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Application Form for the English Discussion Club Orientation 2024
Thank you for your interest to join the English Discussion Club! Now you are added to the mailing list. We will be sending you the reminder every week!
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Email
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Your email
メールアドレス（確認用）／E-mail Address (Retype)
Your answer
氏名（ローマ字）／Name (Roman Letters)
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「名 姓」の順にご記入ください。（例：Taro Todai）／Please write your first name followed by your family name. (e.g. Taro Todai)
Your answer
氏名（漢字）／Name (Kanji Characters)
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「姓 名」の順にご記入ください（例：東大 太郎） 漢字名がない場合は、カタカナで入力してください。／Please write your family name followed by your first name. (ex. 東大 太郎) Please fill in Katakana, if you do not have Kanji Character name.
Your answer
所属（部局）／Affiliation (School/Center/Institute)
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大学院新領域創成科学研究科／Graduate School of Frontier Sciences
宇宙線研究所／Institute for Cosmic Ray Research
物性研究所／Institute for Solid State Physics
大気海洋研究所／Atmosphere and Ocean Research Institute
空間情報科学研究センター／Center for Spatial Information Science
カブリ数物連携宇宙研究機構／Kavli Institute for the Physics and Mathematics of the Universe
生産技術研究所／Institute of Industrial Science
Other:
所属（身分）／Affiliation (Position)
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研究生／Research Student
修士1年／M1
修士2年／M2
博士1年／D1
博士2年／D2
博士3年／D3
Other:
English Discussion Clubに参加する目的/ Your purpose of joining the English Discussion Club
*
Your answer
同意する場合はチェックを入れてください。/Please check the box to acknowledge agreement to our privacy policy.
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このフォームで本学が取得した個人情報は主催者限りで取り扱うものとし、第三者に提供いたしません。／Your personal information will be managed by the organizer and will not be released to any third party.
この規定に同意します／I agree to this privacy policy.
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