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 regulation of the university or KOICA, he or she shall be subject to disciplinary
measures, as stipulated in such regulation, can be enforced.

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 ( )