日本政府(文部科学省)奨学金留学生申请书

1、application for japanese government （monbukagakusho:mext）scholarship©本致炳（殳部网歹坯）奨歹含忽歹隹申请書college of technology students for 2010 （爲等専 学楼 笔学住）instructions（之入 e g）注总）1 . the application should be typed if possible, or neatly handwritten in block letters.（収隙（二 d 乙入 -6 cl ）2 numbers should be in ara

2、bic numerals.（疑字止录做夕总用-、召二匕）3 year should be written using the anno domini system（年君® h cl h o ）4 proper nouns should be written in full, and not abbreviated（矚有 2 询总八2 式看：2看= 1、一仞殆竭 j勺;匕）探 personal data entered in this application will only be used for scholarship selection purposes, and contac

3、t information such as e-mail addresses will only be used for forming related human networks after the student returns home and for sending information by the japanese governmenl（本申诵靱二id敎引la：侦心径韓本奨孝金還君亡纵二僵'矿力、ct、報 e-mail tty 等連絡先lx'v仏 帰国後131抑巾関係者。坯滋r作匕及“匕耍広応15日木政府列各種情報总送信护5以外求使川u、。）1 name in

4、full. in your native language（sex）（於2 （仓®舄）9male （男）（family name/surname）（l?irsl name）（middle name）female （ 4 ）in roman block capitals（口一k）（marital status）（family name/surname）（first name）（middle name）single （未尿）married（fili）2 nationality （）3 date of birlhd 4/）0）19ageyear （年） month （ 0 ） day （

5、0 ）（年齢）號 of april lt 2010（2010 4 4 /） 1 0）4 present address and teleph one nu mber. lacsimile number, e-maii address（观住斫鯨/理诚、j w入*慕e-mail 7 k u x ）present addressf 鲍俘所）telephone/facsimile number 耄祈* 禺 /fax 爭电）paste a passport sized photograph taken within the past 6 months write your name and nation

6、ality in block letters on the back of the photo.（4,5 x 3.5 cm photo）；jg e （4.5cmx3,5cm）e-mail address（if possible, write an e-mail address where you can be contacted for periods that in elude the time before you come to japan, your stay in japan and the period after you return home.（可從 ?阻9、诡 0 甸 q 本

7、笔于令 帰9 ®、統力 孑傀.e-mail t k ud h o ）5 chosen field of study in japan （ 0 本杀甲曹疋分好）bom “majors “nd rclalcd key tcnns br fields of suidf （塚 § 分野（二関目壬为:再門* 勺等力'5 選乙入刁二 上）first choice （爼 1 笫空）majors and related key terms （主玄専門項目等）second choice （第 2 殆空）third choice （第 3 殆空）6 field of study you

8、 specialized in at high school or university （遏农 45 範 lzz；忘他文$ 尢学疋w）専论分谿）7 present, status （with name of school attending or employer）（现忌0）© 分）student : name of school（滋爹申0）老）（滋範営他纟厂ingrade / will graduate in（农歹年次）（车咯见込年月）yearmonththose in employment： name of employer （我労希）（勒務先）8 educational ba

9、ckground:（歹歴）name and address of school（歹絵2所右他）year and 4onth of entrance and completion （入歹2（/卒龙年月）period of schooling you have attended （付哮年）diploma or degree awarded, major subject（于化资稔野论初0 ）elementary educationname（学垃2）from（入歹）years（4）（初等炙盲）elernentarf school（j歹位）locatio n（伺&处）to（辛黄）and mont

10、hs （月）secondary educationname（歹检名）prom（入歹）years（4）（扌等嶷直）lower secondary school（申于）location（陌&地）to（）and months （月）name（孝楼名）from（入孝）years（年）upper secondary school久nrl（爲儘）locatio n（所r比）to（卒営）aiiu months （月）1 ligher educationname（学他g）from（入歹）years（4）八（名等糸育）undergraduate levellocationtoandmonths1）2）（

11、尢歹）（所农处）（）（r ）3total of the years schooling mentioned above （以e总逼全歹儘炙育付歹年救） ?s of april 1, 2010（2010 4 4/）10 爼农）yearsand monthsnotes: 1 exclude kindergarten education or nursery school education.（幼證圍倍育两炙育（含蒸才 1卞7。）2 include preparatory education for university admission in "secondary education”

12、. （l、才 尢李多倦礙*（止中等热疽 c 二令担 ld ）3 . the applicant who has more than one major at his/her university should list all majors in the blank space with * （ 41 濮（7）分总専cl曹玫分时总全疋機二祀入-亍召二七。）9 employment record: begin with the most recent employment excluding part-time jobs, if applicable（灘歴； 7"f 卜。）name a

13、nd location oforganimlion （粉務克所农处）period of employment（劭務朝）position（役蹴2 ）type of work（餓務内甥）fromto1o language proficiency:（盘 学力）（1） evaluate your ability as uexcellent "good", or "poor" in the blank space.（f） 価ghn俊、电、不可总右。疋力入）reading （読t?能力）writing（g 能力）speaking（杨能力）japanese （0本请）

14、english （疑駡）french（77”"）olhers（）（乞7）他）11. japanese language background, if any.（ 0 本请（7）纟夥歴）i ） name and address of institution（唇習娥関名氏a ）ii） period of study（歹響创間fromyeari 4） month（ f）year（年month （/）years（年觴）12. reasons for majoring in the field of study described in item 5. describe the reasons

15、 respectively in detail.<r 5co申兔分眄总箱空丁召理q 各（二二疋翼体的c二祀入召二七）13. what kind of field are you planning to study in japan?（0 本間总苒力、）1 厶.what kind of impression do you have of japan?（本卸兔总捋力、）15. description of desired employment to be taken up after returning home. （帰掘（二殆空丁召腿茎）16. ierson to be notified

16、in applicant's home country. in case oemergency:i ） name in lull:（保名）ii ） address with telephone number, fecsirnilc number, e-mail address（g 两；窓祈* 圣、7 7 -7 x. -2 i e-mail 7 k uo ）present address（现.g 伺）telephone/facsimile numberi 電诉备电 /fax 备-£ ）e-mail addressiii ） occupation:（蹴 g）iv ） relati on ship with the applicant:（本関 ）i7mmigration records to japan （ 0 本八“0滾就祀錄）begin with the most recent travel to japandate （ t）臼）purpose （0 的）fromtofromto18.（h本国籍总有炀力、）i ） yes, i have.（"）ii） no, l have not.（v 必v、）i understand and accept all the matters stated in the ap