|
Homepage : http://www.koica.go.kr/sites/ciat | Email : koica.sp@koworks.org
825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13449, Korea
In completing the attached application form, please be advised to:
Carefully read your Application Guideline(AG) and Program Information(PI) prior to completing the application form;
Application should be typed, not handwritten, except for your signature; handwriting is not acceptable. Fill in the form in English;
Fill in the form in English;
Be sure to fill in every part of the form;
Send the completed form to the KOICA Office in your country or the Embassy of Korea (if the KOICA Office is not available) together with a copy of your passport; and
Be reminded that your participation may be denied if you fail to provide the required information and documents completely and on time.
Application Checklist
Items
|
Page No.
|
Check(√)
if completed
|
Filled in every item of Applicant Information
|
2-4
|
|
Ticked agree/disagree box for (a) Agreement on Collection and Use Personal, Sensitive, and Unique Identifying Information, (b) Consent to Provide Personal, Sensitive and Personally Identifiable Information to a Third Party and (c) Agreement on Use of Personal Information for Sending Promotional Materials
|
5-9
|
|
Thoroughly read Scholarship Program Guideline and Code of Conduct
|
9-13
|
|
Signed the declaration for terms and conditions
|
13
|
|
Signed and filled in every part of Medical History Questionnaire
|
14
|
|
Had an authorized official from your government to complete and sign the Nomination form
|
15
|
|
Have a copy of passport ready for submission
|
-
|
|
This is to certify that I have completed every part of the application form
to apply for the KOICA Scholarship Program.
Date: Applicant's Name: Signature:
Application Form for the KOICA Scholarship Program
|
(Photo)
This form is to be used to apply for the Scholarship Program of the Korea International Cooperation Agency (KOICA), which is implemented as part of the Official Development Assistance Program of the Government of Korea. Please complete the application form and consult with your respective country’s KOICA Office - or the Embassy of Korea in charge of your country, if the former is not available - for further information.
PART 1. APPLICANT INFORMATION (to be completed by the applicant)
I. PROGRAM OF APPLICATION (as in the Program Information)
|
|
Program Title
|
|
|
Name of Degree
|
|
|
Duration
|
from to (DD-MM-YYYY)
|
|
II. PERSONAL DATA
|
|
Name
(as in the passport)
|
First Name
Middle Name
Family Name
|
|
Date of Birth
|
Day
|
|
Month
|
|
Year
|
|
|
Sex
|
□ Male □ Female
|
Airport of Departure
|
|
|
Nationality
|
|
Religion
|
|
|
Home Address
|
|
|
Contact Information
(Including Country Code)
|
Telephone
|
|
Fax
|
|
|
Mobile
|
|
E-mail
|
|
|
Emergency Contact
|
Name
|
|
Relation
|
|
|
|
Telephone
|
|
E-mail
|
|
|
|
Emergency Contact (2)
|
Name
|
|
Relation
|
|
|
Telephone
|
|
E-mail
|
|
|
III. CURRENT EMPLOYMENT
|
|
Organization
|
|
|
Department
|
|
|
Present Position
|
|
Employment Duration
|
from to present (MM-YYYY)
|
|
Type of Organization
|
Government
|
□ Central □ Local
|
|
Institution
|
□ Public □ Private □ International □ NGO
|
|
Others
|
(Please specify)
|
|
Job Description
|
Describe your main duties. Specify any technical equipment or facilities you work on with if applicable.
|
|
|
|
Describe any themes, topics and places of interest you would like to see in the Program related to your tasks mentioned aforesaid.
|
|
|
|
Elaborate on organizational setback or challenges that you wish to address through the Program.
|
|
|
|
Elaborate on your plans to apply the lessons learned from the Program to your organization.
|
|
|
|
VI. CAREER RECORD
|
|
Career Background (Past 5 Years)
|
|
Organization
|
Department
|
Position / Responsibilities
|
Period (MM-YYYY)
|
|
From
|
To
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Educational Background (Higher Education)
|
|
Institution
|
City / Country
|
Field of Study and Degree
|
Period (MM-YYYY)
|
|
From
|
To
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
`
|
|
|
Previous Attendance to Training Program in Foreign Countries
|
|
Have you previously attended any courses sponsored under programs
of Korea (KOICA) or of other countries?
|
□ Yes □ No
|
|
If yes, please specify as below
|
|
Training Institute
|
City / Country
|
Course Title
|
Period (MM-YYYY)
|
|
From
|
To
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
`
|
|
|
|
Dostları ilə paylaş: |
