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Temple University, Japan Campus
Undergraduate
Title
O.P. Jindal Exchange Application Form
General Information
First Name
Middle Name
Last Name
TUID
Email Address
Emergency Contact Information
Primary Emergency Contact Name
Relationship to You
Home Phone (please add country code!)
Mobile Phone (please add country code!)
E-mail Address
Home Address
Passport Information and Scan
Primary Citizenship
Secondary Citizenship (if applicable)
Do you currently have a valid passport?
Do you currently have a valid passport?
Yes, I have a passport valid for 6 months past my program end date.
I have a passport, but it will expire in the next year to six months.
No, I do not have a passort.
Upload a photo or scan of the picture and signature pages of your passport.
Make sure that all fields on the picture and signature pages are clear and legible.
Essay and Eligibility
When do you intend to study at O.P. Jindal?
You may choose only
one
option.
Fall 2025
Academic Year 2025 - 2026
Why are you choosing to study abroad on this specific program? Please include your reasons for selecting this particular location and university, and how the program will help you meet your personal, academic and future career goals. (Minimum 200 words)
Have you be found responsible for a Code of Conduct violation at any college or university?
Have you be found responsible for a Code of Conduct violation at any college or university?
Yes
No
If your answer to the previous question was "Yes", please describe the violations below.
Academics
Class Status
Class Status
Freshman
Sophomore
Junior
Senior
Anticipated Graduation Date
Academic Advisor
Jenika Kaul
Takeki Shimamoto
Yuka Nakamura
Kara Torres
Tamanna Navila
Takami Nishimoto
Kiyoko Sakuma
Elyka Nemoto
Mina Sharpe
Nyereath Nhial
Have you spoken with your academic advisor about participating in this program?
Have you spoken with your academic advisor about participating in this program?
Yes
No
Please list the courses you are taking and any courses you expect to complete before participating in this program.
Please list the courses you plan to take while abroad.
You can find a list of potential courses
here
.
Agreements
I authorize Temple University, Japan Campus staff to access my education records, disciplinary records, and all information contained in those records, maintained by Temple, or any other educational institution I have attended.
I certify that the statements I have made on this application are correct and agree to notify Temple University's Study Abroad Coordinator if I am placed on academic and/or disciplinary warning or probation or if there is a change in circumstances which might compromise my success in studying abroad.
I authorize Temple University, Japan Campus staff to access my education records, disciplinary records, and all information contained in those records, maintained by Temple, or any other educational institution I have attended.
I certify that the statements I have made on this application are correct and agree to notify Temple University's Study Abroad Coordinator if I am placed on academic and/or disciplinary warning or probation or if there is a change in circumstances which might compromise my success in studying abroad.
Yes
No
Submit
