Pre-Application Form

Please note that this is NOT an application form for admission to Oita University. The completed form is needed by the Faculty to determine the acceptability of the prospective applicant.

1. Name:
(In Your Language)
(Family Name) (First Name) (Middle Name)
(In English)
(Family Name) (First Name) (Middle Name)

2. Sex:     • Male         • Female

3. Nationality:

4. Date of Birth: (Month) (Day) (Year)

5. Address:
Phone Number:
Fax Number:
E-mail Address:

6. Final Academic Institutions (Please attach certificate/s of your degree/s; photocopies are acceptable)

(Name of Undergraduate Institution)

(Date of Graduation )

(Name of Graduate School)

(Date of Graduation)

7. Have you taken the Japanese Language Proficiency Test?
•Yes (If yes, write year and Test Score)
•Level 1 (Year Score ) •Level 2 (Year Score )
•Level 3 (Year Score ) •Level 4 (Year Score )

8. Have you taken TOEFL or any other English language test?
•Yes (Write year and score of TOEFL or other test you have taken. Please attach a certificate of the score; a photocopy is acceptable)
•TOEFL (Year Score )  
•Other (Name Year Score )

9. Describe your previous field of study.

10.Write about your proposed major and provide an outline of your study at Oita University.
1) Major and Outline

2) Did your previous academic study (as given in your response to Q.9) involve any aspect of your proposed field of study at Oita University? Provide details if YES.

Overseas Student Officer,
Registrar's Office, Oita University
Dannoharu, Oita 870-1192, JAPAN
Phone: +81-97-554-7444/ Fax:+81-97-554-7445
Email: ""