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APPLICATION GUIDELINES

JAPANESE GOVERNMENT (MEXT) SCHOLARSHIP FOR 2017 (THAILAND)

- TEACHERTRAJNINGSTUDENTS -

The Ministry ofEducation, Culture, Sports, Science, and Technology (MEXT) offers scholarships to foreign teachers who wish to conduct research on school education at Japanese universities as follows :

1. QUALIFICATIONS

MEXT accepts applications from international students for study in Japan. Our aim is to foster human resources who will become bridges of friendship between your country and Japan through study in Japan and who will contribute to the development of both countries and the wider world.

(1) Nationality:

(2) Age :

Thai.

An applicant who has Japanese nationality at the time of application is not eligible. However, persons with dual nationality who hold Japanese nationality and whose place of residence at the time of application is outside of Japan are eligible to apply as long as they give up their Japanese nationality and choose the nationality of the foreign country by the date of their arrival in J~pan. Applicant screening will be conducted at the Japanese Embassy or Consulate.

Not more than 35 years old (must be born on or after April 2, 1982).

(3) Academic and Career Background: Applicants must be graduates of universities or teacher training schools and have worked as teachers at primary/secondary educational institutions or teacher training schools (excluding UPiversities) in their home countries for five years in total as of April 1, 2017. In-service university faculty members are not eligible.

( 4) Japanese Language Ability: Applicants must be keen to learn Japanese. Applicants must be interested in Japan and be keen to deepen their understanding of Japan after arriving in Japan. Applicants must also have the ability to do research and adapt to living in Japan.

(5) Health: Applicants must be free from any mental or physical disability that would be an impediment to the pursuit of study in Japanese University.

( 6) Arrival in Japan: Applicants must be able to arrive in Japan by the designated period (usually October) between the day two weeks before the course starts and the first day of the course. (lfthe applicant arrives in Japan before this period for personal reasons, travel expenses to Japan will not be paid. Excluding cases of unavoidable circumstances, ifthe applicant cannot arrive in Japan by the end of the designated period the applicant must withdraw the offer.)

(7) Visa acquisition: Applicants should, in principle, acquire "College Studenf' visas before entering Japan and enter Japan with "College Student" residence status. The visas should be issued at the Embassy of Japan in Thailand. Those who change their visa status to one other than "College Studenf' after arrival in Japan will lose their qualification to be Japanese Government Scholarship recipients from the date when their visa

status changes.

(8) Applicants must return to their home country and resume their work immediately after the end of the scholarship period. Applicants shall utilize in their teaching careers the results of their research on school education in Japan. Should the applicant not return to the home country and resl)Ille work after the end of the scholarship period, the applicant must return the entire amount of the scholarship starting from the first payment.

fu addition, while the applicant is studying in Japan, helshe shall contribute to mutual understanding between Japan and the home country by participating in activities at schools and in communities with the aim of contributing to the intemationaliz.ation of Japan. The applicant shall make efforts to promote relations between the home country and Japan by maintaining close relations with the university attended after graduation, cooperating

with its conducting of surveys and questionnaires after returning to the home country, and cooperating with all relevant projects and events cpnducted by the Embassy of Japan in Thailand.

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(9) Any applicant who meets any or all of the following conditions is ineligible. If identified after the start of the scholarship period, the applicant will be required to withdraw from the scholarship.

CD Those who are military personnel or military civilian employees at the time of their arrival in Japan;

® Tho~e who have received a Japanese Government Scholarship (MEXT scholarship) in the past;

@ Those who currently make a double application for other MEXT scholarship program such as Research Students;

© Those who are cilrrently emolled at a Japane5e university with a "College Studenf' residence status; those emolled, or scheduled to be emolled, at a Japanese university as a privately financed international student during the period when the scholarship application was filed in the home country until prior to the start of the provision of the scholarship;

@ Recipients of scholarships from institutions other than MEXT (including government institutions in their home countries) that overlapping with the Japanese Government Scholarship after arrival in Japan.;

@ Holders of dual nationality at the time of application who cannot verify that they give up Japanese nationality by the time of the arrival in Japan.

2. PLACEMENT AND SPECIALIZED TRAINING AT UNIVERSITIES

(1) The study/training is implemented only in the universities/study courses listed in a booklet of"Course Guide of Teacher Training Program. " and you can also find from the Embassy of Japan webpage. http://www.mext.gojp/component/a _ menu/education/detaiV _icsFiles/afieldfile/2016/12/12/1379317 _J .pdf

(2) MEXT, in consultation with the universities concerned, will decide on the university where each recipient shall be enrolled by taking into consideration his/her Japanese language ability and specialized courses heJshe wishes to take. Objections regarding university placement will not be accepted.

(3) The training at universities will be conducted in Japanese or English in principle. Language(s) used in each course can be confirmed in "Course Guide of Teacher Training Program. ''.

(4) The recipient students whose Japanese language a~ility is insufficient shall take Japanese-language education in a Japanese language study course at the appointed university or at a university designated by MEXT. Japanese -language education is generally provided for six months at the beginning of the program, but some of the accepting universities may conduct Japanese language education parallel to the training.

(5) The training mainly consists of educational administration (examples: educational administration and finance, school management), educational methods (examples: classroom teaching, learning system theory, curriculum, and educational assessment), specialized subject research (examples: mathematics, physics, chemistry, and gymnastics), and observational tours and practice (examples: class observations, participation in special educatiocal activities, and tours of educational research facilities). Guidance plans may be organized fleXIbly according to the research themes the students wish to study.

( 6) A recipient who has completed a specified course at the university concerned will be given a certificate. However, the purpose of this scholarship program is not to obtain a diploma. Therefore, a recipient cannot be emolled in an undergraduate course at a university or a master's or a doctorate course at a graduate school as a Japanese-government-sponsored international student during this program or right after its completion. (It is not either admitted for a recipient to enroll as privately financed students in an undergraduate course at a university or a master's degree or doctoral course at a graduate school. If the recipient should be enrolled in such a course, the recipient will be required to pay back the entire amount of the scholarship money retroactive to the start of the scholarship payment.)

3. TERM OF SCUOLARSHIP

The term is the period necessary to complete each university's training course and should be between October 2017 (or the starting month of the course) and March 2019. Extension of the tenn is not permitted.

2

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4. SCHOLARSHIP BENEFITS

(1) Allowance : 143.000 yen per month. (In case that the recipient researches in a designated region, 2,000 or 3,000 yen per month will be added. The monetary amount each year may be subject to change

· due to budgetary reasons.) Th!'! scholarship is cancelled in principle ifthe recipient is absent

from the university for an extended period. The scholarship will be also cancelled in principle in the following situations. If the recipient has been receiving the scholarship despite his/her falling

under any 9f the following situations, the recipient will be ordered to return the amount of

scholarship that he/she received during the period wherein he/she was involved with any of the following situations.

CD The recipient is judged to have made a false statement on his/her application;

® The recipient has violated any article ofhis/her pledge to the Minister ofEducation, Culture, Sports, Science and Technology;

® The recipient violates any Japanese laws and is sentenced to imprisonment with or without work for life or for a period of exceeding 1 year; © The recipient is subjected to disciplinary action by the university, including expulsion (The

scholarship payment may be stopped during the period up until punishment is decided by the university.); @ It has been detennined that it will be impossible for the recipient to complete the study course within the standard time period because of poor academic grades, suspension or absent from the university; @ The recipient's status has been changed into one other than "College Student'' as defined in the Appended Table I-4 of the Immigration Act;

('j) The recipient has received a scholarship from another institution (excluding those specified as

being for research expenditures).

(2) Transportation CD Transportation to Japan : The recipient will be provided an economy-class airplane ticket, according to

his/her itinerary and route as designated by MEXT, from the international airport

nearest to his/her home country residence*, where in principle is in the country of nationality, to the Narita International Airport or any other international airport that the appointed university usually uses when they enter to Japan. Expenses such as

inland transportation from his/her home address to the international airport. airport tax. airport usage fees, special taxes on travel, or inland transportation within Japan

including a connecting flight will NOT be covered. (*Although the address in the home country stated in the application form is in principle regarded as the recipient's "home country residence," if it will be changed at the time of leaving from his/her home country the changed address will be regarded as "home country

residence.") ® Transportation from Japan : The recipient who returns to his/her home country within the fixed period after

the expiration ofhis/her scholarship will be provided, upon application, with an

economy-class airplane ticket for travel from the Narita International Airport or any other international airport that the appointed university usually uses to the

international airport nearest to his/her home address, where in principle is in the

country of nationality.

(Note 1) Any aviation. and accident insurance to and from Japan shall be borne by the recipient. . (Note 2) Should the recipient not return to his/her home country soon after the end of the scholarship period

to resume his/her duties, the transportation fee for the return to the home country will not be

provided.

(3) Tuition and Other Fees: Fees for the entrance examination, matriculation and tuition at universities will be paid

by the Japanese Government.

3

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5. DOCUMENTS TO BE SUBMITTED

Applicants must submit the following documents together to Bureau of International Cooperation, Office of the Permanent Secretary, Ministry of Education in Thailand by the required date. The submitted documents will not be returned.

1 Application Form (prescribed form for 2017) 1 Original

2 Photographs 4.Sx3.5 cm (upper body, full-face with no hat) and must have been taken within the past 6 months 3 Original (~should be pasted on the application and admission forms)

3 Certified academic transcript from the last university attended 1 Original (issued by that university)

4 Diploma from the last university attended (issued by that university) 1 Copy

5 Translation of diploma (No.4) in English (issued by that university) 1 Original

6 Certificate of employment (issued by the present employer) 1 Original

*(Note 1) These documents must be written in Japanese or English, otherwise translations in either of these languages should be attached. *(Note 2) No application will be considered unless the application documents and all other necessary attached

documents are fully and correctly completed.

6. SELECTION

(1) ·The Embassy of Japan will carry out the primary selection of applicants by means of a review of the submitted documents, a written examination (subject: Japanese, English) and an interview. Note: In order to judge the level of language education needed for successful candidates after their arrival in Japan, written examinations in Japanese will be given for reference purposes at the time of the primary selection.

(2) Results of the primary selection will be notified on March 3, 2017. (3) Applicants who pass the primary selection will be recommended by the Embassy of Japan to MEXT. ( 4) MEXT will conduct the secondary (final) selection of the applicants recommended by the Embassy ofJapan

and determine the scholarship recipients. (5) Results of the secondary (final) selection will be notified on a date separately designated by the Embassy of

Japan.

7. NOTES

(1) The recipient is advised to learn, before departing for Japan, the Japanese language and to acquire some information about Japanese weather, climate, customs, and university education in Japan, as well as about the

difference between the Japanese legal system and that of his/her home country. (2) As the first installment of the scholarship payment cannot be provided immediately upon the recipient's arrival, the recipient should bring at least approximately US $2,000 or the equivalent thereof to cover immediate needs after

arrival in Japan. (3) Recipient must enroll in National Health Insurance (NHI) upon arrival in Japan.

( 4) Accommodations: CD Residence halls for international students provided by universities.

Some universities have residence halls for international students. The recipients enrolled at such universities may reside at these residence halls under certain conditions. However, due to the limited number of rooms,

some of these facilities may be unavailable. ® Private boarding houses or apartments:

Those who are unable to find accommodation in the aforementioned facilities may live in regular dormitories of

the university or in private boarding houses/apartments.

4

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(5) All expenses inctirred by the presence of dependents must be borne by the grantee. He/She is advised to take into consideration the various difficulties and great expense that will be involved in finding housing for them. Therefore, those who want to accompany their families are well advised to come alone first and let them come after suitable accommodation has been found.

(6) Information regarding the recipient (name, gender, birthdate, nationality, accepting university, graduate school/ undergraduate school, specialty, period of enrollment, career path after completion of course, contact information [ ad~ess, telephone number, e-mail address]) may b.e shared with relevant government organizations for the purpose of the use of the information in international student exchange programs (support during period of study, follow-up, improvement of the international student system) implemented by the Japanese Government. Information regarding the recipient other than date of birth and contact information may be opened to the public after study in Japan in order to introduce the activities of returning recipients around the world in materials produced by the Japanese Government as publicity for promoting the acceptance of international students in Japan. These matters are included in the Pledge stipulating rules and regulations which MEXT Scholarship recipients must comply with and submit when they have been granted the Scholarship. Excluding exceptional circumstances, only those concurring with these conditions will be accepted as MEXT Scholarship recipients and will be granted the Scholarship.

(7) More detailed information on this scholarship program is available at the Embassy of Japan.· (8) In addition to the regulations stipulated in the Application Guidelines, those that are necessary to implement the

MEXT Scholarship are determined by the Japanese government

8. REFERENCE

For application and information (~-:i1u~;Jm)

Bureau oflntemational Cooperation, Office of the Permanent Secretary, Ministry ofEducation

Tel. 0-2628-5646-7ext113 URL: http://www.bic.moe.go.th

For information in details (~'ilUtl1l..J~'Ell.Jft) . Japan Information Service Embassy of Japan 177 Witthayu Road, Lumpini Paturnwan, Bangkok 10330

Tel: 0-2696-3004, 0-2207-8504 (Ms. Supatra Pothong and Ms.Nuttawan Tanpaibule)

Office Hours: 09.00-12.00 I 13.30 - 16.30 (Monday- Friday)

Fax: 0-2207-8512 URL: http://www.th.emb-japan.go.jp

5

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APPLICATION FORM JAPANESE GOVERNMENT (MONBUKAGAKUSHO: MEXT) SCHOLARSHIP FOR 2017 (THAILAND)

TEACHER TRAINING STUDENTS

Registration No. 9J"" ~~~~~~~~ INSTRUCTIONS (rc.AJ:.(7)i'£ft)

1 . Type application if possible, or write in neatly by hand and in block letters. (ll!l~l.:rc..A T;:,.:: c.)

2. Use Arabic numerals. (lt~l±'.lfJll~~~ Jllv'-0.:: c .)

3 . Write years in the Anno Domini system. (~%1:l:T" .. Ci!9M c T-0.:: b.l

4 . Write proper nouns in full, without abbreviation. (lifil:tf;f,l~l±T~-C:iEi\:ft;f,f#Fc L., -W=i!I~ L.ftv'.:: !:.)

* Personal data entered in this application will only be used for scholarship selection purposes, and contact information such as email addresses will only be used to· form academic networks after the student returns home and by the Japanese government to send out information as needed.

(;;j>:Jti~•1.:rc.tiG ~tl,f;::fl.A.!A'f&l.:-:>v '-C l:l:, ;;$:~$~(7)~~(7.)f;:: !bl.:i!JllT;:, IitJ•l:l:, '1;¥1.: email 7!'v:A'1i?C1)jfiil}1t;l.:-:>v '-Cl:l:, ~§1lli;l.::talt M!lf**C7)*:;tr'7-::7~tf-'5.::c&11~,~1.:,r,i:.13 *i!:lcJl'if J:1J~fltlW~i!i!T'::if.l~l.:1±~fllLftv'. l

1 . Name in full, in native language (tt<i\ ( 13 OOi!t)

(Surname) (tt) (Given name) (;f,) (Middle name) ( ~ ~ • ."4-1)

In Capital English alphabet (7 ;v7 7 '°' :;t r::kJ'C~)

(Surname) (Jl<j;) (Given name) (;f,) (Middle name) (~ V .q.-.i.)

liEPiease write your name exactly as it appears in your passport. (i,ll I) fj:/ ~.A ;!{- r (7.)~~c ~-1.:T;:,.:: c)

2. Sex (Ml) 3. Marital Status (~111~)

OMale (~) OFemale (fr:) OSingle (~:!lf) DMarried C.retM1)

4-1. Nationality (!Eli) 4-2. Do you have Japanese nationality? ( 13 ;;j>:!Eff(7):fj~)

OYes (l:l:i,')

5. Dateofbirthandageas of Aprill, 2017(1:4'Jl 13&112017if4Jl 1 f3!JUEC7)ipilf;)

19 Age

Month (Jl) Day 03) Year (4') (iflif;)

6. Current Employment status C!ltm(7):ti<::&) (l)Your status/ occupation and position (~ • :jjt~)

Name of the institution where you are employed (i!J~;it;) :

(2) Present type of work (Describe teaching subjects or work duties. liEUniversity faculty members are ineligible to apply. )

(lJl.J'£UJUl~f"l~ (~~HlJU;t, ll~UJP'l11/'.l:::-:>~'°t"•< ~ t. *:k$11)~Jll;tlflfn-r~tt~'. ) )

.... --- -- --- -- --- ---- -- -----. Paste your photograph (or

insert digital image) taken

within the past 6 months.

Write your name and

nationality in block letters

on the back of the photo.

(4.5cmX3.5cm in size)

(:!j:JJ; (4. 5X3. 5 cm))

7. Current address, telephone/facsimile number, and email address (~{±ffl'RU:ili!M1!=%, 77 ~ ::7 .Ailf%lilU: email 7 l'"v.A)

Current address (:g!,{$_ffl) :

Telephone/facsimile number ('ilt~-1}/FAX #%) Mobile phone :

Email address:

*If possible, write an email address that can be used before, during and alter your stay in Japan. (PT~tt~ll IJ, lll B iitr- B ;;$:i;''.'jtcp~~001&1.:bf;:: IJ ~~'~It

;:,.:_C;>li'f:tB~ho email 7 l'"v.A~!C.AT-0.::c.l

-1-

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8. Have you graduated from a university or a teacher's college? C:k•-:t tclill!j:Ja4P.t~&:a:-2f5.~ L T~'-0 "/J>.)

DY es, I have. (Iii,') ;:!{Please submit certificate of graduation. ($.~ffi.!Yl1F:a:-t'Hl:li- -0:: C:.)

ONo, I have not. (i,'i,';t) _,You are NOT eligible to apply.

9. Are you currently a teacher at a primary or a Secondary school or a teacher_ at teacher's college (excluding universities) in your home country?

(!3000).fJJ~, tp~~ili'JlMO)~Q\O)~-~ .. :ttcli~JHbt•& (:k~Hio O)f<A"'t'<boil>.)

DYes, I am. (liH

ONo, I am not. (i,'i,';t) ->You are NOT eligible to apply.

?.:<Please submit a certificate of employment. (:t:E~fil!Yl:m=:a:-~1l:li"" o:: C:.)

10. Do you have a total of over five years of teaching/ school administrating eXPerience at your current. job as of April l, 2017. (2017 ~ 4 A 1 13 mt£-e:iii'.)J 5 iF i;J.J:.QJm4&:flt • •&1UUHf(zi! <b o "/J>.)

OYes, I do. (liH ONo, I do not . (1,'1,';t) --> If not, you are NOT eligible to apply.

11. Other scholarship(s) (i!E.QJ~~3?i:)

(!)Have you been awarded any Japanese Government (MEXT) Scholarship in the past? Those who have received this scholarship in the past are ineligible. (~:l<l;:i!J

•71-ooA••~~•mah~::e:~~-o~ ~~-~$~00•71-ooA••~e:L-camah~~~·~~~~·~l

ONo, I have not. ("'"'*-) PYes, I have. (Iii,\) ->You are NOT eligible to apply.

?.Elf you are unsure whether a scholarship you received in the past corresponds to a MEXT Scholarship, please consult with the Japane_se embassy or consulates in your

country beforehand. (~~l;:~tfi Lf::~•'li:"/Ji:SC'ifllfit.¥:1li'~'"f~l;:~~~T o il>i§tp::f:IYJO).t;{?Jli¥:Jliil;:t£7'1-~!itl;:tll~T o:: C:.)

(2) Are you applying for any other scholarships (Research Student Program, etc.) from Japanese Government (MEXT)? It is not permitted to apply for other Japanese

government (MEXT) Scholarships. (ftll.(1) 13 ;$:~H? (::Jz:'ifllfil-•1!1) ~'.'¥=1ti: (ilf~'m''.'¥=~~) l;:fJt-lli L n 'oil'. /jgO) 13 ;$:~}ff (::Jz:l'mfit.$:1!1) '!l!$:1!l c O)#t

Bli~6'.>t:.ht.n'.)

ONo, I am not.

OYes, I am. (l:H') ->You are NOT eligible to apply.

(3) Are you receiving or planning to receive a scholarship from an organization other than that of the Japanese Government (MEXT) (including an organization of your

home country government) that overlaps with the MEXT Scholarship? (;$:$tl.!tl::. J:: o~'.'¥=~ C: :ill:fi L. 13 ;$:~K-l' (::Jz:'ifllfil-•1!1l J;(~0)1l!ili!I ( 13 00~,lf;jt!iM:a:--E;t:J)

t.Pt:.~'.'¥=1ti:~H:'.'ll:~L-n'olitHi~~:a:-"fJE L T•'oil'ol

ONo, I am not. ("'"'*-l OYes, I am. (l:l:H -+Describe the scholarship(~~{?i:O)~~)

~:(If accepted for this MEXT Scholarship, you have to decline the above-described scholarship.

12. Do you have any intentions of immediately returning to your country upon completing the program and resuming to work, and utilizing the fruits of your research

OYes. (fil, ')

ONo. (i,'i,';t) -You are NOT eligible to apply.

13. PaSt field of specialized study in a university or teacher training school (Be as specific as possible.)

(:k~:Xli@'.~4.6.t~"'t'~LJ'tl~Jr~?t!T ("'t'~-OfcitJl.f4'(l(Jl::.1F<;::, !::.))

-2-

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14. Academic Background: ($~)

' Diploma or Degree Awarded, ' Year and Month of Duration of ' Name and Address of School : Major Subject, Skipped Years/Levels ' c+&,g&v:mf£±l!ll

Entrance and Completion Attendance ' C+m·1H~· ' (.A"t&V:lf:~'FJl) C*+<Fti:l ' il>V~ Fl • illr~~<l)ftilll ' •Name 'From . yrs

Primary Education c+&,gJ (}\$)

(VJ~~-) . {'F)

and Elementary School

Location To (114~&)

mans

(ffl'f£!1l!) : (lf:~) (Jl)

Name From yrs

Lower Secondary ($&,g) (]\$) ('F)

Education and

(iili:Jlll cp ~ti1f) Location To mons

' (f.Ji'f£!1l!) (lf:*) (Jl)

Upper Secondary ' Name : From yrs '

Education ' <+&,g) ' (]\$) ('F) ' '

{~PJ!cp~~-) ' and ' High School Location : To mons

{f.Ji'f£it!l) ' (2f:;i) (ilti&l ' (Jl) ' ' ' Name 'From yrs

Undergraduate ' <+&,g) (]\$) ('F) G.P.A.

(;k"t) : and : Bachelor's Degree : Location To mans

(f.Ji'ffit!l) (~) (Jl)

Name From yrs

Graduate ($&,g) (]\$) ('F)

(:;k~~) and

Master's Degree Location To mans ' ' '

(f.Ji'ffit!l) (f~7) (Jl)

Notes: 1. Exclude kindergarten education and nursery school education. (j;lifJtlll · i*W"ffi~l!'l:l:-2;;!::/1,t,n\)

2. Preparatory education for university admission is included in secondary education. (~ 'V!Po r :k¥7llli~1! J li~WJcp~~1f 1;::"2;";!::(Lo .)

3 . If the applicant has .passed the university entrance qualification examination, indicate this in the column with "*-!." ( r :k"t.A'ti!H~~~U 1;:: .g.~ l., c ~'

0J.1~1;::1:t-t:C7J'IH.· *-1 ™';::JC}\ To:: c.) 4 . Any school years or levels skipped should be indicated in the fourth column (Diploma or Degree Awarded, Major Subject, Skipped Years/Levels).

(Example: Graduated high school in 2 years.) (~':bl<J>o rjRV:i&J :a-1., c~'o~1;::1t, -!:<l)~:a-~'43Tollt1i~tt<l) r+& · )!{~ • W*~§

1iW@<l):tl\i£J lii!l;::1C.A To:: c. (fY!Jl i9i& 3 'F~HWl&l;::J: ~ 3!1Wl¥:¥J

5. If you attended multiple schools at the same level of education due to moving house or college readmission, please indicate the schools in the same column

and include the number of years of study and the status of study at each school. ( tff,5-<l)~f,Z;~:;k:¥;<7Jflj:}\"t~~~ai I;::, liil~1f~ftl'fJI!l:<7J$&

1;::t£ff 1., c~'tc!iHl'li, iPl t:.lii11;::.fJti:C1J~&C7Jf£tiHctlt t.,, T-"c<7Jf~~:tl\i51.H$~<F~::i;::"2;"1ho::. c.J

15. Employment record as teachers at pijmary, secondary educational institutions or teacher training schools (excluding universities) : Begin with the most recent

employment. CW~. 9'~~W"UiM<l)ilO~&U:M4P.X:~ (#~H?<O <7J~Jil.c t.,-C<7Jti/!f: ~Qiil>~E~.)

Name and location of organization Period of employment Position Type of work

(iil.J~;t;& Uf.Ji':f£i1!!) <lll~Wlr.iJ Month/Year (~Ui::l'i) CUH9if'l$)

from

to Present

from

to

from

to

-- Years('F) -- Months(Jl) *as of April I, 2017 (2017 4'- 4 Jl I 13 '!l!.tE) Total period of employment

l*Persons with less than five years of experience are be!igible to apply. GUJ:f£QUt,11r.il

(5 "!'IC~tt.t~"fl'l°.tlflm"l'~ t.t~'.)

-3-

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16. State the titles or subjects of books and papers (including graduation theses) authored by applicant, if any, with the name, address of publisher and the date of

publication. <~Hf, »x C¥~arrx:a::-2itr.):Oicbhl'!·h'Jl'!4;, tfl!t&.tt~, tfl!t&.if.Jl s, tfl!t&.JJ!m:a::ta.AT"o.:c.l

Book/ Article/ Theses Title

("~ /~ii.Jt) (J!<t)

17. Japanese language background, if any ( S *11iCO!!f!'l1/ Ill) (1) Name of institution(s)

Address (!±ml

(2) Period of study

<~~wir.ii

18. Language ability (~"¥'JJ)

from

Year (if-) Month (Jl )

Publisher Date of publication

(tf:lJtH±l (lfjil§:if-Jl 13)

to

Year (if-) Month (Jl)

Evaluate your ability as "Excellent, " "Good," or "Poor" in the blanks. (§ C.~iil!il7)? *-.II!, .ll! .. ;;i:;:or:a:: l:, ".:>-Crc.A To.: c.)

Reading Writing Speaking

(ii'ttrlmJJ) <•< lmJJ) (~TlmJJl

Japanese

(13*~)

English

(~i!)

Other{ )

RCl)lihl

19. University and teaching field(s) of specialty to which you wish to attend (~:mT o 7c"¥'lft.. V:?t'f)

Place of publication

(tfjll§:~ffi)

Years (if.rm

Listening

<e<tmJJl

Please choose three universities at most and teaching field(s) of the specialty you wish to attend from those listed in the"Course Guide" from the Embassy of Japan webpage . (http://www.mext.go.jp/component/a_menu/education/detail/ _icsfiles/afieldfile/2016/12/12/1379317_8.pdf) and fill it in order of preferer,ce.

:>.<Make sure in advance that your selected teaching field(s) can be provided at the university that you want to attend.

(f:>-;x.ff--< rJ il'~*~"to:k~&V'?tl!fa-i9dc a -:>:l:\.'~V'. ?t'l!fl.:-:>~·-c1:t1f;~-t-o::k$\.'~~i>n-c~'of'l~"t'6:Jo.:: c a-•ilii1.:~-t-o.:: c. l

First choice (~ 1 ~~)

Name of university (;k~qs) Teaching field (?t!lf)

Second choice <:m 2 *~)

Name of university (;le~~) Teaching field (?t!lfl

Third choice

Name of university (;k~qs) Teaching field (?ti!')

-4-

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20. Proposed research plan in Japan ( J:i *"l'QJli1f~ttiii)

In more than 300 words, state the outline of your major field of study and research plan. Your statement must be typewritten or written in block letters.

This section will be used as one of the most important references for selection. Additional sheets of paper may be attached ifnecassary.

:::O)GJf:rettii!iltiiit~UJJtl{t1.#:l>..!: tto(f)<:, iJl~Hii!li~ 300 ~~J:<:11"*111;::c.A -to::: 1:: . IC..AI±~ 1' ::t:i<1±a:t::1;:J: :o t, 0) 1:: t.,£-~t1.;a,g.tiM*~if!JJo \..,-rt J: P ,

~Selected universities and fields on page 4 (no. 19). should be related to your research plan

"!t::. , i!Ga:ll;"il'i'mifl;:JC~T :O:lf;i!:k~&TJ:$1Jfl"1*GJ13l::tll!li I:: Mi!-? ltt::.P'l~l::T :0::: I::.

Research Theme (ilf~7--~') :

(for example, Teaching Mathematics)

Proposed. study program in details (in more than 300 words)

Note: !. It would be advised that your research plan should relate with your field of teaching and academic background.

2. Those who desire multiple research topics may indicate as many as two research plans. If you do so, please indicate them clearly by itemizing such selections. (Example: If you select mathematics education research as your first choice and scientilic education research as your second, you may indicate their respective research plans in this column/space. In doing so, be certain to select a university/teaching field from the "Course Guide" that offers the mathematics and science education research training program that you desire .)

3. "Course Guide" is available on the Embassy of Japan webpage. http://www.mext.go.jp/ component/ 8.JJlenu/ education/ detail/ _icsFiles/ afieldfile/2016/12/12/13 79317 J!.pdf

-5-

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21. Emergency Contact in home country (Jlt00(7)~~l!l!11!1%)

(1 Name in full (a;,g) :

(2) Current Address(Jj/,j±ffl') :

(3) Telephone/ Mobile phone (1U~#% /~1!HlaM!i'%) :

(4 Email address:

(5) Occu ation (Qi~) :

(6) Relationship to applicant (;;j;::)\.c(7)r;:){,!/;) :

l understand and accept all the matters stated in the Application Guideline for Japanese Government (MEXT) Scholarship (Teacher

Training Students) for 2017 and hereby appl}:' for this scholarship.

(f.M;t 2017 ~~ f:l :<$:if;lcffef ()(JWf.+$~') ~$::il:fR$1:.~$~:tJW:~t\!~h-C1t'o:iJ!Ji~T-" .. CH¥ L-C$~~ L ;l;-t")

Applicant's signature : <Ellm1·1i-~l

Applicant's name (in capital English alphabet) : CEl':.:lfa:~J

Date of application : (E!ll#i!"Jl l'l)

year(~) month(Jl)

*tr·nJrnmn1fh~~ln.h~mm11HJlJfl"'i* ~1-.ltl-.lmn Application Guideline 11ii1 4

(1cinm1tJm:1u1-.l~ci-.l1iJ'U.n11:116-.lntJ1Hn1i1'U)

-6-

date ( 13)

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FOR APPLICANT'S USE

AD1\1ISSION FORM JAPANESE GOVERNMENT (MONBUKAGAKUSHQ: MExT,l SCHOLARSHIP FOR 2017

TEACHER TRAINING STUDENTS

Registration No. -=T_-____ _

Full name in Roman block capitals and native language

Paste your passport

photograph taken within the (Family Name) (First Name)

last 6 months. Write your ·

name and nationality in block

~fl) letters on the back oft.he

photo.

•:• Examination schedule : 4 February 2017 (Sat) (Photo size 4.5 x 3.5 an)

Time Subject

09:00 - 10:00 English

10:00 - 12:00 Japanese*

•:• All applicants must sit for Japanese Language test. The score is for reference only.

•:• Applicant has to bring this admission form and display it on the desk in the examination room. Those who fail to bring this form will not be allowed to enter the examination room.

•:• Dictionaries, books, mobile phone, smart watch and etc., are not allowed in the examination room.

AD1\1ISSION FORM JAPANESE GOVERNMENT (MONBUKAGAKUSHO: MEXTI SCHOLARSIDP FOR 2017

TEACHER TRAINING STUDENTS

Registration No. -=T'---------

Full name in Roman block capitals and native language

Paste your passport

photograph taken within the

(Family Name) (First Name) last 6 months. Write your

name and nationality in block

~fl) letters on the back of the

photo.

(Photo size 4.5 x 3.5 an)

FOR EMBASSY'S USE