Application Form for jica training and Dialogue Programs

9. Prohibition of Political Activity
Participants shall not take part in any political activity, such as supporting a certain political group or getting involved in any political movements.


10. Compliance with the Regulations of the University and KOICA
10-1. Participants shall fully comply with the academic regulations of the university and guideline of KOICA.
10-2. If a participant violates any of the regulations of the university or KOICA, the participant shall be subject to disciplinary measures, as stipulated in such regulation.

IV. DECLARATION

I, , of , (name of applicant) (name of country) certify that the statements I made in this form are true and correct to the best of my knowledge. If accepted for the program, I agree to respect SP Participant Guideline and Code of Conduct set forth above. If I fail to comply the terms and conditions of KOICA Scholarship Program, I will accept any penalties and consequences including dismissal from the Program and report to my government and/or employer. Date: Applicant's Name:   Signature:

PART 3. MEDICAL HISTORY QUESTIONAIRE

MEDICAL HISTORY QUESTIONAIRE (to be completed by the applicant)

1. Present Status Do you currently use any drugs for the treatment of a medical condition? (give name & dosage) □ No □ Yes >> Name of Medication ( ), Quantity ( )