Tokyo Campus Entry Record
Please submit this Tokyo Campus Entry Record as a part of measures against the spread of COVID-19 upon entering the Tokyo Campus, University of Tsukuba.
Please be sure to contact us immediately if you test positive for COVID-19 within three days after leaving the Tokyo Campus.
, Tel: 03-3942-6918, Fax: 03-3942-6824
If you set a spam email filtering, please make sure that you can get an auto-reply email from gmail.
＜Personal Information Handling＞
We will not use personal information which we collect from this form except for keeping entry record in relation to COVID-19. We will make sure to take active measures of safety by appointing a management representative in order to avoid the risks such as loss and leakage, etc.
Record upon Entry
Please fill out the followings upon entering the Tokyo Campus.
Degree Programs in Business Sciences (Master's, Doctoral Program in Business Administration)
Degree Programs in Business Sciences (Master's, Doctoral Program in Law)
Master's Program in Systems Management
Master's Program in Advanced Studies of Business Law
Doctoral Program in Systems Management and Business Law
Law School Program
MBA Program in International Business
Degree Programs in Comprehensive Human Sciences, Master's Program in Counseling
Degree Programs in Comprehensive Human Sciences, Doctoral Program in Counseling Science
Degree Programs in Comprehensive Human Sciences (Master's, Doctoral Program in Rehabilitation Science)
Degree Programs in Comprehensive Human Sciences (Master's, Doctoral Program in Sport and Wellness Promotion)
Master's Program in Lifespan Development
Doctoral Program in Lifespan Developmental Sciences
Master's Program in Sports and Health Promotion
Doctoral Program in Sport and Wellness Promotion
Degree Programs in Comprehensive Human Sciences (Master's, Doctoral Program in Informatics)
Master's Program in Library, Information and Media Studies
If you choose "others", please specify your affiliation.
Have you recently tested positive for COVID-19?
I have tested positive for COVID-19 in the last 10 days.
I have tested positive for COVID-19 more than 10 days ago.
I had tested positive for COVID-19 more than 10 days ago, but at least 72 hours have passed since recovery.
I have never tested positive for COVID-19
In the last 14 days, have you had relatively slight cold symptoms, lasting a few days, including fever and cough, or severe symptoms including shortness of breath, excessive fatigue, and high fever?
I had them in the last 14 days.
I have never had them in the last 14 days.
Purpose of Entry ex) : attend a seminar, research at the library, etc.
When entering the Tokyo Campus, please fill in the all of the fields above. After completing them, please go to the next page leaving the fields unanswered, and submit this form. You will get an auto-reply email so please show it to a security guard at the main entrance for approval of entry. When leaving the Tokyo Campus, please click "回答を編集(Edit)" on that auto-reply email to go on to fill out the second page and resubmit it. Please remember to show the auto-reply email, which is sent to you upon your second submission, to a security guard at the main entrance before leaving.
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This form was created inside of 筑波大学 大学院人間総合科学学術院 人間総合科学研究群 情報学学位プログラム.