Application form

    Name (at the time of graduation)*
    Name (current)

    *If your name is different from when you graduated, please also provide your current name.

    Birthday*
    / /
    Sex*
    Postal cade*
    * Residing outside Japan, please enter 000-0000.
    Prefecture*
    Address*
    Phone number*
    FAX
    E-mail*
    Membership category*
    Place of employment
    Faculty/Graduate School *
    Department / Major*
    Year of graduation
    年*    		 (Including certified withdrawals)
    Faculty/Graduate School 2
    Department / Major 2
    Year of graduation 2 (Including certified withdrawals)
    Affiliated Department *For retirees, name of last department
    Year of retirement
    Registration for KUON,
    a service for Kyoto University One Network
    Comment

    *500 words or less