MEXT Undergraduate 2017

Application Form [UNDERGRADUATE 2017]

Social Science

Natural

Science

Science

Science

(Physics)

Natural
(Biology)

Natural
(Medicine)

APPLICATION FOR JAPANESE GOVERNMENT (MONBUKAGAKUSHO) SCHOLARSHIP 2017

Undergraduate Students
INSTRUCTIONS
1.
The application should be typewritten if possible, or neatly hand-written in block letters.
2.
Numbers should be in Arabic figures.
3.
Year should be written in the Anno Domini system.
4.
Proper nouns should be written in full, and not abbreviated.
5.
Use our format to help to speed-up the short-listing process.

1.

Name in full, in native language _____________,_____________ __________

(Family name) (First name)
(Middle
name)

In Roman block capitals _______________, ____________ _____________

(Family name)
(First name)
(Middle
name)
Nationality

2.2 Japanese nationality

Yes
No
________________________

(Sex)
Male
Female

(Marital Status)

Single
Married

3. Date of birth

______________________________________________
(Year)
(Month)
(Day)
(Age)
4. Present status with the name of the school attended, or of employer
_________________________________________________________________

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5. Mailing address and telephone number, facsimile number, e-mail address
_______________________________________________________________________________
_______________________________________________________________________________
6.
Chosen field of study in Japan
First Priority
_________________
Second Priority _________________
Third Priority
_________________
7.
Field of study specialized in the past at your high school or university
____________________________________________________________________________

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8.
Education background
Name and Address
of School

Name

Year
and
Month
of
Entrance
and
Completion
From

Elementary
Education
Elementary School

Secondary

Low

Education

er

Location

To

Name

From

Location

To

Period of
schooling
attended

Certificate/
Degree

Major
subject

yrs
and
mths

yrs
an
d
mths

Secondary
School
Uppe

Name

From

Location

To

yrs
an

*-1

d
mths
*-2

Higher
Education
Undergraduate
Level

Name

Location

From

yrs
a
nd

To

2)________
mth
s

Total years of
mentioned above

1)________

schooling

as

3)________

yrs
an
d
mths

Notes:
i. Exclude kindergarten education, nursery school education or remove classes (for
secondary school education).
ii. Include preparatory education for university admission in secondary education.
iii. If the applicant has passed the qualifying examination to a university, indicate this in the
blank with * - 1.
iv. The applicant who has more than one major at his/her university should list all the majors,

MEXT Undergraduate 2017

including minors, in the blank with * - 2.
v. For the certificate/degree column, please indicate UPSR, PMR, SPM, STPM or A-Level,
etc. accordingly.

MEXT Undergraduate 2017

9.
Reasons for majoring in the field of study described in item 6.
___________________________________________________________________________
___________________________________________________________________________
10.
Description of desired employment to be taken up after returning home.
___________________________________________________________________________
___________________________________________________________________________
11.
Person to be notified in applicants home country, in case of emergency:
i)

Name in full: ______________________________________________________

ii)

Address: with telephone number, facsimile number, e-mail address

__________________________________________________________________
__________________________________________________________________
iii)

Occupation:
_____________________________________________________________________

iv)

Relationship to applicant:
Date of application :

Applicants signature :
_________________________________
Applicants name
(in Roman block capitals) :
__________________________________
===========================================================
Have you learnt Japanese Language before?

Yes

No

Name

of

Institute:

_______________________________________
If you are called to sit for the written examination held by the Embassy, do you want to sit
for the Japanese language paper?

MEXT Undergraduate 2017

Yes
Note:

No

Please read our guidelines carefully. Do not leave any column blank, if you
do so, your application will strictly NOT be considered.

MEXT Undergraduate 2017

ASCOJA Recommendation

ASEAN Council of Japan Alumni (ASCOJA) aims to foster human resources that can provide
leadership as a bridge between Japan and home country even after returning home. In addition to
the specialized field of study in graduate school, ASCOJA members also have a chance to deepen
their understanding of Japan by learning Japanese language, culture, and through activities such as
experiencing customs and exchange with Japanese people during their stay in Japan.

MEXT Scholarship candidates who fulfill the requirements below are eligible for the ASCOJA
Recommendation:

Will receive 1 year of Japanese language preparatory education at Tokyo Japanese Language
Education Center before enrolling into graduate school.

Will apply for a university in Tokyo or around the region (where student can participate in ASCOJAs
activities without hindrance).

If you are interested to join ASCOJA kindly tick in the box below

YES

NO