Personal Information Entry

1.Basic information
Applicant name
（For visa purposes, enter your name as listed on your passport.）
  • Last name
  • First name
Phonetic(Katakana)
  • Last name ※Please type using full-width characters.
  • First name ※Please type using full-width characters.
English notation
※Please type using half-width characters.
Date of birth
※Please enter using the calendar displayed
Sex
2.Information of request
Research field
Course It will be automatically displayed when you select the research field
Name of professor in Graduate School It will be automatically displayed when you select the research field
Examination category 秋入学(2025年10月入学)
Graduate program for working professionals
3.Information of applicant for admission
Permanent domicile
※If you are a foreign national, please choose "外国籍/Foreign national"
Nationality
Current status of residence
Postal code
※Please enter without "-(hyphen)"
※Please type using half-width characters.
Address Prefectures
※If you are a foreign national, please choose "外国/Foreign"
City
Street
Apartment
Face photo
※Please select an image with a 4:3 ratio of height to width for the portrait photo.
※Please select an image up to 5MB in size for your portrait photo.
※Face photos can only be uploaded in JPG format.
※Face photos can only be used half-width alphanumeric characters.
Apply to take the "Entrance Examination for International Applicants Living Abroad"
4.Reference of applicant for admission
Telephone
Phone number
※Please enter without "-(hyphen)"
※Please enter in single-byte numbers. (Enter "+" if necessary)
Mobile phone number
※Please enter without "-(hyphen)"
※Please enter in single-byte numbers. (Enter "+" if necessary)
E-mail address
E-mail address is used to inform the application situation.If you use an e-mail address such as a mobile phone, please make settings so that you can receive e-mails from "juntendo.ac.jp".
E-mail address(For confirmation)
Current Company Workplace Name
Workplace Phone number
※Please enter without "-(hyphen)"
※Please enter in single-byte numbers. (Enter "+" if necessary)
5.Language examination
Examination subject
＊Please select the subject you want to take for the Language Exam. If you meet the conditions for an exemption listed on the Admission Information website and want the exemption, please select "免除/Exemption".
＊If you want to take the "Entrance Examination for International Applicants Living Abroad", please select "免除/Exemption".
Applicants who meet conditions will be exempted from taking the Language Examination. Applicants must submit the corresponding test certificate along with their application.
Language examination Standardized Language Test
Test type
Score
※Please type using half-width characters.
Preliminary Review Result Please perform a preliminary review.
Our university Regular Language Exam Pass Date
（or Clinical resident Matching test）
※If you already passed Juntendo language examination , please fillin the pass date.
※Please enter using the calendar displayed
6.Academic background Please enter either "University/College" or "Other schools".
University/College Period ～
University/College
Faculty
Department
Graduate
Graduate school Period ～
Graduate school
Faculty
Major
Course
Graduate
Other schools Period ～
Schools
Department name, etc.
7.Qualification
Qualification1 Year/Month
Qualification name
Qualification2 Year/Month
Qualification name
Qualification3 Year/Month
Qualification name
8.Working experience
Work experience1 Period ～
Name of employer
Work experience2 Period ～
Name of employer
Work experience3 Period ～
Name of employer
Work experience4 Period ～
Name of employer
9.Reward and Punishment
Reward and Punishment1 Year/Month
Reward and Punishment
Reward and Punishment2 Year/Month
Reward and Punishment
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