Online Application for Short Term Exchange Program
Keio University, Graduate School of Science and Technology

-2020 Fall Semester-

Only those nominated by our partner institutions are allowed to apply for this program.
Have you been nominated by our partner institution? Yes No
The Name of Your Home Institution

Name
*Spell your name as it appears on your passport (in all capital letters).
Surname
Given Name
Middle Name
Date of Birth (yyyy/mm/dd)
Nationality
Sex Male Female
Term of Study at Keio 2020 Fall Semester (Sept. 22, 2020 - March 31, 2021)
2020 Fall & Spring Semesters (Sept. 22, 2020 - Sept. 21, 2021)
E-mail Address
ex) taro.keio@a2.keio.jp
Re-enter E-mail Address to Confirm
ex) taro.keio@a2.keio.jp

Submission of Application Documents
Please submit the following application documents by uploading files.
You are also requested to submit hard copies of the application documents disignated in our website to the international office of your home institution.
2. Short-term International Student Application Form (PDF file)
3. Statement of Purpose for Research Stay (PDF file)
*Only applicable to students applying for “Research based Program” and “Research and Courses Program
*Do not forget your signature and the date on the bottom of your paper.
4. Course Registration Plan
*Only applicable to students applying for “Research and Courses Program” and “Courses focused Program”
6. Application for Certificate of Eligibility(COE) (Excel file)
7. Effective passport copy of your face page

8. Application for Dormitory
Do you wish to live in the keio dormitory? Yes No
If you wish to live in the Keio dormitory, please select your preferred dormitories in order of your priority.
Please note that you cannot choose the dormitory. The housing coordinator will allocate you according to the room availability.
For the details of each dormitory, please refer to http://www.ic.keio.ac.jp/en/life/housing/ryu_boshu.html
1st Priority
2nd Priority
3rd Priority
4th Priority
5th Priority
6th Priority
7th Priority
8th Priority
9th Priority
Please note that we may not be able to meet your preference as this depends on room availability.