Indicate which level you want to study in Japan.

Mark / on Masters Studies if you want to do Masters only.

Mark / on Doctoral Studies if you want to do Doctoral only.
Mark / on both Masters and Doctoral Studies if you want to do both Masters and Doctoral. MEXT Postgraduate 2017

Application Form: [POSTGRADUATE 2017]

*Valid in Malaysia only.

Social Science

Masters Studies

Natural Science

Doctoral Studies

APPLICATION FOR JAPANESE GOVERNMENT (MONBUKAGAKUSHO: MEXT) SCHOLARSHIPS 2017

Research Students
INSTRUCTIONS
1. The application should be typewritten if possible, or neatly hand-written in block letters.
2. Numbers should be in Arabic numerals.
3. Year should be written in the Anno Domini (AD) system.
4. Proper nouns (including address) should be written in full, and not abbreviated.
thoseaddress
without
surname,
5. Please provideFor
present
and
telephone number in Malaysia.
write
your
fathers
name
6. Use our format to help to speed-up thefor
short-listing process. Do not change our format.
Family name and your
Write Christian name only if it appears in your
name for First name.
passport, else write Chinese characters or Xiao
Mei for First name and - for Middle
name.
1. Name in full, in your native language
(Sex)

Abu Bakar

Tan
Ramasamy

Siti Fatimah

Catherine
Letchumy

(Family name/ Surname)

binti

Xiao Mei
-

(First name)

Male

(Middle name)

In Roman block capitals

(Marital Status)

ABU BAKAR
TAN
RAMASAMY

SITI FATIMAH
CATHERINE
LETCHUMY

(Family name/ Surname)

2. Nationality

3. Date of birth

Female

BINTI
XIAO MEI
-

(First name)

Malaysian

Single

Married

(Middle name)

2a. Do you have Japanese nationality?

1987

(Year)

(Month)

(Day)

No
29

(Age, as of 1st April 2017)

4. Present status with the name of the university attending or employer

Support Engineer, XXXXXX Sdn. Bhd.

Lecturer, Universiti Malaya
Undergraduate student, Universiti Kebangsaan Malaysia

Provide address with postcode

and state.

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

Present address
: No. XX, Jalan Wangsa, Bandar Baru Maju Jaya, Cheras, 68000

6.

Telephone/Facsimile number

E-mail address

Selangor
+6012-XXX-XXXX, +603-XXXX-XXXX (Fax)
xxxxxxxxx@xxxxxxx.com
Provide telephone numbers in

Malaysia only.
Field of study specialized (NOT list of subjects) in the PAST (be as detailed and concrete as possible)
The Embassy of Japan will not provide any
guidance on how to fill in items 6 and 7. Do
not leave blank.

The Embassy of Japan will not provide any

guidance on how to fill in items 6 and 7. Do
not leave blank.
7.

MEXT Postgraduate 2017

Proposed study program IN JAPAN.

(State the name & outline of your major field of study and the details of your study program This
section will be used as one of the most important references for selection. Statement must be
typewritten [font: Tahoma, size: 10pt] or written in block letters. Additional sheet of paper [maximum 3
additional sheets] may be attached ONLY IF NECESSARY. If you have good command of Japanese [JLPT
Level 2 or above], write in Japanese.)
i)

Present field of study

ii)

Your research theme after arrival in Japan

iii)

Study programme in Japan in detail (STUDY/RESEARCH PROPOSAL)

MEXT Postgraduate 2017

8. Education background
Level of
Education
Elementary
Education

Name and Address

of School

Period of schooling

Year and Month

attended

of Entrance

(EXCLUDING
Remove Class)

and Completion

Name

From

SRK Bandar Tasik

January 1994

Certificate (i.e. UPSR,

PMR,SPM & etc)

And

Diploma or Degree
awarded with MAJOR
SUBJECT

yrs

UPSR

and
1.Elementary
School

Location

To

Kuala Lumpur

December 1998

Secondary
Education:

Name

From

SMK Bandar Tasik

January 1999

1.Lower Secondary
School

Location

Kuala Lumpur
Name

January 1999

Location

To

yrs

PMR

and

You may add one more

To
row for different school
December 2001
attended for the same
education category.
From

SMK (P) Bandar Selatan

mths

mths

yrs

SPM

and

Kuala Lumpur
2004
State SPM/ UEC/December
A-Levels for
Upper
Secondary School if do not have diploma,
matriculation or foundation studies.
From
XXX College

mths

Name
2.Upper Secondary
School

June 2005

Location

Kuala Lumpur

June 2007

1.Undergraduate

YYY University

August 2007

Location

To

Kuala Lumpur

August 2010

1 mths

yrs

and

Level

1 mths

Graduate Level is for postgraduate,

Name
i.e. Masters or PhD only. State NIL
From
if not applicable. Do not leave blank.

yrs
and

Nil
Location

Diploma in
Information
Technology

To

EDUCATION:

2.Graduate Level

yrs

and

Graduate Level is for undergraduate,

i.e. Bachelors degree only.
Name
From

HIGHER

To

mths

TOTAL

years

schooling
mentioned above

of

16

yrs

and

2 mths

Bachelor Degree in
Information
Technology

MEXT Postgraduate 2017

9. TWO recent Employment record. Begin with most recent employment, if applicable. (DO NOT INCLUDE
INTERNSHIP OR PART TIME JOBS)
Name and address of organization

Period of employment

XXXXXX Sdn. Bhd.

Lot 665, Jalan Wangsa,
Bandar Baru Maju Jaya
68000 Cheras, Kuala Lumpur
Nil

Position

Support Engineer

From

August 2010
To

current

TYPE of work

Provide computer
technical support
for customers

From
Summarize type of work in 15 words.

State NIL if not applicable.

To
Do not leave blank.
Date of application:

20 March 2016
Applicants signature:
__________________________________
Applicants name
(in Roman block capitals):

Sign here.

SITI FATIMAH BINTI ABU BAKAR

CATHERINE TAN XIAO MEI
LETCHUMY RAMASAMY

Name as in passport.

Have you learnt Japanese language before?

/

YES

If yes, name of Institute:

NO

XXX Japanese Language School

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

NO

NOTE: Please read our guidelines carefully; follow the instructions and fill-in correctly
before submitting. Do not leave any column blank, if you do so, your
application may not be considered.
Attachment (please tick):/ REQUIRED One (1) copy of original or certified academic transcript (Bachelors/ Masters only)
OPTIONAL One (1) copy of certified degree certificate (Bachelors/ Masters only)
* Bachelors/ Masters academic transcripts and degree certificates only. UPSR/ PMR/ SPM/ O-Levels/ STPM/ A-Levels/
Matriculation/ Diploma results, IC photocopies and resume/CVs are not required. Masters student must submit one (1) copy each
of Bachelors and Masters academic transcripts.

MEXT Postgraduate 2017

ASCOJA Recommendation
ASEAN Council of Japan Alumni (ASCOJA) aims to foster human resources that can provide
leadership as a bridge between Japan and home country even after returning home. In addition to
the specialized field of study in graduate school, ASCOJA members also have a chance to deepen
their understanding of Japan by learning Japanese language, culture, and through activities such
as experiencing customs and exchange with Japanese people during their stay in Japan.

MEXT Scholarship candidates who fulfill the requirements below are eligible for the ASCOJA
Recommendation:

Will depart to Japan as Research Student in April 2017

Will proceed to Masters Course (candidates taking PhD courses are not eligible)
Will

apply for a university in Tokyo or around the region (where student can participate in

ASCOJAs activities without hindrance).

Will

receive 6 months of Japanese language preparatory education at Tokyo Japanese

Language Education Center before enrolling into graduate school.

If you are interested to join ASCOJA kindly tick in the box below

YES
NO