Applicant's Name(Print):

　　　　　　　　　　　　　 (Family) 　　　　　　　　 (First) 　　　　 　　　　 (Middle)

To the Applicant : Please indicate your full name above. Give this form and one of the envelopes marked “confidential" addressed to yourself, to the person you have asked to recommend you. Ask this person to place the completed form in the envelope, seal the envelope, sign across the seal, and return the unopened envelope with your application.

To the Applicant and the Recommender : This recommendation will be used for an admissional purposes only.

To the Recommender : Please respond to the following questions. Please type or print. After completing this form, place it in the envelope provided, seal the envelope, sign across the seal, and return it to the applicant. This recommendation is a required part of the application process; prompt return to the candidate is important. We appreciate your assistance and would like to assure you that your comments will be carefully considered.

Recommender's name :

Title and Institution (if work address used) :

Address :

Telephone & Facsimile :

１．During which period of time have you had the most frequent contact with the applicant? From 　　　　　　 to 　　　　.

２．What was the nature of your relationship?

３．In what areas does the applicant need improvement or growth?

４．Please comment on the applicant's interpersonal skills. How well does he or she work within a team?

５．How would you describe the applicant's leadership skills?

６．Please comment on the applicant's degree of self-confidence.

７．Please comment on the applicant's personal character?

８．Please indicate your overall evaluation of the applicant.

　　（　）Strongly recommended （　）Recommended （　）Recomended with reservation （　）Not recommended

９．Please make whatever additional comments you wish about the applicant's potential for graduate (or undergraduate) study in Japan and potential for becoming a responsible, effective person in your country. Additional pages may be attached, and the back page is also available.

　　　　　　　　　　Signature 　　　　　　　　　　　　　　　　　　　　　 Date