Application Form for Dual Master’s Degree Program 2016
Student No.
Date of Birth
/
Date: / /20
Affiliation
Name
/ 19
MM/DD/YYYY
Current
Address
Tel
E-mail
Permanent
Address
Years old
M1 / M2
Academic
Advisor
Mobile Phone
Tel:
Preferred Host Universities (Please enter the number up to 2 in order of preference)
American University
(AU)
The International
Institute of Social
Studies of Erasmus
University Rotterdam
(ISS)
Royal Holloway,
University of London
(RHUL)
The University of York
(UY)
KyungHee University
(KHU)
Research Theme at Ritsumeikan University
Research Theme and Preferred Major at Host University
Future Plans after Completing DMDP
Educational Record
Name of School
Major, Degree Awarded
Completion Year/Month
High School
Undergraduate Level
Graduate Level
Employment Record and Others (Studying abroad, Social Activities, etc.)
Period (MM/YYYY)
Details
From
To
From
To
From
To
Foreign Language Proficiency, Academic Performance at RU, Expected Date of Completion
Reading
Writing
Listening Speaking
Total
Date of Issue
English Language Proficiency
check off the below and enter your score.
□TOEFL®-iBT / □IELTS
Accumulated GPA
Expected to Complete RU on
Comments from Academic
Advisor
MM/ YYYY
(GPA at undergraduate Level:
(
) ( GPA at GSIR:
:
) MM/YYYY
)