Professional Documents
Culture Documents
Application U
Application U
Application U
Bangkok
Chiang Mai
Khon Kaen
Songkla
Registration No.
INSTRUCTIONS
The application should be typed if possible, or neatly handwritten in block letters.
Numbers should be in Arabic numerals.
Year should be written using the Anno Domini system. )
Proper nouns should be written in full, and not abbreviated. )
Personal data entered in this application will only be used for scholarship selection purposes, and contact information such as e-mail addresses will
only be used for forming related human networks after the student returns home and for sending of information by the Japanese Government.
E-mail
(Sex)
Male
(Family name)
(First name)
(Middle name)
(Family name)
(First name)
(Middle name)
Female
(Marital Status)
Single
Married()
Yes
No
Date of birth(
19
Age
Year
Month
Day
4.5cm3.5cm photo
Present address(
((4.5cm3.5cm))
Telephone/Facsimile number(/FAX
Mobile ()
E-mail address
If possible, write an e-mail address where we can contact you for periods that include the time before you come to Japan, your stay in Japan and the period
after you return home. E-mail
Chosen field of study in Japan (please check X)
Select from 1.FIELDS OF STUDYin Announcement.
Fields of Study
U1
U2
Subjects
Natural Sciences A
Natural Sciences B
Natural Sciences C
6.
Chosen majors in Japan (Please complete it all 3 choices within the same Field of Study in page 1 in Announcement Form)
First Choice
Second Choice
Third Choice
7Would you like to take Japanese Language Test given for evaluation for those who are in the programme of Japanese language
and those who would like to be evaluated their Japanese language skills?
Yes
No
in
grade
/ will graduate in
Year
Month
10Educational background:
Name and Address of School
Elementary Education
Name
)
From
years
To
and
months
From
years
To
and
months
From
years
To
and
months
From
years
()
Elementary School
Location
)
Secondary Education
Name
)
Location
)
Name
)
Location
)
*-1
Duration of
Attendances
*-2
Higher Education
Name
)
Undergraduate Level
Location
)
To
As of April 1, 2016
(2016 4 1 )
1)
2)
and
months
3)
years
and
months
Notes: 1. In Thailand, elementary school is for 6 years, lower secondary school is for 3 years, upper secondary school is for 3 years and university is for 4 years.
Those who skipped class, the total years of education are decreased. ( 6 3 3 4
)
2Exclude kindergarten education or nursery school education. ()
3Include preparatory education for university admission in upper secondary school.)
4If the applicant has passed the qualifying examination for admission to a university, indicate this in the blank with *-1.(
-1
5. Any school years or levels skipped should be indicated in the fourth column (Diploma or Degree awarded, Major Subject, Skipped years and levels).
(Example: Graduated high school in two years, etc.)
3
6The applicant who has more than one major at his/her university should list all majors in the blank space with *-2
*-2
G.P.A
11Language proficiency:
(1) Evaluate your ability as Excellent", Good", or Poor" in the blank space.
Reading
Writing
Speaking
Japanese
English
Others(
()
Specify the test results for any English proficiency examinations you may have taken.
PTE Academic
points
TOEIC
points Others
TOEFL
points IELTS
points
points ()
Have you ever passed the Japanese Language Proficiency Test? Please Mark either (1) or (2) with a circle. If you marked (1), please state your level.
(1) Yes, I have.
Japanese Language Proficiency Test
Level
__________
from
to
Year()
Month()
Total:
Year()
Years
Month()
13Reasons for choosing to major in the field of study described in item no.6 (page 1). *Specify the reasons for each field of study entered in item no.6. Also, ensure
that the fields of study in this section are the same as the fields of study entered in item no.6
(6
Second choice
Third choice
Date
Purpose
From
To
From
To
I understand and accept all the matters stated in the Application for Japanese Government (MONBUKAGAKUSHO:MEXT) Scholarship for 2016, and hereby apply
for this scholarship. 2016
Date of application:
Applicant's signature:
Applicant's name
in Roman block letters
( 4 )
1.
1
2. Admission Form ( )
1
3. Admission Form (4.53.5 cm)
3
4.
1
5. 1
6.
1
( )
7. JLPT ( )
1
8. EJU ( )
1
*
**
**
1.
2. 5-15 1
3. (11-12 2558)
2-3
( 8-12 2558
13.30 -16.30 .)
4. (Fields of Study )