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Application Form
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 for International Cooperative Graduate Program
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*Please send application in excel format.
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Name
*as appears on passport		First NameFamily Name
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NationalityGender
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Date of birth
(yyyy/mm/dd)		AgeMarital Status
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Address for correspondencePostal Code
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Contact DetailsPhoneE-mail
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Major
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University
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Year in universityAdmissionExpected Graduation
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Preferred durationFromto
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Preferred NIMS researcher
* Find the researcher best suited to your research: https://samurai.nims.go.jp/?locale=en		1
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I have contacted the preferred NIMS researcher, who has expressed the agreement on this application.
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Details of
supervisory professor
of your university
Should be Professor or
Associate professor		NamePosition
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Affiliation
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PhoneE-mail
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Theme of the doctoral thesis
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Relevant skills
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Language skillsEnglish (TOEFL, IELTS, TOEIC)
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Japanese
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Other languages
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1. Education
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Name of universityAdmissionGraduationFaculty and department
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2. Research experience (including internship experience)
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FromToName of company or institution
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3. List of publications
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4. List of oral presentations
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5. Outline of research plan at NIMS（about 200 words）
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6. Other noteworthy information
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　[Note]
1) NIMS will not support visa procedure for the accompanying family members.
2) Academic Transcript (Bs. and Ms. Course) should be attached.
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