Instructor ID
Instructor Name *
Instructor Name (Katakana)
Phone Number （Mobile phone number recommended） *
E-mail address *
*
Month —以下から選択してください—Jan.Feb.Mar.Apr.May.Jun.Jul.Aug.Sep.Oct.Nov.Dec. Day —以下から選択してください—12345678910111213141516171819202122232425262728293031 Year —以下から選択してください—20202021202220232024202520262027202820292030 Day of Week —以下から選択してください—Mon.Tue.Wed.Thu.Fri.Sat.
Period 1Period 2Period 3Period 4Period 5Period 6Period 7Other
Period 1 Faculty/Graduate School —以下から選択してください—Faculty・Computer and Information SciencesFaculty・Science and EngineeringFaculty・Bioscience and Applied ChemistryFaculty・Koganei Teacher Training CourseFaculty・KLACGraduate School・Computer and Information SciencesGraduate School・Science and EngineeringGraduate School・IISTGECOther Class Title *
Period 2 Faculty/Graduate School —以下から選択してください—Faculty・Computer and Information SciencesFaculty・Science and EngineeringFaculty・Bioscience and Applied ChemistryFaculty・Koganei Teacher Training CourseFaculty・KLACGraduate School・Computer and Information SciencesGraduate School・Science and EngineeringGraduate School・IISTGECOther Class Title *
Period 3 Faculty/Graduate School —以下から選択してください—Faculty・Computer and Information SciencesFaculty・Science and EngineeringFaculty・Bioscience and Applied ChemistryFaculty・Koganei Teacher Training CourseFaculty・KLACGraduate School・Computer and Information SciencesGraduate School・Science and EngineeringGraduate School・IISTGECOther Class Title *
Period 4 Faculty/Graduate School —以下から選択してください—Faculty・Computer and Information SciencesFaculty・Science and EngineeringFaculty・Bioscience and Applied ChemistryFaculty・Koganei Teacher Training CourseFaculty・KLACGraduate School・Computer and Information SciencesGraduate School・Science and EngineeringGraduate School・IISTGECOther Class Title *
Period 5 Faculty/Graduate School —以下から選択してください—Faculty・Computer and Information SciencesFaculty・Science and EngineeringFaculty・Bioscience and Applied ChemistryFaculty・Koganei Teacher Training CourseFaculty・KLACGraduate School・Computer and Information SciencesGraduate School・Science and EngineeringGraduate School・IISTGECOther Class Title *
Period 6 Faculty/Graduate School —以下から選択してください—Faculty・Computer and Information SciencesFaculty・Science and EngineeringFaculty・Bioscience and Applied ChemistryFaculty・Koganei Teacher Training CourseFaculty・KLACGraduate School・Computer and Information SciencesGraduate School・Science and EngineeringGraduate School・IISTGECOther Class Title *
Period 7 Faculty/Graduate School —以下から選択してください—Faculty・Computer and Information SciencesFaculty・Science and EngineeringFaculty・Bioscience and Applied ChemistryFaculty・Koganei Teacher Training CourseFaculty・KLACGraduate School・Computer and Information SciencesGraduate School・Science and EngineeringGraduate School・IISTGECOther Class Title *
Other *
SicknessOfficial Business （Request(s) from public institution(s)）Academic Meeting ※If you are a full-time instructor, please submit a business trip request to your academic department / graduate school section.Primary University Business（Your main university business）Overseas Business Trip ※If you are a full-time instructor, please submit an overseas business trip request to your academic department /graduate school section.Personal Reason(s)OtherHosei University Business
If you select “Other”, please provide a specific reason *
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