【FORM 1】

Research Plan Form

In the spaces below please provide a statement of your planned field of study and tentative study plan. Please write in
English, do not use abbreviations, and use the Anno Domini system for any dates (e.g. “I graduated in 2012.”)

Title:

Subject:

Plan & Method:

Desired Supervising Professor Contact Status

I have been in contact with this professor and obtained

approval for my research plan.

＊Please make sure to obtain approval for your research plan from your desired supervising professor prior to making an application.

－1－
 【FORM 2】

Letter of Recommendation

To the Recommender:
The candidate named below has applied for admission to a Master’s/Doctoral program at Ritsumeikan University. Please
complete this form to aid us in our assessment of the candidate. Once completed please seal the form in an envelope and return
it to the candidate. Thank you.

Applicant’s Name:
(Family) (First) (Middle)

Please comment on the candidate’s academic performance, potential, and motivation to the best of your knowledge, including
any research or involvement in campus activities. Feel free to add any details that you feel will help us in our evaluation.

Recommender’s Information

Name: Signature:

Institution: Position:

Relationship to Referee: Date:

－2－
 【FORM 3】 Questionnaire
1．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｡））

2．State the titles or subjects of books or papers (including graduation thesis authored by the applicant), if any, with the name and address of the publisher and
the date of publication.（著書，論文（卒業論文を含む｡）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｡）

3．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

4．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 Good Fair Poor
（優） （良） （可） （不可）
Reading
（読む能力）
Writing
（書く能力）
Speaking
（話す能力）

5．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 Relationship Age

（氏 名） (続 柄) （年 齢）

6. Immigration Records to Japan（日本への渡航記録）

Date（日付） Purpose（渡航目的）

From

To

From

To

－3－
立命館大学大学院 外国籍志願者情報 様式/Form GS 1

RITSUMEIKAN UNIVERSITY GRADUATE SCHOOL APPLICATION SHEET

FOR NON-JAPANESE APPLICANTS
［ 注意 / NOTE ］
日本国籍を有しない者（特別永住者を除く）のみ記入対象。該当 氏名
する項目のみ記入してください。 Name
For Applicants who do not have Japanese nationality only
受験番号*
(excluding special permanent residents). Complete only the Examinee No.
sections that apply to you. *記入不要 Office use only

勤務先（所在地） 勤務内容 勤務期間

Name of employer (Address) Job description Period of employment

( )
(MM/DD/YYYY)

職　　　 歴
( )
Work experience (MM/DD/YYYY)

( )
(MM/DD/YYYY)

( )
(MM/DD/YYYY)

兵　　　 役 終了 from 　 　　 , 　 　 　 to 　 　　 , 　 　　 . 終了予定 　, 　 .

Military service Finished month year month year Duty (to be) completed month year
現住所 Address 〒 　　　　　－ Phone number：

日本国内の
緊急連絡先
氏名 Name:
Emergency contact 志願者との関係 Relationship to applicant 職業 Occupation
info in Japan

以上の通り、相違ありません。
I certify that the above statements are true and correct to the best of my knowledge.

日付(Date):　　　　 　　　　　(MM/DD/YYYY) 署名(Signature):　　 　　　　　　　　　　　　　　 .

2019.4