Ritsumeikan University International PBL Program Nomination Form

Fall 2021 Enrollment

Student Name College of Enrollment

Year Duration of Study List Any Learning
(As written on passport, FAMILY Major at Home University Gender (Policy Science or Student's E-mail address Other/Notes
Level (1 semester/2 semesters) Disabilities If Applicable
NAME Given-names) International Relations)

1 SUHENDAR Dhika Januar Japanese Studies M 3 International Relations 1 semester None

dhika.januar@ui.ac.id
2 Select Select Select Select

3 Select Select Select Select

4 Select Select Select Select

5 Select Select Select Select

6 Select Select Select Select

University Name

Coordinator Name

Address of Office
Diisi oleh Kantor Urusan Internasional UI
E-mail

Phone

Date of Submission