proficiency tests in the list below, please fill in your test details and attach the original score report with your application. Photocopies or certified copies of the test score reports will not be accepted. Test Name Test Date (Year, Month)   Test Score TOEFL®(iBT)   Registration Number: TOEFL®(PBT)   Registration Number: IELTS    Test Report Form Number: TOEIC®   The EIKEN Test in Practical English Proficiency   JLPT    □ N1   □ N2 EJU   * Test results are valid for two years from the date of the test up until the date of application. The date of application is the postmark date of your submitted application or, if applying online, the recorded date of your complete online application. * TOEFL® and IELTS: Please request the test center to send the score reports to APU directly. The institution code of APU is 2791. VI. Documents to be returned Please note that APU will only return original documents that cannot be reissued upon request. I request for document(s) to be returned.  □ Yes  □ No   Document name(s): IV. Application Fee A non-refundable application fee is compulsory for the application. Applications will not be evaluated without the application fee. Cash payments will not be accepted. Payment methods for the application fee are as follows: □ Bank Transfer (Overseas) Payment Date: Payer’s Name: □ Bank Transfer (in Japan) Payment Date: Payer’s Name: □ Bank Check* Bank Name: Check Number: □ Credit Card My APU Login ID: * Payment by bank check is not applicable for applicants residing in Japan. * Student Certification: I certify that all information on this application and on all required documents is complete and accurate to the best of my knowledge. Failure to report all institutions attended will invalidate my application and may result in dismissal if admitted. I agree to the“Personal Information Policy”included at the end of this application.                                   Signature (required)             Date    We strongly recommend you keep a copy of all submitted materials for your records.
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  • 9. 5 2015 Please answer the following two essay questions using legible characters in your own words. Both handwritten and typed versions will be accepted. The length of each essay should be approximately 600 words. Please include the word count at the end of each answer. Application Essay Name Nationality A 1. Please write the reason(s) why you wish to attend APU and how you intend to approach your studies within your choice of college (APM/APS). ( words)
  • 10. 6 2015 2. Please write about any previous commendable experiences, any extracurricular activities you hope to pursue after you have entered the university, and your plans after graduation from APU. ( words)
  • 11. 7 2015 International Students Certificate of Eligibility / Resident Status Questionnaire I. Applicant Information II. Immigration-Related Issues Applicant’s Name: 1. Family name:   Given name(s): 2. Current Status: □ Student       Name of School: □ Employed (Excluding part-time jobs)  Name of Company:       Occupation: □ Other (Please specify): 3. Have you entered Japan previously? □ No  □ Yes, number of times: If your answer to Question 3 is“Yes”, please fill in the following: Date of Entry: yy/mm/dd Date of Departure: yy/mm/dd 4. Have you ever applied for the“Certificate of Eligibility for Status of Residence”in Japan? □ No  □ Yes, number of times: If your answer to Question 4 is“Yes”, please fill in the following: Application Date: yy/mm/dd Place of Application: Applied Status: □ Pre-College □ Student □ Dependent □ Temporary □ Other Issued/Denied: □ Denied □ Date of Issue: yy/mm/dd * You must fill in the above information if you have ever applied for a “Certificate of Eligibility for Status of Residence”. Please fill in this information even if your “Certificate of Eligibility for Status of Residence”was not accepted or you did not enter Japan. * You must submit photocopies of all passport pages with immigration stamps showing your arrivals and departures into Japan. FOR UNIVERSITY USE 大学使用欄 受験番号 会 場 名 A III. Financial Information 5. Relationship with Financial Sponsor □ Father  □ Mother  □ Other (Please specify): Please fill in the following information about your financial sponsor. Family name:   Given name(s): Home Address:  Home Phone: Company Name:  Occupation: Company Address: (city/country)  Company Phone:
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  • 13. 9 2015 A 推 薦 書 / Letter of Recommendation 最終出身学校の教員もしくは勤務先の上司・雇用主などで、志願者を最低1年以上知っている人物に記入を依頼してください。 Please ask an instructor from the last school/institute you attended or employer/supervisor from the company you worked for to write this recommendation letter. This must be a person whom you have known for at least a year or more. 志願者氏名 Applicant's Name : 姓 Family Name:   名 Given Name(s): *できるだけ詳しく書いてください。 *英語または日本語で明確に記入してください。 *記入後は全ての書類を厳封し志願者に渡すか、アドミッション ズ・オフィスに直送してください。 書類送付先:立命館アジア太平洋大学 アドミッションズ・オフィス(国際) 〒 874-8577 日本国大分県別府市十文字原 1 丁目 1 番 *記載事項に不明な点がある場合は、推薦者に直接問い合わせを することがあります。必ず電話番号をご記入ください。 * Please make your recommendations as detailed as possible. * ‌Please write your recommendation clearly in English or Japanese. * You may then either return the sealed envelope to the applicant or mail it to us at: Ritsumeikan Asia Pacific University, Admissions Office(International), 1-1 Jumonjibaru, Beppu, Oita, 874-8577 Japan * Please write your phone number as we may contact you directly if there are any unclear statements on this form. 1. 他の一般的な学生との比較において、本志願者をどのように評価されますか。あてはまると思われるレベルに を記入してください。   How does the applicant compare in the following areas with other students in general? Please check( )the appropriate box. 非常に優秀 Truly Exceptional 優秀 Excellent とても良い Very Good 良い Good 平均以下 Below Average 評価不可能 Unable to Assess 学力 Academic Ability 分析力 Analytical Ability 独創性・創造性 Originality / Creativity 柔軟性 Flexibility 口頭表現能力 Ability in Oral Expression 文章表現能力 Ability in Written Expression 協調性 Ability to Work with Others 指導力 Leadership 志願者へ To the Applicant 推薦者へ To the individual writing this Letter of Recommendation
  • 14. 10 2015 A 2.可能であれば、志願者の学業におけるおおよその順位のあてはまるレベルに をつけてください。 If possible, please indicate the approximate academic rank of the applicant by checking the appropriate box. □ Top 5% □ Top 10% □ Top 25% □ Middle 50% □ Lower 25% 3.志願者の成績証明書にあらわれない面、例えば特技や素質などをできるだけ詳しく記入してください。また長所だけでなく、志願者の短 所もあわせて記入してください。 Please include any other comments about the applicant's character/personality that may not be reflected on his/her academic transcripts. 4.不明な点がある場合は、記入者に直接問い合わせることがありますので、以下にご記入ください。 Please fill in the following information as we may contact you directly if there are any unclear statements ①推薦者の氏名 ②職業 Name of person writing the recommendation Occupation ③所属機関 ④役職 Name of institution Job title ⑤Email ⑥電話番号 Phone ⑦署名 ⑧日付 Signature  Date ①志願者の得意分野や特技、他の者より優れている素質・特徴は何ですか(学内および学外における活動などを含む)。  What talents or unique character traits does the applicant possess (including school-related or independent activities)? ③ 立命館アジア太平洋大学での経験を、志願者は将来どのように役立てていくと思いますか。  In what way do you feel that the applicant’s experiences at Ritsumeikan Asia Pacific University will benefit him/her in the future? ②志願者が、今後努力しなければいけないと思う分野は何ですか。  What area or field do you feel the applicant needs to concentrate more on?
  • 15. 11 2015 English Proficiency Evaluation To the Applicant C Please write your comments about the applicant’s language abilities. Excellent TOEFL(iBT)>100 Good 100≧TOEFL(iBT) 80 Average 80≧TOEFL(iBT) ≧61 Below Average 61TOEFL(iBT) Speaking □ □ □ □ Listening □ □ □ □ Writing □ □ □ □ Reading □ □ □ □ Please ask your English teacher to write this evaluation. If possible, the teacher should have taught you for at least a year or more. Applicant's Name: Family Name:    Given Name(s): * Please make your recommendation as detailed as possible. * Please write your recommendation clearly in English or Japanese. * You may then either return the sealed envelope to the applicant, or mail it to us at: Ritsumeikan Asia Pacific University, Admissions Office(International), 1-1 Jumonjibaru, Beppu, Oita, 874-8577 Japan * Please write your phone number as we may contact you directly if there are any unclear statements on this form. To the evaluator Please fill in the following information as we may contact you directly if there are any unclear statements. ①Name of person writing the evaluation ②Occupation ③Name of institution ④Job title ⑤Time period that you have taught the applicant / ― /   YY  /  MM   YY  /  MM ⑥Email ⑦Phone ⑧Signature ⑨Date
  • 16. 12 2015 日本語能力認定書 志願者へ C 志願者の言語能力についてご意見を聞かせてください。 優 JLPT N1144 良 144≧JLPT N199 JLPT N2135 可 99≧JLPT N189 135≧JLPT N2>99 不可 99≧JLPT N2 話す力 □ □ □ □ 聞く力 □ □ □ □ 書く力 □ □ □ □ 読む力 □ □ □ □ あなたの日本語指導教員に渡してください。可能な限り、最低 1 年以上あなたを指導した教員に依頼してください。 志願者氏名 姓 :    名 : *できるだけ詳しく書いてください。 *英語または日本語で明確に記入してください。 *記入後は全ての書類を厳封し志願者に渡すか、アドミッションズ・オフィスに直送してください。  書類送付先:立命館アジア太平洋大学 アドミッションズ・オフィス(国際)        〒 874-8577 日本国大分県別府市十文字原 1 丁目 1 番 *記載事項に不明な点がある場合は、認定者に直接問い合わせをすることがあります。必ず電話番号をご記入ください。 認定者へ 不明な点がある場合は、記入者に直接問い合わせることがありますので、以下にご記入ください。 ①認定者の氏名 ②職業 ③所属機関 ④役職 ⑤志願者を指導した期間 / ― /    年  /  月     年  /  月 ⑥Email ⑦電話番号 ⑧署名 ⑨日付
  • 17. 13 2015 Name Nationality E Only individuals who will obtain a student visa before enrollment are eligible to apply for the APU Tuition Reduction Scholarship at the time of application. Those who would like to apply for the APU Tuition Reduction Scholarship must answer the following two questions. APU Tuition Reduction Scholarship Application 1. How would the APU Tuition Reduction Scholarship assist you in reaching your educational and career goals?(approximately 300 words) ( words) 2.  Please check the appropriate box for your annual household income situation. A B C D E Below 1,500,000JPY / Below 19,000USD Between 1,500,000JPY and 3,000,000JPY / Between 19,000USD and 38,000USD Between 3,000,000JPY and 4,500,000JPY / Between 38,000USD and 57,000USD Between 4,500,000JPY and 6,000,000JPY / Between 57,000USD and 76,000USD Above 6,000,000JPY / Above 76,000USD □ □ □ □ □
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  • 19. 15 2015 F 活動実績報告書 / Extracurricular Activities Report 氏名 Name 国籍 Nationality  あなたの高校時代もしくはそれに相当する課程(Grade 10)以降の活動実績について、その詳細を下欄に記入してください。 この報告書に記入されていないものは評価の対象となりません。記入欄が不足する場合には、同じ様式の別紙に記入して提出 しても構いません。  なお、下欄(B)~(E)に記入した実績については、それを証明する資料・合格証書・成績証明書等のコピーに資料番号「B - 1」「B - 2」「C - 1」などのように番号を記入し提出してください(言語証明書は原本提出)。英語または日本語以外で作成された証 明書等は、英語または日本語の翻訳を添付してください。 Fill in details of your activities, qualifications, licenses, achievements, etc. from high school grade 10 and above (or equivalent of high school grade 10 and above). Please note that any activities, qualifications, licenses, achievements, etc. not listed on this form will not be considered in your application's evaluation. If you need more space, please attach a separate sheet. Please attach the copies (A4 size) of awards or certificates which prove the result/grade/score/etc. written on sections (B) to (E) below. However, for language proficiency test scores, you must submit the original score report. Please also include a reference number written as B - 1, B - 2, C - 1, etc. on each copy. For documents that are not written in English or Japanese, please attach an official translation. 団体名 Organization’s Name 所属期間 From, to 役職 Your Post/Role 年Y   月M~   年Y   月M 年Y   月M~   年Y   月M 年Y   月M~   年Y   月M (A)高校時代もしくはそれ以降に所属した部・クラブなど    Fill in any clubs, groups, organizations, etc. that you participated in during grade 10 and later. 資料番号 Attached document’s number 開催年月日 Year/month/day 主催団体名 Name of sponsor/ organizer 大会等の名称 Name of tournament/ contest/ competition 種 目 名 Name of event 大会の規模 Type of event 参加者・団体数 Number of participants/ groups 順位等 Rank, etc. B–1 □ 全国/National □ 地域/Regional □ 学内/School B–2 □ 全国/National □ 地域/Regional □ 学内/School B–3 □ 全国/National □ 地域/Regional □ 学内/School B–4 □ 全国/National □ 地域/Regional □ 学内/School B–5 □ 全国/National □ 地域/Regional □ 学内/School (B)大会・競技会・コンテスト等の実績 Fill in the results of tournaments/contests, etc. that you participated in.
  • 20. 16 2015 資料番号 Attached document’s number 取得年月日 Date of completion (Year/month/day) 資格・検定等の名称 Name of qualification/ standardized test, etc. 認定機関の名称 Name of issuing authority 取得段位・スコア・成績等 Level of attainment/score/results D–1 D–2 D–3 資料番号 Attached document’s number 滞在期間・滞在年数 Duration From, to 滞在国・地域名 Country/region/city 滞在目的・理由、在籍学校名、滞在期間中の活動概要など Reasons for residing abroad, name of school attended, type of activities involved in, etc. E–1   年    月   Y    M   〜   年    月   Y    M E–2   年    月   Y    M   〜   年    月   Y    M (D)資格・検定・段位・スコア等 Fill in your results of qualifications/standardized tests, etc. (E)海外滞在経験(滞在期間が1ヵ月以上にわたる場合のみ記入)    Fill in any experience you have living abroad (only if the duration was for one month or longer). (C)その他の活動実績があれば記入してください。    Fill in the details of any other activities, etc. that you would like to include in addition to those listed on the previous page. 資料番号 Attached document’s number 活動の概要 Details of additional activities 期間 From, to 年Y/月M 〜 年Y/月M C–1 C–2 C–3 C–4 C–5 C–6
  • 21. employment rate ⑬⑫⑪⑩⑨⑧⑦⑥⑤④③②① 3. Which of the following factors from Question 2 influenced your decision to apply to APU? (Please choose only 1 option.) 4. Which of the following criteria were the most influential in your choice of university? (Up to 3 answers are allowed.) Thank you for answering this survey. FOR UNIVERSITY USE 2. How did you obtain information about APU? (Multiple answers allowed.) We would appreciate your kind cooperation in filling out this survey. Answers will not affect your application in any manner and will be used to improve our admissions process. (at high school) Other (non-school venue) Other scholarships. content APU Survey 1. When did you start to think about applying to APU? Please check the boxes as shown below. Example: More than 6 months ago 3 to 6 months ago 2 to 3 months ago About a month ago Recently (Less than a month) ① Internet ③ Government Embassy ⑤ APU Information Session (at high school) ⑦ APU Overseas Office ⑨ Family Member/Friends ⑪ APU Student/Graduate ⑬ Other ① International recognition ③ Curriculum content ⑤ Language education ⑦ Tuition fees/scholarships ⑨ Cultural diversity ⑪ Teacher recommendation ② Newspaper/Magazine ④ College Fair ⑥ APU Information Session (non-school venue) ⑧ APU Staff/Faculty Member ⑩ School Teacher/Counselor ⑫ APU Prospectus ② Reputation in home country ④ Strength of faculty/research ⑥ University location ⑧ Graduate employment rate ⑩ Parent encouragement ⑫ Other Name: Name: Name:
  • 22. Personal Information Policy Personal information collected from individuals during the admissions process will be handled in accordance with the following: (1) Purpose of Use of Personal Information ① To carry out the admissions process, such as screening, etc. ② To notify results ③ To send enrollment-related documents ④ To complete the procedures to attain the Certificate of Eligibility to issue a student visa ⑤ To send the orientation guide for International students ⑥To send information on pre-enrollment education ⑦To send information on post-enrollment living matters (accommodation services, personal injury insurance, university co-op, etc.) ⑧To send various questionnaires after admission (2) Management of Personal Information   Ritsumeikan Asia Pacific University will manage the personal information of application in compliance with relevant laws and regulations. Information will be managed securely to prevent loss, destruction or divulgence. (3) Outsourcing of Handling of Personal Information   Ritsumeikan Asia Pacific University may outsource part of the handling of the personal information of applicants when necessary, such as the receipt of applications or the data entry of personal details. In such cases, Ritsumeikan Asia Pacific University and the external organization will sign a contract regarding the appropriate management of personal information. (4) Statistical Use of Personal Information   Ritsumeikan Asia Pacific University may use data extracted from applicants’ personal information to conduct various statistical analysis to be used for surveys and research relating to the admissions process. This data may also be provided to students interested in applying to Ritsumeikan Asia Pacific University. However, the university shall ensure that any information made public cannot be used to identify specific individuals. E02 Not For Sale