BEASISWA KULIAH S2 DI JEPANG OLEH AJINOMOTO SCHOLARSHIP TAHUN 2017 | INDBeasiswa
APPLICATION FORM
FORM
1
Ajinomoto Scholarship for ASEAN International Students
「
・
・
・
・
Type or write in Japanese or in English block letters. ( 明
Numbers should be Arabic numerals. ( 数
Years should be written using the Anno Domini system. ( 年
Proper nouns should be written in full and not abbreviated. ( 固
Name
氏
姓
Family name
)
)
)
)
名 First and middle name
(In Roman
block capitals)
Date of birth
生
年
Day
Year
Age
年
Month
Sex
性
Female
男
国
Male
婚
status
Marital
Married
未
Single
Nationality
出
写
Photograph
Paste a passport size
photograph taken within
past 6 month. Write your
name in block letters on
the back of the photo.）
Place of Birth
Present status with the name of your university or employer)
現
現
Address
Present contact address
Tel:
Fax :
Cell Phone:
E-mail :
緊
Name
Address
Tel
Fax
Person to contact in case of emergency
Relation:
GPA(Grade Point Average)
GRE
（ If possible）
学
Bachelor’s
Master’s
General Point
科
(Subject name)
Subject Point
Educational background
小
Elementary School
Name and Location of
School
Period
attended
to schools
Years and
month
attended
Name
From
To
Location (City)
Major Subject, Diploma or
Degree Awarded
Year
s
Months
Name
中
Middle School
Location (City)
Name
高
High School
Location (City)
From
To
Years
Months
From
To
Year
s
Months
大
University/College
Name
Location (City)
From
To
Year
s
Months
4年
5年
大
Graduate School
4-Year University/College
5-Year University/College
Name
From
Location (City)
To
Year
s
Months
修
Total years of education
Ye
ars
Months
職
Employment record
(Please fill in your record in chronological order)
組
Name and address of organization
勤
Period of employment
役
Position
職
Type of work
From
To
From
To
From
To
Academic Degree
学
機
月
Institution
Month
年
Year
Conferred Degree:
a) Bachelor’s Degree b) Master’s Degree
c) Doctorial Degree
取
学
東
（※希
Name of the graduate school, the major and host professor of the University of Tokyo which you
wish to enroll.
Graduate School
Major (Course)
Host Professor
Select one with placing × in the (
以
(
) 外
Foreign research student (Generally 1 year) + Master course student (2 years)
Master course student (2 years)
（
Japanese Language Proficiency
日
日
).
学
(If possible)
Details of Japanese Language Study
学
Period of
Study(MM/YY)
学
Total study Hours
日
Name of Institution or Course in the university
From:
To:
Hours
Result of your JLPT (Japanese Language Proficiency Test)
日
受
Date of the test
Month
Year
受
Place of the test
試
Your test result
Level passed:
Total score:
語
語
Language Proficiency (Except your native language)
(Evaluate your language level using the following scale:
4 – Excellent, 3 – Good, 2 – Fair, 1 - Poor.)
Japanese
English
Others (Specify in
Others (Specify in
blank)
blank)
(
)
(
)
Reading
Writing
Oral
Communication
他
details (name of the sponsor, duration, amount, etc).
If you are applying for other scholarship, state the
I understand and accept all the matters stated in the Application for “Ajinomoto
Scholarship for ASEAN International Students” and hereby apply for this
scholarship.
(私
)
Date of application
申
申
Applicant’s Signature
Applicant’s name
申
(In Roman block capitals)
FORM
1
Ajinomoto Scholarship for ASEAN International Students
「
・
・
・
・
Type or write in Japanese or in English block letters. ( 明
Numbers should be Arabic numerals. ( 数
Years should be written using the Anno Domini system. ( 年
Proper nouns should be written in full and not abbreviated. ( 固
Name
氏
姓
Family name
)
)
)
)
名 First and middle name
(In Roman
block capitals)
Date of birth
生
年
Day
Year
Age
年
Month
Sex
性
Female
男
国
Male
婚
status
Marital
Married
未
Single
Nationality
出
写
Photograph
Paste a passport size
photograph taken within
past 6 month. Write your
name in block letters on
the back of the photo.）
Place of Birth
Present status with the name of your university or employer)
現
現
Address
Present contact address
Tel:
Fax :
Cell Phone:
E-mail :
緊
Name
Address
Tel
Fax
Person to contact in case of emergency
Relation:
GPA(Grade Point Average)
GRE
（ If possible）
学
Bachelor’s
Master’s
General Point
科
(Subject name)
Subject Point
Educational background
小
Elementary School
Name and Location of
School
Period
attended
to schools
Years and
month
attended
Name
From
To
Location (City)
Major Subject, Diploma or
Degree Awarded
Year
s
Months
Name
中
Middle School
Location (City)
Name
高
High School
Location (City)
From
To
Years
Months
From
To
Year
s
Months
大
University/College
Name
Location (City)
From
To
Year
s
Months
4年
5年
大
Graduate School
4-Year University/College
5-Year University/College
Name
From
Location (City)
To
Year
s
Months
修
Total years of education
Ye
ars
Months
職
Employment record
(Please fill in your record in chronological order)
組
Name and address of organization
勤
Period of employment
役
Position
職
Type of work
From
To
From
To
From
To
Academic Degree
学
機
月
Institution
Month
年
Year
Conferred Degree:
a) Bachelor’s Degree b) Master’s Degree
c) Doctorial Degree
取
学
東
（※希
Name of the graduate school, the major and host professor of the University of Tokyo which you
wish to enroll.
Graduate School
Major (Course)
Host Professor
Select one with placing × in the (
以
(
) 外
Foreign research student (Generally 1 year) + Master course student (2 years)
Master course student (2 years)
（
Japanese Language Proficiency
日
日
).
学
(If possible)
Details of Japanese Language Study
学
Period of
Study(MM/YY)
学
Total study Hours
日
Name of Institution or Course in the university
From:
To:
Hours
Result of your JLPT (Japanese Language Proficiency Test)
日
受
Date of the test
Month
Year
受
Place of the test
試
Your test result
Level passed:
Total score:
語
語
Language Proficiency (Except your native language)
(Evaluate your language level using the following scale:
4 – Excellent, 3 – Good, 2 – Fair, 1 - Poor.)
Japanese
English
Others (Specify in
Others (Specify in
blank)
blank)
(
)
(
)
Reading
Writing
Oral
Communication
他
details (name of the sponsor, duration, amount, etc).
If you are applying for other scholarship, state the
I understand and accept all the matters stated in the Application for “Ajinomoto
Scholarship for ASEAN International Students” and hereby apply for this
scholarship.
(私
)
Date of application
申
申
Applicant’s Signature
Applicant’s name
申
(In Roman block capitals)