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    2012 Form (Komai Fellowship)

    Uploaded by

    Ikhsan Hafats
    This document is an application form for the Hitachi Scholarship Foundation's Komai Fellowship. It requests information such as the applicant's name, nationality, date of birth, contact details, current position and department, proposed research place and period in Japan, Japanese host scientist details, educational background, language abilities, research experience, publications, proposed research plan and goals, other fellowship applications, and details of any dependents accompanying the applicant. The form is used to evaluate applicants for the Komai Fellowship award.

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    Attribution Non-Commercial (BY-NC)
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    2012 Form (Komai Fellowship)

    Uploaded by

    Ikhsan Hafats
    40 views3 pages
    This document is an application form for the Hitachi Scholarship Foundation's Komai Fellowship. It requests information such as the applicant's name, nationality, date of birth, contact details, current position and department, proposed research place and period in Japan, Japanese host scientist details, educational background, language abilities, research experience, publications, proposed research plan and goals, other fellowship applications, and details of any dependents accompanying the applicant. The form is used to evaluate applicants for the Komai Fellowship award.

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    This document is an application form for the Hitachi Scholarship Foundation's Komai Fellowship. It requests information such as the applicant's name, nationality, date of birth, contact details, current position and department, proposed research place and period in Japan, Japanese host scientist details, educational background, language abilities, research experience, publications, proposed research plan and goals, other fellowship applications, and details of any dependents accompanying the applicant. The form is used to evaluate applicants for the Komai Fellowship award.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    40 views3 pages

    2012 Form (Komai Fellowship)

    Uploaded by

    Ikhsan Hafats
    This document is an application form for the Hitachi Scholarship Foundation's Komai Fellowship. It requests information such as the applicant's name, nationality, date of birth, contact details, current position and department, proposed research place and period in Japan, Japanese host scientist details, educational background, language abilities, research experience, publications, proposed research plan and goals, other fellowship applications, and details of any dependents accompanying the applicant. The form is used to evaluate applicants for the Komai Fellowship award.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    of 3

    THE HITACHI SCHOLARSHIP FOUNDATION

    APPLICATION FORM FOR KOMAI FELLOWSHIP


    Name:
    (Family Name) (First Name) (Middle Name)

    Nationality: Date of Birth:

    Age:
    (Year) (Month) (Day)

    Sex (circle): Marital Status (circle):

    Male or Single or

    Female Married

    Current Title/Position in University: Department/ Faculty: Address (University): Home Address: TEL:
    (Office) (Mobile Phone)

    FAX:
    (Office)

    E-Mail Address:

    Contact in case of Emergency Name & Relation: TEL/FAX/E-Mail: Proposal on Fellowship Place of Research: Period: From
    (Year) (Month) (Day)

    To
    (Year) (Month) (Day)

    Japanese Host Scientist Name: Title or Position: Institute: E-Mail Address: Reason for Proposal

    Relation with Proposed Host Scientist

    Educational Background Name of School Place/Country

    Degree

    Year

    Field

    Financed by

    2012 KOMAI FELLOWSHIP

    Honors Awarded: Language Ability 1. Please evaluate your language ability by Excellent, Good, Fair or Poor. Reading Writing Listening Speaking English Japanese 2. Please describe how long and where you have studied English and Japanese. Institute Location Period English Japanese 3. Please describe your score if you have taken the Test of English as a Foreign Language (TOEFL) or similar test. Score: When: (Year) (Month) Record of Past Entry into / Stay in Japan No. of Times Former Stay in Japan Location Period (YY/MM YY/MM)

    Work Experience School/Institution


    (Location)

    Period
    (YY/MM YY/MM)

    Position

    Type of Work

    Field of Specialization Outline of Current Research Title: Contents

    THE HITACHI SCHOLARSHIP FOUNDATION

    Major Publication: Please attach the list. Proposed Research Plan in Japan (Please attach a proposed schedule as well.) Title: Summary

    Goal and Significance of Proposed Research

    Are you applying for any fellowship other than Komai Fellowship? If yes, please indicate to which fellowship the application has been made.

    Are you planning to be accompanied by any dependent? If yes, please indicate their names and relationship. Name (Family/First/Middle) Relation

    Date: Signature:

    2012 KOMAI FELLOWSHIP

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