Keio Application Sample
Application Form
■Name and personal information Last/Family English Katakana Chinese Characters Date of Birth (Year/Month/Day) Current Address Telephone Number / /
SAMPLE
First/Given
* Date: 2013 Middle / 2 / 4
Keio University Faculty of Environment and Information Studies GIGA Program
Sex Male □Female
Nationality
3 College Road Purchase, NY, 12345 USA 1-XXXX-XXX-XXX E-mail Address
■Academic background (Starting from elementary/primary school to high school) Location Name of School Yukichi Elementary School ABC Middle School XYZ International High School Tokyo, Japan NY, U.S.A. NY, U.S.A.
Dates Attended
(Year/Month – Year/Month)
(State/Province, Country)
Grades Attended 1-5 5-8 9 - 12 -
*
2000/4 – 2004/9 2004/9 – 2008/6 2008/9 – 2012/6 -
■Resume after graduating from high school (Including Vocational/Foreign Language School, University, and Work Experience if any) Location Period Name of Institution * (Year/Month – Year/Month) (State/Province, Country) Alpha Computer School Tokyo, Japan 2012/9 – 2013/3 1/2
Application Form 2013/9 Admission for GIGA
■Language proficiency (If both other than English, documentation proving your proficiency in English is needed for application.) Native Language(s) Language of Instruction in High School English Other ( Specify: Japanese English □ Other ( Specify: ) )
■Test score information (include only the best scores that you have sent to KEIO if any) Test Date Name of Test Name of Subject/Section (Year/Month) 2010/10 Critical Reading SAT Reasoning Test 2010/10 2011/11 SAT Subject Test 2012/1 2012/1 Mathematics Writing Subject1. Math Level1 Subject2. Biology E 1. Math HL 2. English SL International Baccalaureate Diploma Program Examination Extended Essay 2012/5 3. Biology HL 4. History SL 5. Geography SL 6. Japanese HL Japanese
Score/Grade 640 700 560 770 660 5 5 5 4 6 4 C B
*
Theory of Knowledge Other: specify below ( ) ■Main source of fund for tuition and other
■Name and personal information Last/Family English Katakana Chinese Characters Date of Birth (Year/Month/Day) Current Address Telephone Number / /
SAMPLE
First/Given
* Date: 2013 Middle / 2 / 4
Keio University Faculty of Environment and Information Studies GIGA Program
Sex Male □Female
Nationality
3 College Road Purchase, NY, 12345 USA 1-XXXX-XXX-XXX E-mail Address
■Academic background (Starting from elementary/primary school to high school) Location Name of School Yukichi Elementary School ABC Middle School XYZ International High School Tokyo, Japan NY, U.S.A. NY, U.S.A.
Dates Attended
(Year/Month – Year/Month)
(State/Province, Country)
Grades Attended 1-5 5-8 9 - 12 -
*
2000/4 – 2004/9 2004/9 – 2008/6 2008/9 – 2012/6 -
■Resume after graduating from high school (Including Vocational/Foreign Language School, University, and Work Experience if any) Location Period Name of Institution * (Year/Month – Year/Month) (State/Province, Country) Alpha Computer School Tokyo, Japan 2012/9 – 2013/3 1/2
Application Form 2013/9 Admission for GIGA
■Language proficiency (If both other than English, documentation proving your proficiency in English is needed for application.) Native Language(s) Language of Instruction in High School English Other ( Specify: Japanese English □ Other ( Specify: ) )
■Test score information (include only the best scores that you have sent to KEIO if any) Test Date Name of Test Name of Subject/Section (Year/Month) 2010/10 Critical Reading SAT Reasoning Test 2010/10 2011/11 SAT Subject Test 2012/1 2012/1 Mathematics Writing Subject1. Math Level1 Subject2. Biology E 1. Math HL 2. English SL International Baccalaureate Diploma Program Examination Extended Essay 2012/5 3. Biology HL 4. History SL 5. Geography SL 6. Japanese HL Japanese
Score/Grade 640 700 560 770 660 5 5 5 4 6 4 C B
*
Theory of Knowledge Other: specify below ( ) ■Main source of fund for tuition and other