TOHO UNIVERSITY VISIT REQUEST FORM


Toho University International Communication Center is responsible for coordinating official visit requests from representatives of international universities, research institutions and medical/healthcare institutions. For visitors to receive maximum benefit from their visit, please complete and submit this request form at least 8 weeks prior to the date of the visit.


IMPORTANT NOTES:
  • Requests for meeting the President or other senior academic/administrative staff, or visiting affiliated hospitals require no less than 10 weeksf notice.
  • We may request additional information materials, such as CVs and immunization records depending on the purpose of the visit.
  • We will review each submitted request form carefully to determine if the visit is appropriate and advise the sender of the outcome of the request. We may not be able to accommodate requests due to limited times and resources. Toho University reserves the right to decline the request and not all the requests to be accepted.


Person making visit request
Title*
Dr   Mr   Ms   Other  (   )
Last Name*
First Name*
Position*
Organization*
Email*


Confirm E-mail Address.


Proposed dates of your visit    the dates below are confirmed
Start date*
End date*


Office/Faculty of interest*
 President Office  
 Faculty of Medicine / Graduate School of Medicine  
       ( Toho University Omori Medical Center    Toho University Ohashi Medical Center  
         Toho University Sakura Medical Center )
Faculty of Pharmaceutical Sciences / Graduate School of Pharmaceutical Sciences  
Faculty of Science / Graduate School of Science  
Faculty of Nursing / Graduate School of Nursing  
Other ();


Person(s) you would like to meet


Objectives of your visit*
Courtesy call  
Discussion on future collaboration and/or student/academic exchange  
Site visit  
Other ();


Please specify areas and topics of interest for discussion/site visit*


Number of visitors*   


Names of delegation / visitors
Leader
Last Name
First Name
Position and organization


Background Information about your organization*


Additional Information