Scholarship Survey For Use by Students Studying Abroad at Konan University

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Survey For Use by Students Studying Abroad at Konan University Konan International Exchange Center Year-in-Japan study abroad students are able to apply for the following scholarships. All applicants will be informed regarding the result of their scholarship application once a final decision has been made, prior to the start of the program. If you would like to apply for the following scholarships, please read carefully the information given below regarding each scholarship, provide the required information, and submit a signed copy of this form. Type of Support Applicant Qualifications and Conditions (Essential Points Summary) 独立行政法人日本学生支援機構 (JASSO) 海外留学支援制度 ( 協定受入 ) JASSO : 80,000 JPY Per Month 1 Applicants possessing Japanese citizenship are not eligible. 2 Applicants must have a superior academic record at their current university and excellent character. Furthermore, the applicant s GPA from their most recent school term must be higher than 2.30 when calculated using 3.00 as the highest possible score (i.e. roughly higher than 3.00 on the 4.00 point system: see the JASSO GPA Evaluation Chart below). 3 Applicants must have a clear purpose and plan for studying in Japan and be able to benefit from the exchange experience. 4 Applicants must be in need of financial assistance due to economic reasons 5 Applicants will return to their current university and continue their studies, or will receive a degree from their current university, following completion of the study abroad program. Do you meet all the qualifications and conditions listed above? Yes No JASSO GPA: HUMAP 留学生交流推進制度 ( 受入 ) HUMAP : 80,000 JPY Per Month 1 Applicants possessing Japanese citizenship are not eligible. 2 Applicants must have a superior academic or research record, and must have excellent character. 3 Applicants must have a clear purpose and plan for studying in Japan and be able to benefit from the exchange experience. 4 Applicants must be in need of financial assistance due to economic reasons. *The support offered by HUMAP is designed for participating universities listed below only. -University of Illinois at Urbana-Champaign -University of Pittsburgh -University of Hawaii at Manoa -University of Arizona -Université François-Rabelais (Tours) -Edith Cowan University -Murdoch University Do you meet all the qualifications and conditions listed above? Yes No 甲南奨学金 Konan : 10,000-53,000JPY Per Month The amount awarded varies each year depending on the number of scholarship recipients and university funding. Applicants must not be recipients of either the JASSO or HUMAP scholarships. Do you understand all the qualifications and conditions listed above? Yes No

Conditions Regarding Receipt of Other s Funds Disbursement Method Conditions that Apply After a Has Been Awarded Other Confirmation of intent to apply and list of necessary documents scholarship if you receive scholarships etc. for study abroad from other organizations, for which the total amount is in excess of 80,000 yen per month (not including student loans to cover travel expenses etc.). *If you have been awarded any other scholarships for study abroad or are in the process of applying for one or you are planning to apply for a scholarship for study abroad, you must enter the name and the amount of the monthly allowance of the scholarship below: If yes, fill in the blanks below: Monthly Amount: JPY If you are in the process of applying for a scholarship, please enter the date by which you will know whether or not you will receive it : scholarship if you receive other scholarships, for which the total amount is in excess of 80,000 yen per month. *If you have been awarded any other scholarships or are in the process of applying for one or you are planning to apply for a scholarship, you must enter the name and the amount of the monthly allowance of the scholarship below: If yes, fill in the blanks below: Monthly Amount: JPY If you are in the process of applying for a scholarship, please enter the date by which you will know whether or not you will receive it : scholarship if you receive scholarships etc. for study abroad from other organizations, for which the total amount is in excess of 80,000 yen per month (not including student loans to cover travel expenses, etc.). *If you have been awarded any other scholarships for study abroad or are in the process of applying for one or you are planning to apply for a scholarship for study abroad, you must enter the name and the amount of the monthly allowance of the scholarship below: If yes, fill in the blanks below: Monthly Amount: JPY If you are in the process of applying for a scholarship, please enter the date by which you will know whether or not you will receive it : The monthly stipends will be disbursed directly to a Japanese bank account each month. It is therefore necessary for scholarship recipients to open a Japanese bank account without delay after arriving in Japan. While scholarship funds are generally disbursed by the end of the month, depending on circumstances related to the university and the organizations that provide scholarship funds, there are cases in which funds are disbursed the following month. [Every month]: For the funds to be dispensed, you are required to sign a form verifying your continued active participation in the program. (By the 15th of each month) [At the end of program]: You will be requested to write and submit a report(s) related to your study in Japan. (The type of report(s) varies depending on the type of scholarship) It is not possible to guarantee that those who extend the length of their program will also be able to extend their receipt of scholarship funds. You are not able to contact the organizations that provide scholarship funds directly. Any contact is to be made through KIEC. If you have any questions or inquiries regarding your scholarship, please consult KIEC staff. Any communication made directly to the organizations that provide scholarship funds will most likely be forwarded to KIEC staff. Your grades at Konan University will be disclosed to scholarship organizations after the program. I wish to apply for this scholarship. Please submit the following with this document: 別紙様式 1: Reasons and Purposes for Applying for JASSO/ HUMAP/ KONAN I do not qualify / do not wish to apply for this scholarship. I agree to disclose the transcript supplement to JASSO for confirmation of credit transfer after the program. I wish to apply for this scholarship. Please submit the following with this document: 別紙様式 1: Reasons and Purposes for Applying for JASSO/ HUMAP/ KONAN 別紙様式 2-3: Certificate of Enrollment of the Applicant for HUMAP 別紙様式 2-4: Application for HUMAP I do not qualify / do not wish to apply for this scholarship. I have read the above statement and accept the conditions outlined. Your Signature Date Home University Faculty/Department I wish to apply for this scholarship. Please submit the following with this document: 別紙様式 1: Reasons and Purposes for Applying for JASSO/ HUMAP/ KONAN I do not qualify / do not wish to apply for this scholarship.

Reasons and Purposes for Applying for JASSO/ HUMAP/ KONAN (Please write in English/minimum 400 words if you apply for the scholarship.) 別紙様式 1 Home Institution

別紙様式 2-3 HUMAP 留学生交流推進制度 ( 受入 ) 候補者在籍証明書 Certificate of Enrollment of the Applicant for HUMAP Student Exchange Promotion Program (Inbound) 公益財団法人ひょうご震災記念 21 世紀研究機構理事長様 To the President, Hyogo Earthquake Memorial 21st Century Research Institute 下記の HUMAP 留学生交流推進制度 ( 受入 ) 奨学金等支給申請者は ここに記載のとおり 本学に在籍していることを証明します This is to certify that the following person who is applying for HUMAP Student Exchange Promotion Program (Inbound) is registered as a regular student at our institution in the following capacity. 申請者氏名 of applicant 在籍大学名 of institution 在籍学部 / 研究科 Faculty/ School 学年 *1 School Year *1 卒業 / 修了予定年月 *2 Expected date of completion/ graduation *2 取得予定学位 Degree to be awarded 留学先大学名 Host institution in Japan 学部 (Undergraduate) 学年 修士 (Master's) School year 博士 (Doctorate) 年 Year 月 Month 学士 (Bachelor's degree) 専攻 修士 (Master's degree) Major 博士 (Doctor's degree) 甲南大学 提出年月日 年 月 日 Date Year Month Day 氏名 職名 Title 署名 Signature *1: 学年欄は 申請時の学年を記載すること *1: Please fill in the school year at the time of application. *2: 日本に留学した場合の卒業 / 修了年月日を記入すること *2: Expected date of completion/ graduation should include the period of study in Japan. 申請者の在籍大学の責任者が記入すること Note:This form should be filled in by the authorized person of the applicant's home institution.

別紙様式 2-4 HUMAP 留学生交流推進制度 ( 受入 ) 申請書 Application for HUMAP Student Exchange Promotion Program (Inbound) 公益財団法人ひょうご震災記念 21 世紀研究機構理事長様 To the President, Hyogo Earthquake Memorial 21st Century Research Institute 氏名 ( アルファヘ ット ) in alphabet 姓 Family name 名 Given name ミト ルネーム ( イニシャル ) Middle initial(s) 国籍 Nationality 生年月日 Date of birth 19 年 Y 月 M 日 D 性別 Sex 男 M 女 F 在籍大学名 ( 英文 ) Home institution 学部 / 研究科 Faculty/ School 在籍年次 School year 受入大学名 ( 日本語 ) Host institution 学科 / 専攻 Department/ Course 所在国名 Country 学部 Undergrad. 年次 Y 修士課程 Master 年次 Y 博士課程 Doctor 年次 Y 甲南大学 留学希望期間 Desired study period 20 年 Y 月 M 日 D ~ 20 年 Y 月 M 日 D 日本への短期留学の必要性及び日本での学習 研究計画 ( 日本語 ) Necessity to study in Japan and study plan 私は 上記の記載事項に相違のないことを確認し HUMAP 留学生として奨学金の支給を受けたく申請します また 採用の際には 他団体から月額 8 万円以上の奨学金を受給しないこと 及び承認された留学期間終了後は速やかに帰国し 在籍大学に復学することを誓約いたします I, the undersigned, certify that the above statements are true and correct, and hereby apply for HUMAP Student Exchange Promotion Program (Inbound). Further, if I am selected as a grantee, I agree not to receive other scholarships in excess of 80,000 yen per month, and to return to my home institution after completing the approved study period in Japan. 署名 記入年月日 Signature of applicant: Date: 年 Y 月 M 日 D