မူရင္းကိုေဒနားမွာ လားဗ်ာလ္ ေဒါင္းလုိက္ပါ ထိုင္းပိုင္ တစ္မ်ိဳး အဂၤလိပ္ပိုင္ တစ္ဖံုပါလာပါလိမ့္မယ္ ၾကိဳက္ေစာ္ကိုရာ ေဂါင္းလုိက္ပါဖိ
ေဒခ်င့္ေစာ္ Nikon-Chulalongkorn Scholarship 2012 က ပီးေစာ္ၿဖစ္ပါေရ။
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APPLICATION FORM NIKON-CHULALONGKORN SCHOLARSHIP 2012
1. Personal Information
Name (Mr./Ms./Mrs.) Last Name
Nationality: Marital Status q Male q Female
Date of Birth (dd/mm/yy) Place of Birth Age
Present Address:
Permanent Address (if different):
Telephone Fax
Mobile Phone E-mail
q Studying at
Degree/Major
Expected Graduation Date (dd/mm/yy)
q Employing at
Position
Date of Employment (dd/mm/yy)
2. Academic Qualifications
List of all secondary schools, colleges, universities and professional schools attended, starting from the most recent.
| Institution | Location | Dates Attended From/To | Degree /GPA or Score | Field of Study |
| | | | | |
| | | | | |
| | | | | |
3. Academic honours, awards, prizes or other academic recognition received.
4. Language Proficiency
| Foreign Language | Listening | Reading | Speaking | Writing | Qualification/Level/Score & Date Received (if any) |
| | | | | | |
| | | | | | |
| | | | | | |
| | | | | | |
5. Employment/Training Records
List of all employment and training, starting from the most recent.
| Organization /Location | Position Held | Dates Employed/Trained (From/To) |
| | | |
| | | |
| | | |
6. Extra circular and community activities, including any positions held and honors or
awards received, in order of importance to you
awards received, in order of importance to you
7. Desired University in Japan
State your reasons:
8. Proposed study program / subject of research (State your reasons; also indicate your research performance and capability. Use not more than one additional page, if required)
9. Personal Statement (Including your reason to apply for the scholarship and the plan after completing the study in Japan. Use not more than one additional page, if required)
10. Reference (who issues the letter of recommendation for the applicant)
Name Position
Affiliation
Address
Telephone E-mail
Relationship to the applicant
11. Attachments q Recommendation Letter
q Academic Records / Transcript
q Copy of Language Qualification (such as TOEFL, IELTS, if any)
q
I declare that the information given forth in this application (including attachments) is true, complete and accurate.
Applicant Signature Date
Filled application form and all attachments must reach
the Office of International Affairs, Chulalongkorn University by 7 June 2012
the Office of International Affairs, Chulalongkorn University by 7 June 2012