8/14/2019 Application Gakubu
1/4
APPLICATION FOR JAPANESE GOVERNMENT
MONBUKAGAKUSHO:MEXT)SCHOLARSHIP
Undergraduate Students for 2010
INSTRUCTIONS
The application should be typed if possible, or neatly
handwritten in block letters.
Numbers should be in Arabic numerals.
Year should be written using the Anno Domini system. )
Proper nouns should be written in full, and not abbreviated.
)
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 information by the Japanese Government.
E-mail
Name in full, in your native language (Sex)
Male
(Family name/Surname) (First name) (Middle name) Female
In Roman block capitals
(Marital Status)
(Family name/Surname) (First name) (Middle name) Single
Married( )
Nationality
Date of birth(
19 Age
Year Month Day as of April 1, 2010 2010
Present address and telephone number, facsimile number, e-mail
address
E-mail Present address(
Telephone/Facsimile number( /FAX
E-mail address
If possible, write an e-mail address where you can be contacted
for periods that include the time before you come to Japan,
your stay in Japan and the period after you return home.
E-mail
Chosen field of study in Japan
Select from 1.FIELDS OF STUDY in Application booklet.
First Choice
Second Choice
Paste a passport sized
photograph taken
within the past 6
months. Write your
name and nationality
in block letters on the
back of the photo.
4.5 x 3.5 cm photo
( (4.5cm3.5cm))
1
8/14/2019 Application Gakubu
3/4
FromTo
10 Language proficiency:
(1 ) Evaluate your ability as Excellent", Good", or Poor" in the
blank space.
Reading Writing Speaking
Japanese
English
French
Others( )( )
11. Japanese language background, if any.( )
) Name and address of institution
( )
) Period of study
( ) from to
Year( ) Month( ) Year( ) Month( ) Years( )
12 Reasons for majoring in the field of study described in item
5. *Describe the reasons respectively in detail
( )
13 What kind of field are you planning to study in Japan?
( )
14. What kind of impression do you have of Japan?
15 Description of desired employment to be taken up after
returning home.
( )
8/14/2019 Application Gakubu
4/4
16. Person to be notified in applicant's home country, in case
of emergency:
( )
Name in full:
Address with telephone number, facsimile number, e-mail
address
E-mail )
Present Address(
Telephone/Facsimile number( /FAX
E-mail address
Occupation:
Relationship with the applicant:
17.Immigration Records to Japan Begin with the most recent
travel to Japan
Date Purpose
From
To
From
To
18.
) Yes, I have.
) No, I have not.
I understand and accept all the matters stated in the
Application for Japanese Government (MONBUKAGAKUSHO:MEXT)
Scholarship
for 2010, and hereby apply for this scholarship.
2010
Date of application:
Applicant's signature:
Applicant's name
in Roman block capitals
