2021ᖺ

ᖺᗘ᪥ᮏᨻᗓ䠄ᩥ㒊⛉Ꮫ┬䠅ዡᏛ㔠␃Ꮫ⏕䚷㓄⨨ᕼᮃ኱Ꮫ⏦ㄳ᭩
䠄ᩍဨ◊ಟ␃Ꮫ⏕䠅
2021 PLACEMENT PREFERENCE APPLICATION FORM FOR JAPANESE GOVERNMENT
䚷(TEACHER TRAINING STUDENTS)
(MEXT) SCHOLARSHIP䚷

ࠉ(ጣ) Surname ࠉ(ྡ) Given name ࠉ(㺮㺢㺼㺷㺦㺎㺯) Middle name

䚷1.Ặྡ䠄䡭䢕䢈䡣䢉䢚䡫䢀䠅
䚷䚷Name in Alphabet

䈜⥛䜚䛿䝟䝇䝫䞊䝖䛾⾲グ䛸ྠ୍䛻䛩䜛䛣䛸䚷䚷Write your name exactly as it appears in your passport.

䚷2.ᛶู
䕕䚷⏨䚷Male䚷䚷䚷䚷䚷䚷䚷䚷䚷䚷䚷䚷䚷䚷䚷 䕕䚷ዪ䚷Female
䚷䚷Gender

䚷3.ᅜ⡠
Nationality

䚷4.⏕ᖺ᭶᪥ ᖺ ᭶ ᪥ ᖺ㱋 䠄2021/4/1⌧ᅾ䠅 ṓ
Date of Birth yyyy mm dd Age (As of April 1, 2021) yrs

䚷5. ᕼᮃ኱Ꮫཬ䜃ศ㔝
䚷䚷The University in Japan and teaching field of the specialty you wish to attend
(1) Choose five universities at most and teaching fields of the specialty you wish
㻔㻝㻕䡞䝁
䝁䞊䝇䜺䜲䝗䛃䛛䜙ᕼᮃ䛩䜛኱Ꮫཬ䜃ศ㔝䜢᭱኱䠑䛴䜎䛷 to attend from those listed in the "Course Guide" and fill in the course codes in
㑅䜃䚸ᕼᮃ㡰䛻䝁䞊䝇䝁䞊䝗䜢グ㍕䛩䜛䛣䛸䡝
order of preference.
㻔㻞㻕⏦ㄳ᭩䛻グ㍕䛩䜛䛂㻞㻜㻚᪥ᮏ䛷䛾◊✲ィ⏬䛃䛸㛵㐃䛩䜛䝁䞊 (2) Select the courses related to your answer for "20. Research Plan in Japan"
䝇䜢㑅䜆䛣䛸䚹
in the application form.
㻔㻟㻕ศ㔝䛻䛴䛔䛶䛿ᕼᮃ䛩䜛኱Ꮫ䛷ᐇ᪋䛥䜜䛶䛔䜛ෆᐜ䛷䛒䜛 (3) Make sure in advance that your selected teaching field is offered at the
䛣䛸䜢஦๓䛻☜ㄆ䛧䚸䝁䞊䝇䝁䞊䝗䛸୍⮴䛥䛫䜛䛣䛸䚹
university that you want to attend. Match it to the course code.
㻔㻠㻕䛂䝁䞊䝇䜺䜲䝗䛃䛾኱Ꮫ䛤䛸䛾䝨䞊䝆䛻グ㍕䛾䝁䞊䝇䝁䞊䝗䚸 (4) Correctly fill in the course code and the teaching field given on the page for
ศ㔝ྡ䜢ṇ☜䛻グධ䛩䜛䛣䛸䚹ᩍ⫱኱Ꮫ䛾ሙྜ䛿኱Ꮫྡ䜢┬
␎䛧䛺䛔䜘䛖≉䛻␃ព䛩䜛䛣䛸䠄౛䠖䡚㼁㼚㼕㼢㼑㼞㼟㼕㼠㼥㻌㼛㼒 each university listed in the "Course Guide." In the case of a university of
㻱㼐㼡㼏㼍㼠㼕㼛㼚䠅䚹 education, be particularly careful not to shorten the university name but write the
full name (e.g., 䡚University of Education).
ᕼᮃ㡰఩ ኱Ꮫྡ䠄┬␎䛧䛺䛔䠅 5᱆䛾䝁䞊䝇䝁䞊䝗 ศ㔝
Preference Name of University (Do not abbreviate the names) Five digit course code Teaching field

➨䠍ᕼᮃ
First choice

➨䠎ᕼᮃ
Second choice

➨䠏ᕼᮃ
Third choice

➨䠐ᕼᮃ
Fourth choice

➨䠑ᕼᮃ
Fifth choice

6䠊䜒䛧䚸ୖグ䛾኱Ꮫ䛻ධᏛ䛷䛝䛺䛔ሙྜ䛿ḟ䛾䛹䛱䜙䜢㑅䜆䛛䚹ୗグ䛾ヱᙜ䛩䜛䜒䛾䛻䝏䜵䝑䜽䜢௜䛡䜛䛣䛸䚹䛺䛚䚸䛂i. ᩥ
㒊⛉Ꮫ┬䛾ᣦᐃ䛧䛯኱Ꮫ䛻ධᏛ䛩䜛䚹䛃䜢ᕼᮃ䛩䜛ሙྜ䛷䜒䚸ᡤᐃ䛾ᮇ㛫ෆ䠄2021ᖺ8᭶୰᪪䜎䛷䠅䛻ཷධ኱Ꮫ䛜Ỵᐃ䛧䛺
䛔ሙྜ䛿୙᥇⏝䛸䛺䜛䛣䛸䜢⌮ゎ䛩䜛䛣䛸䚹
In case you are not admitted to all of the above universities, which option below do you choose? Please aware that you will not be
accepted as a MEXT Scholrship student in case when the accepting university has yet to be determined at the time when the placement
period expires in the middle of August 2021 even if you selected "i. I will study at at university designated by MEXT."

䕕ϸ. ᩥ㒊⛉Ꮫ┬䛾ᣦᐃ䛧䛯኱Ꮫ䛻ධᏛ䛩䜛䡝 I will study at a university designated by MEXT.

䕕Ϲ. ᪥ᮏ␃Ꮫ䜢᩿ᛕ䛩䜛䡝 I will withdraw my application to study in Japan.