Consulting Sheet
Akita University, Graduate School of International Resource Sciences

Please fill in the following items and send this sheet to <nyushi@jimu.akita-u.ac.jp <mailto:nyushi@jimu.akita-u.ac.jp>> with a subject of email, "Consulting GSIRS".

Fundamental item
Your Name		
Your Nationality		
Your Sex	☐Female  ☐Male	
Your Hold Degree		
Desired enrollment period	Year :
 ☐October  ☐April	
Desired Course	☐Master's course   ☐Doctoral course	
Desired Division	☐Earth Resource Science
☐Earth Resource Engineering and Environmental Science	
Desired "Faculty Member"(Supervisor)	*	
Expected Financial Sponsor during enrollment	☐Nothing (Private expense)  ☐MEXT  ☐JICA  ☐Other(             )	
* Referred to guideline.

Educational Background
School Name	Required
Number of Years
Schooling you
have attended	Year and Month of
Entrance and Completion
( YYYY / MM )	Diploma or Degree
Awarded	
Elementary Education / Elementary School	Years	From

To		
				
Secondary Education / Lower Secondary School	Years	From

To		
				
Secondary Education / Upper Secondary School	Years	From

To		
				
Higher Education / Undergraduate level	Years	From

To		
				
Higher Education / Graduate level	Years	From

To		
				
	Years	From

To		
	Years	From

To		

Employment Record
Employer	Position	Period of employment
( YYYY / MM )	
		From           To	
		From           To	
		From           To	
		From           To	

Qualifications and Licenses
		Date	
		Date	
		Date	

Achievements
		Date	
		Date