APPLICATION FORM <April 2026 Enrollment> Office Use Only 受付番号

International Undergraduate Program in Science

School of Science, Osaka University
2026年度 大阪大学 理学部 国際科学特別入試

Please fill this form by typing.

I. Personal Details
Family name/Surname First name Middle name(s) ID Photo

Name as Written on
Passport
Max. 40mmx40mm
Name in Chinese Characters /
Japanese Katakana (if applicable)
yyyy mm dd
Date of Birth Gender

Nationality
*All nationalities should be listed.
Have you previously studied in Japan on a Student Visa or do you
□ Yes □ No
have a current valid visa for Japan?
Correspondence Address
Home Address
(If different from your home address)

Address

Post Code

Country

Home Telephone Mobile Phone

Number Number

Email Address

Emergency Contact Information

Relationship to the
Name
Applicant

Address

Post Code Country

Home Telephone Mobile Phone

Number Number
*Emergency email address should be different from applicant's.
Email Address

II. Department of Your Choice *Please choose one.

Department of Department of Department of Department of

Mathematics Physics Chemistry Biological Sciences
数学科 物理学科 化学科 生物科学科

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III. Educational Background
Name of School 1

Location

Elementary Period (yyyy/mm) Start End

Education Name of School 2

Location

Period (yyyy/mm) Start End

Name of School 1

Location
Secondary Education Period (yyyy/mm) Start End
(including High
School) Name of School 2

Location

Period (yyyy/mm) Start End

Name of School
Tertiary
Location
Post-Secondary
Period (yyyy/mm) Start End

Name of School
Tertiary
Location
University
Period (yyyy/mm) Start End

Name of School

Others Location

Period (yyyy/mm) Start End

IV. Language Proficiency

Are you a native English speaker or are you fluent in
□ Yes □ No
English at the level of a native speaker?
Is English the language of instruction in your high
□ Yes □ No
school?
If you answered No to both of the above, please fill in the relevant fields below.
English Exam Name Score Date of Exam (yyyy/mm/dd)
TOEFL □ iBT □ Others

IELTS □ Academic Module

Others *Please specify

Are you a native Japanese speaker or are you fluent in
□ Yes □ No
Japanese at the level of a native speaker?
If you answered No to the above, please fill in the relevant fields below.
Exam Name Score Date of Exam (yyyy/mm/dd)
Japanese JLPT Level

Certificate/Letter issued by an Educational Institution □

Others *Please specify

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 V. International Qualifications
Please fill in the grade or score of each subject you have taken in the relevant field below.
If you have taken a national standardized test, please fill in the name of the test.
Mathematics Physics Chemistry Biology

International Baccalaureate

GCE A Levels

EJU
*Please specify
Others

Are the scores filled in above predicted scores? □ Yes □ No

If you answered Yes, please specify when you will be
(yyyy/mm/dd)
able to submit your official final scores.

VI. How did you first hear about this program?

VII. Special Accomodations

Write down any comments related to disabilities/disorders which we should take into consideration during your assessment.

VIII. Disclaimer and Signature

I hereby declare that all the information provided is true and correct, and the submitted documents contain no forgeries. Should any
falsehoods or untrue information be found before or after enrollment, I understand that any acceptance may be revoked, and no
appeals will be allowed under any circumstances.

I agree:
- to comply with the rules on admission, enrolment, fee payment and refunds of Osaka University.
- to notify Osaka University International College Office if there are any changes to the information
I have given in this application for admission.
- to permit Osaka University to access my academic records from other institutions.
- to permit Osaka University to disclose personal information collected from the application form to
the relevant bodies for verification and assessment of previous qualifications.
- that submitted application documents will not be returned to the applicant for any reason.

Signature of Applicant Date

If applicant is under the age of 18

Name of Parent/Guardian Relationship to the Applicant

Signature of parent/guardian Date

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Check list

1 □ Application Form

2-1 □ Official Transcript(s) issued by Educational Instituion

2-2 □ Certificate of (expected) Graduation/Copy of High School Diploma

3 □ Recommendation Letter(s) (sealed, signed by the Recommender)

4 □ Standardized Test Score*

5 □ Essay

6 □ Application Fee Payment Certificate**

7 □ Copy of your Passport

8 □ Certificate of English Proficiency (if applicable)*

9 □ Certificate of Japanese Proficiency*

*You may ask each applicable office to send us your official results directly.
**Payment should be made no later than January 8, 2025.

The application documents package must reach us at the address below by January 10, 2025.

<IUPS> International College Office

Osaka University
511, Interdisciplinary Research Building
1-2, Machikaneyama, Toyonaka
Osaka
560-0043, Japan

大阪大学
インターナショナルカレッジ <IUPS>
〒560-0043 大阪府豊中市待兼山町 1-2
文理融合型研究棟 511
Japan

Email Address: [email protected]