Please do not mark in the above space. Tohoku University Admissions for Global Entrance Examination ■■ Date____________________________ School Name Principal's Name Form Preparer TO■President of Tohoku University I take responsibility for its evaluation of the below-named applicant for a Global Entrance Examination■. 1. Applicant's Name etc. Phonetic Japanese (if known) Name 2. Desired School/Faculty etc. Desired School/Faculty School/Faculty of: ■ Science 3. Comments Applicant Assessment Form (Please ask your high school etc. to prepare this form.) ____________________________ ____________________________ Official Seal ____________________________ Seal Gender (M/F) Date of Birth (D/M/Y) / / Department/ Course Department of: Department of Chemistry Advanced Molecular Chemistry Course Date/Expected Date of Graduation/Completion: / / For the Academic Year 2023 Faculty of Science Please print this as a double-sided form. Address ____________________________ Phone No. ____________________________
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