ࡱ> y Rpobjbj6{{F F 8cT;?>(((*>,>,>,>,>,>,>$yA+DP>+&\(++P> >666+*>6+*>66<@K@=𘈟^?4(= > ?0;?= Dg4~D==D2=()rC6 *\h*(((P>P>5^(((;?++++D(((((((((F + q: APPLICATION FOR JAPANESE GOVERNMENT (MONBUKAGAKUSHO:M%84) SCHOLARSHIP e,g?e^eyf[w hYf[ёYuf[u3uˊf Research Students for 2012xvzYuf[u 00000).3425#4)/.3eQ Nn0la 00000The application should be typed if possible, or neatly handwritten in block letters. fwk0eQY00S0h0a) 00000Numbers should be in Arabic numerals.peW[o0{(upeW[0(uD00S0h0a) 00000Years should be written using the Anno Domini system. t^So0Y0y0f0fh0Y00S0h0a) 00000Proper nouns should be written in full and not abbreviated. V g T^o0Y0y0f0ck_j0 Tyh0W0 NRweuW0j0D0S0h0a) 00000 * 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.) (,g3uˊfk0 U00_0 PN`1Xk0d0D0f0o0 ,ghYf[ёn0xn0_00k0O(uY00{0K0o0 yrk0E-mail0000I{n0#a}HQk0d0D0f0o0 0^V_k0J0Q00On00000000\O0S0h0Ss0_k0_X0e,g?e^00T.z`1X0OY00NYk0o0O(uW0j0D00 (Sex) Name in full in native language %Male7u 00Y TV))0 000000(Family name) 00 (First name) 00000 (Middle name) %FemalesY 00In Roman block capitals (Marital Status) 00000W[ 0000000000(Family name) 00 (First name) 0000 (Middle name) %Single*gZZ Write your name exactly same as is printed in your passport %Married(eZZ) Nationality ; Possesion of Japanese nationality00%Yes, I have.o0D0 00V0M| 000000000000000000000000000000 0000 %No, I don t have it.(D0D0H0) Date of birth(ut^ge 0 0019 00Yeart^ 0 Monthg Daye 0 Age(as of April 1,2012)t^b(2012t^ges(W Present status with the name of the university attended or employer 00sw(Wf['Yf[ TSo0RRHQ T~0g0eQY00S0h0a  Present address and telephone number, facsimile number, e-mail address 00sOO@bSs0q 00000juS E-mail0000 00sOO@b(Present address  00qjuS/FAXjuS(Telephone/facsimile number  00E-mail address 00* If possible, write an e-mail address that can be used for periods including the time before you come to Japan, your stay in Japan and the period after you return home. 00Sj0P00!neMR^e,gYuf[-N^0^V_k00_00OD0}Q00S0h0L0N`U000E-mail00000eQY00S0h00 Field of specialization studied in the pastBe as detailed and specific as possible.) 00NSk0\;eW0_0\RΑg0M00`0Q0wQSOvk0s0}k0fO0S0h0a Educational background f[tk Name and Address of School f[!h TSs0@b(W0W Year and Month of Entrance and Completion (eQf[Ss0RSmit^g)Amount of time spent at the school attended Of[t^pe Diploma or Degree awarded, Major subject f[MO0njh :OJPJo( h :OJo(ha\hd4CJOJPJQJo(h :OJPJQJaJo(hsOJPJQJaJo(hd4OJPJQJaJhwOJPJQJaJo(ha\OJPJQJaJo(hd4OJPJQJaJo((jhd4h :OJPJQJUaJo(hd4h :OJPJQJaJo(hd4hd4OJPJQJaJo(hd4hd4OJPJQJaJhd4h7BOJPJQJaJo( "46<Xb RTvx|~ "V\`h :B*OJo(phh :OJPJQJo(h :OJQJo(h,/CJOJo(hS#Ah :OJo( hAEKOJo( hS#AOJo( h7BOJo(h :OJPJo(jh :Uo(h :CJOJo( h :OJo(8PRH $$Ifa$ $,WD`,a$$a$ ,4PVN|6LNln"ϾƮϾƦϾƦϾϮϗ{tdhYrhYrCJOJPJQJo( hYrOJo(hYrCJOJPJQJo(hYrhYrCJOJPJQJhYrhYrOJPJQJaJh :OJPJ h :OJh :CJKHPJh :CJOJh :OJPJo( h :OJo(h :B*OJPJo(phh :B*OJo(phh :B*OJPJQJo(ph'"8Nnyyyyyyyyyyyyy $$Ifa$|kd$$IfrZo'z S 4a",wk $d\$Ifa$~kd$$IfrZo'z S 4a $$Ifa$  "*,.46HJP`bdjlnt|~  .02DFJLrtôh :CJKHPJh :CJOJo(h :h :CJOJmH sH h :h :OJmH o(sH h :h :OJPJmH o(sH h :CJOJ h :OJo( h :OJh :OJPJo(?,BDFHbxz|~ 0DF $d\$Ifa$FHJLtkbbbbb $$Ifa$~kdR$$IfrZo'z S 4a $$Ifa$ $d\$Ifa$   "$,.0BDFJLN\^`bnxz|$&(.68:@BTV\lnpvxh :CJKHPJh :CJOJo( h :OJ h :OJo(h :OJPJo(h :CJOJR .<>@BLZ\^`z $d\$Ifa$&8NPRTnwnnbbbbbbb $d\$Ifa$ $$Ifa$~kd$$If$rZo'z S 4a $$Ifa$  < P R T V $$Ifa$ $d\$Ifa$      : < > P R V X x z !!! !!! !"!$!,!.!0!B!D!F!J!L!N!\!^!`!b!n!x!z!|!!!!!!!!!!!!!!! " "h :CJKHPJ h :OJh :CJOJh :CJOJo( h :OJo(h :OJPJo(QV X z !wwwwwkkkkkk $d\$Ifa$ $$Ifa$~kd$$If5rZo'z S 4a !!!! !.!!@!B!L!Z!\!^!`!z!!!!!!!!!!! $$Ifa$ $d\$Ifa$!! ""*"@"B"D"F"`"v"x"z"wwkkkkkkkkk $d\$Ifa$ $$Ifa$~kd$$If8rZo'z S 4a """" "("*","2"4"F"H"N"^"`"b"h"j"z"|"~""""""""""""""""""""""# # ##,#.#0#B#D#H#J#############$TTǹDzDzǰU hS#AOJo( h7BOJo( hu\:OJo( hAEKOJo(h :CJKHPJh :CJOJo( h :OJh :OJPJo(h :CJOJ h :OJo(Cz"|"""""""""""""""" #.#B#D#F#H# $$Ifa$ $d\$Ifa$H#J####TT2TwhVVMM $$Ifa$$$IfWD,`a$gdAEK$$IfWD,`a$ $$Ifa$~kdz$$If-rZo'z S 4a  000000years 00000t^ 00* If the blank spaces above are not sufficient for the information required, please attach a separate sheet 000((l) Nkk0fM0M00j0D04XTk0o0 iS_j0%R}k0eQW0f0mNY00S0h0a) State the titles or subjects of books or papers (including graduation thesis authored by the applicant), if any, with the name and address of the publisher and the date of publication.Wf ֊eRSmi֊e0+T0a L0B00p0]0n0L T QHr>y T QHrt^ge QHr4X@b0Y0S0h0a 0 Employment Record: Begin with the most recent employment, if applicable.wtk Name and address of organization RRHQSs0@b(W0W Period of employment RRg Position y_w T Type of work wRQ[  From To From To 10Japanese language proficiency: Evaluate your level and insert an X where appropriate in the following blank space. 00e,gR0]UOn0F0H0 rS_kk0pS0eQY00S0h0a Excellent *Q Good o Fair S Poor  NS Reading 0R Writing fO0R Speaking qY0R  11Foreign language proficiency: Evaluate your level and insert an X where appropriate in the following blank space. 00YVR0]UOn0F0H0 rS_kk0pS0eQY00S0h0a Excellent *Q Good o Fair S Poor  NS English 񂞊     French N     German r     Spanish            12Have you been awarded a Japanese Government (Monbukagakusho) Scholarship in the past? If so, please specify the period, the name of the university, etc.NSk0VYuf[uk0c(uU00_0S0h0L0B00K00B00j00p0 ]0n0g0SeQ'Yf[ TI{0eQn0S0h00 00p!) Yes, I have. B00 Period: 0 University: q!) No, I have not. j0D0 13Accompanying Dependents (Provide the following information if you plan to bring any family members to Japan.) 0 T4O[ek!neY004XT T4ON[n0[eL0D004XTk0eQY00S0h00 * All expenses incurred by the presence of dependents must be borne by the grantee. He/She is advised to take into consideration various difficulties and the great expense that will be involved in finding living quarters. Therefore, those who wish to be accompanied by their families are advised to come alone first and let their dependents come after suitable accommodation has been found. l j0J0 T4Ok0_j0L}o0Y0y0f0Yuf[un0bg0B00L0 [e(un0[00d0Q00S0h0o0vS_Vg0B00Ìe0^8^k0rRؚk0j00n0g0B00K0X00bwU00_0D00S0n0_00 Yuf[uo0~0Z0XSg0egeW0 iS_j0[00d0Q0_0_ [e0|Ts0[[00S0h00 Name l0 T Relationship (}0g)Age t^0b 14. Person to be notified in applicant's home country in case of emergency: 00(}%`n0n0kVn0#a}HQ) 0p! Name in full: 0000l T 0q! Address: with telephone number, facsimile number, e-mail address 0000OO@bqjuS 00000juSSs0E-mail00000eQn0S0h0a 0000sOO@b(Present address) 0000qjuS/FAXjuS(Telephone/Facsimile number  0000E-mail address 0 r! Occupation: 0000w0mi 0s! Relationship: 0000,gNh0n0O 15.Immigration Records to Japane,gx0n0!n*2 DateeN 0 Purpose!n*vv From To From To 00000000000000000000000000000000000000000000000000000000000000 I understand and accept all the matters stated in the Application for Japanese Government(MONBUKAGAKUSHO:MEXT) Scholarship for 2012, and hereby apply for this scholarship0 yo02012t^^e,g?e^eyf[w hYf[ёYuf[uRƖk0 U00f0D00N0Y0y0f0NW0f03uˊW0~0Y0 Date of application: 3uˊt^ge 00000000000000000000 0000000000 Applicant's signature: 3uˊr T 000000 Applicant's name in Roman block capitals  3uˊl T 0000000000      PAGE 4  Paste a passport sized photograph or digital image taken within the past 6 months. 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