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Online Application for CEMS Exchange (Incoming) Students

This online application is for CEMS exchange students who have been nominated by CEMS Academic Partner universities to come to Keio University. In addition to the CEMS application you already sent to your home CEMS School, you must submit this application to Keio University as well as other required documents.

* Please type in Roman Alphabet (English). DO NOT use characters with diacritical marks (e.g., á, ę, ö).

* When you complete the online registration, a "confirmation e-mail" will be sent to your registered e-mail address. If you do not receive this confirmation, please re-enter your information on this online application.

* When the information you provided in this application has been changed (e.g., change of address, email address, telephone number, etc.), you must immediately inform Keio CEMS Office by emailing to keio@cems.org


 


Applicant's Name
LAST (Family) Name
(in BLOCK CAPITALS)

Your name should be spelled as it appears on your passport.
FIRST Name
(in BLOCK CAPITALS)

Your name should be spelled as it appears on your passport.
MIDDLE Name
(in BLOCK CAPITALS)

Your name should be spelled as it appears on your passport.
LAST (Family) Name in Katakana
(if possible)
FIRST Name in Katakana
(if possible)
MIDDLE Name in Katakana
(if possible)
LAST (Family) Name in Kanji
(if possible)
FIRST Name in Kanji
(if possible)
MIDDLE Name in Kanji
(if possible)

Date of Birth ( yyyy/mm/dd )

Sex

Nationality

Your Home CEMS School
Country
Name of Institution
Term at KEIO     

Present Address in your home country
Postal Code
Address
Country
Telephone
e.g., (+81-3-5427-1613)
Cellular Phone (if any)
e.g., (+81-30-5427-1613)
Fax
e.g., (+81-3-5427-1613)
Email Address
Confirm Email Address

Permanent Contact

*You must always keep us informed of your mailing address so you always have access to documents mailed from Keio University. Unless you notify us, we will use the permanent contact below as your mailing address. If your permanent contact is the same as your present address you provided above, you do not have to fill this section.

Apartment / Street
Town
 / City
Province
 / State
Postal Code
Country
Phone Number
e.g., (+81-3-5427-1613)

Use of Personal Information

By submitting this registration form, I consent to Keio University sharing my personal information (full name, name of home institution, gender, age, date of birth, nationality, e-mail address, information on CEMS Exchange Student Record Form and Study proposal, Self-evaluation for Japanese Language proficiency, Certificate of Health, and dietary restrictions, COE application and Certificate of Financial Support, and transcript) within Keio University and the CEMS Community*.
Your information will be used for administrative purposes only and will not be shared with third parties without prior consent.

*CEMS Community includes but is not limited to the CEMS Global Office, CEMS Student Board, CEMS Club, professors and instructors, and partner companies (for the purpose of company visits).