Social Science

Application Form [UNDERGRADUATE 2013]

Natural Science A (Physics)

Natural Science B (Biology)

APPLICATION FOR JAPANESE GOVERNMENT (MONBUKAGAKUSHO) SCHOLARSHIP 2013

Undergraduate Students
INSTRUCTIONS
1. The application should be typewritten if possible, or neatly hand-written in block letters.
2. Numbers should be in Arabic figures.
3. Year should be written in the Anno Domini system.
4. Proper nouns should be written in full, and not abbreviated.
5. Use our format to help to speed-up the short-listing process.

(Sex)
Male
Female

1. Name in full, in native language _____________,_____________ __________

(Family name)
(First name)
(Middle name)

In Roman block capitals _______________, ____________ _____________

(Family name)
(First name)
(Middle name)
Nationality
________________________

3.

Date of birth

Single
Married

Japanese nationality
Yes
No

19_____________________________________________________
(Year)

4.

2.2

(Marital Status)

(Month)

(Day)

(Age)

Present status with the name of the school attended, or of employer

_________________________________________________________________

Present address and telephone number, facsimile number, e-mail address

_______________________________________________________________________________
_______________________________________________________________________________

6. Chosen field of study in Japan

First Priority

_________________

Second Priority

_________________

Third Priority

_________________

7. Field of study specialized in the past at your high school or university

____________________________________________________________________________

8. Education background
Name and Address
of School

Name

Year
and
Month
of
Entrance
and
Completion
From

Location

To

Elementary
Education

Lower

Certificate/
Degree

Major
subject

yrs
and
mths

Elementary School

Secondary
Education

Period
of
schooling
attended

Name

From

Location

To

yrs
and
mths

Secondary
School
Upper

Name

From

Location

To

yrs

*-1

and
mths
*-2
Higher
Education

Name

From

yrs
1)________
and

Undergraduate
Level

Location

2)________

To
mths

3)________
Total
years
of
mentioned above

schooling

as

yrs
and
mths

Notes:
i.

Exclude kindergarten education, nursery school education or remove classes (for

secondary school education).

ii.

Include preparatory education for university admission in secondary education.

iii.

If the applicant has passed the qualifying examination to a university, indicate this in the
blank with * - 1.

iv.

The applicant who has more than one major at his/her university should list all the majors,
including minors, in the blank with * - 2.

v.

For the certificate/degree column, please indicate UPSR, PMR, SPM, STPM or A-Level,
etc. accordingly.

9. Reasons for majoring in the field of study described in item 6.

___________________________________________________________________________
___________________________________________________________________________
10. Description of desired employment to be taken up after returning home.
___________________________________________________________________________
___________________________________________________________________________
11. Person to be notified in applicants home country, in case of emergency:
i)

Name in full: ______________________________________________________

ii)

Address: with telephone number, facsimile number, e-mail address

__________________________________________________________________
__________________________________________________________________

iii)

Occupation:
_____________________________________________________________________

iv)

Relationship to applicant:
Date of application :

Applicants signature :
_________________________________
Applicants name
(in Roman block capitals) :
__________________________________
===========================================================
Have you learnt Japanese Language before?

Yes

No

Name of Institute: _______________________________________

If you are called to sit for the written examination held by the Embassy, do you want to sit
for the Japanese language paper (optional)?

Yes
Note:

No

Please read our guidelines carefully. Do not leave any column blank, if
you do so, your application will strictly NOT be considered.