Tembusan:

Kepala Badan Kebijakan Fiskal

1 . . Mulabasa Hutabarat . . . . . ,
l'(NIP 1 95401 061 983031 001 (
Plh. ~ep~
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_-
Atas perhatian dan kerja sama Saudara, kami ucapkan terima kasih.
Untuk mengetahui lebih rinci mengenai program tersebut dapat dipelajari pada dokumen
terlampir.
1 . Daftar Riwayat Hidup (bahasa Inggris);
2. Application for m A2-3 rangkap 2, diisi lengkap, diketik rapi, dan ditempel pas foto berwarna
ukuran4x6 em;
3. Essayuntuk masing-masing bidangstudi
4. Cer tificate of Health
5. Suratrekomendasi terbaru dari atasan
6. FotoeopySertifikat Nilai TOEFL
7. Fotokopi ijazah Strata 1 (S1 ) danTranskrip Nilai Akademik (dalamBahasaInggris)
8. FotocopyKartu Identitas (KTP atau Paspor).
Apabila unit Saudara akan memanfaatkan kesempatan tersebut, kami mengharapkan agar
ditunjuk seorang ealon peserta yang memenuhi persyaratan, dan dalamwaktu yang bersamaan
tidak diealonkan untuk uti ogram lain. Nama ealon tersebut agar disampaikan kepada
kami paling lambat tang a 1 5 Sept mber 201 3 dengan melampirkan dokumen-dokumen sebagai
berikut:
Seluruh biaya yang berkenaan dengan pelaksanaan program dimaksud ditanggung oleh
Monbukagakusho/Pemer intah J epanq,
Sehubungan dengan surat Kepala Biro Kerja Sama Teknik Luar Negeri, Kementerian
Sekretariat Negara nomor B- 14497/Kemsetneg/Setmen/KTLN/KL.03.00108/2013tanggal 2 Agustus
201 3 mengenai hal tersebut di atas (fotokopi terlampir), bersama ini kami beritahukan bahwa
Kementerian Keuangan mendapatkan tawaran beasiswa (Master ) untuk bidang Hukumdi Kyushu
Univer sity dan bidang Administrasi Bisnis di Hitotsubashi Univer sity dari Pemerintah
JepanglMonbukagakusho Tahun 201 4.
Yth. Terlampir
Kementerian Keuangan
J akarta
4 September 201 3 :S- 614 IKF.7/2013
: BiasaI sangat segera
: Satu berkas
: Tawaran Beasiswa Monbukagakusho
Young Leader s Pr ogr am (YLP) 201 3 di J epang
Nomor
Sifat
Lampiran
Hal
GEDUNG R. M. NOTOHAMIPRODJ O LANTAI 7 J ALAN DR. WAHIDIN RAYA NOMOR 1 J AKARTA 1 071 0
TELEPON (021 ) 345 1 1 28. FAKSIMILE (021 ) 3451 205 SITUS www. nskaldepkeyoo. ld
[ ,
KEMENTERIAN KEUANGAN REPUBLIK INDONESIA
BADAN KEBIJ AKAN FISKAL
PUSAT KEBIJ AKAN REGIONAL DAN BILATERAL
Yth.
1. Kepala Biro Sumber DayaManusia, Sekretariat J enderal
2. Sekretaris InspektoratJ enderal
3 "", Sekretaris DirektoratJ enderal Anggaran
'4 . Sekretaris Direktorat J enderal Pajak
5. Sekretaris Direktorat J enderal Beadan Cukai
6. Sekretaris DirektoratJ enderal Kekayaan Negara
7. Sekretaris DirektoratJ enderal Perbendaharaan
8. Sekretaris Direktorat J enderal Perimbangan Keuangan
9. Sekretaris Direktorat J enderal Pengelolaan Utang
10. Sekretaris Badan KebijakanFiskal
11. Sekretaris Badan Pendidikandan Pelatihan Keuangan
Kementerian Keuangan
J akarta
:S- 614IKF.7/2013
4 September 2013
: Tawaranprogramtraining di India
Surat No.
Tanggal
Hal
GEOUNG R.M. NOTOHAMJ PROOJ OLANTAI 7J ALAN OR. WAHlOINRAYA NOMOR 1J AKARTA 10710
TElEPON (021) 3 4 5 1128, FAKSIMllE (021) 3 4 51205 SITUS www.fiskal.c!eokev.ooJ d
KEMENTERIAN KEUANGAN REPUBLIK INDONESIA
BADAN KEBIJAKAN FISKAL
PUSAT KEBIJAKAN REGIONAL DAN BILATERAL
KB/302ltawalUldsi Augustl20 13/1
a, Oaftar Riwayat Hidup .
b. Application form yang telah diisi lengkapdan telahdisetujui oleh atasan
c. Essay untuk masing-masing bidangstudi
d. Certificate of Health
e, Recommendation Form
f. Copy Sertifikat Nilai TOEFL
g. Copy IjasahdanTranskrip NilaiAkademik(dalarnBahasa Inggris)
h. Copy Kartu Identitas (KTP atau paspor)
Terlampir kami sampaikan formulir pendaftaran dan brosur untuk program pendidikan
dimaksud. Informasi lengkap dan formulir terkait juga dapat diakses di situs Kedutaan Besar
J epang (http://www.id.emb-japan.go.jp). Untuk informasi lebih lanjut dapat menghubungi Bagian
Pendidikan Kedutaan Besar J epang (021-31924308ext. 175atau 176).
Atas perhatian dan kerja sama yang baik, kami sampaikan terima kasih.
-:I ~.~_~aris KementerianSekretariatNegara
/-.~\~~~fl1a; ,'ro Kerja SamaTeknikLuar Negeri
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Tembusan:
Seskemsetneg sebagai laporan
Biaya yang berkaitan dengan program dimaksud sepenuhnya ditanggung oleh
Monbukagakushol Pemerintah J epang.
Apabila Kementerian/lnstans.i Saudara akan memanfaatkan tawaran tersebut dapat
langsung menyerahkan/mengirimkan formulir yang telah diisi ke Bagian Pendidikan Kedutaan
Besar J epang di J I. M.H. Thamrin No. 24, J akarta Pusat 10350 paling lambat tanggal 20
September 2013, dengan melampirkan berkas kelengkapan (masing-masingrangkap 5) sebagai
berikut:
Dengan hormat kami sampaikan tawaran beasiswa dari Pemerintah Jepangl
Monbukagakusho program Master untuk bidang Sekolah Pemerintahan di National Graduate
Institutefor PolicyStudies (GRIPS), Hukumdi KyushuUniversity, PemerintahanOaerahdi GRIPS,
dan Administrasi Bisnis di Hitotsubashi University, dengan jadwal keberangkatanbulan Oktober
tahun 2014.
Kepada Yth.
(daftar terlampir)
di
J akarta
J akarta,~Agustus 2013 B-ltt4~'f'/Kemsetneg/Setmen/KTLN/KL 03.00108/2013
Segera
Formulir pendaftaran
Tawaranbeasiswa
Young Leaders' Program (yLP) 2013
Nomor
Sifat
Lampiran :
Hal
KEMENTERIAN SEKRETARIAT NEGARA
REPUBLIK INDONESIA
J alan Veteran No. 17-18, J akarta10110, Telepon (021) 3845627, 3442327
Situs: www.setneg.go.id
KB/J 02ltawaranldsl Augusrl2013/2
di
J akarta.
9. Kepala BiroKepegawaian
KementerianHukumdanHakAsasi Manusia
10. Kepala Biro Hukumdan Kerjasama Luar negeri
Kejaksaan Agung
11. Kepala Biro Umum
Lembaga Administrasi Negara
12. Kepala Biro Umumdan Perlengkapan
Lembaga IImuPengetahuan Indonesia
13. Kepala Pusat Pendidikan dan Pelatihan, KementerianSekretariat Negara
14. Kepala Biro Personil, Sekretariat Kabinet
7.
5.
4.
3. Sekretaris J enderal KementerianPerindustrian
u.p. Kepala Biro Umum
Sekretaris J enderal KementerianAgama
U.p.Kepala Biro HukumdanKLN
Sekretaris J enderal KementerianDalamNegeri
u.p. Kepala PusatAdministrasi Ke~aSama Luar Negeri
Kepala Pusat Kebijakan Fiskal dan Regional
Kementerian Keuangan
Kepala Biro Perencanaandan SDM
Kementerian Badan Usaha Milik Negara
8. Sekretaris
Mahkamah Agung
1. Sekretaris J enderal KementerianPendidikan Nasional
u.p. Kepala Biro Perencanaandan Kerjasama Luar Negeri
2. Sekretaris J enderal KementerianPerdagangan
U.p. Kepala Biro Perencanaan
Kepada Yth.:
KE:MENTERIAN SEKRETARIAT NEGARA
REPUBLIK INDONESIA
J alan Veteran No. 17-18, J akarta 10110, Telepon (021) 3845627, 3442327
Situs: www.setneg.go.id
I Information Concerning the Recruitment of Students
1 Number of Participants
2 Matters to be Attended for Eligibility and Application
3 Notice Period and Method
4 Acceptance of Application Forms
(I)The language used and the attached translation
(2) Applications
(3) Reasons for applying and future plans
(4) Transcript of last attended institution
(5) Certificate of graduation (Attach an English translation)
(6) Medical certificate
(7) Incomplete application forms
5 Conditions for Recruitment
6 Applicants Staying in J apan
7 Applicant Who Has Already Been to J apan
II Selection Outline
1 Method of Screening
2 Criteria for Selection
III Recommendation Outline
IV Selection and Announcement of Result
The First Screening
2 The Second Screening
3 Announcement of Results
4 No Change of Assigned University
5 Waiting List
V Procedures after Selection
Visa
2 Airline Ticket
3 Changes in the Date of Departure
4 Withdrawal or Revocation of Acceptance
5 Students Accompanied by Family Members
6 Guidance before Departure Date
VI Year-Long Schedule
CONTENTS
GUIDANCE
FOR
JAPANESE GOVERNMENT (MONBUKAGAKUSHO: MEXT) SCHOLARSHIP FOR 2014
YOUNG LEADERS' PROGRAM (YLP) STUDENT
-I-
1 Number of Participants
There are five different courses available to students, and each course will accept from 10 to 20 students
at the maximum, and for a total of 80 students in a program.
2 Matters to be Attended for Eligibility and Application
a Applicants must have graduated a university with excellent grades and be eligible to study in J apan for
one year.
b Applicants must meet all qualifications stated in the entrance requirements. Please observe the
requirements strictly.
c The number of students we allow into this program is kept down to a minimum. All candidates
for this program will be evaluated relatively. Therefore, candidates who meet all qualifications still
might not be selected (It is also possible that none of the candidates from your institution will be
selected.). Take this point into consideration when recommending candidates.
d ~ome students in the past gave up studying in the middle of the program due to mental and physical
problems. Please take into consideration the fact that the environment of J apan might be different fromthat
of the applicants home country. Therefore, the applicants medical examination records and records of
previous illness must becarefully reviewed.
e Remember that the number of participants and treatment of the students could differ from this
document due to J apanese financial difficulties.
f Military personnel and military civilian employees registered on the active list are excluded from
participation.
3 Notice Period and Method
Each institution can decide how to notify students about recruitment for this Scholarship. However,
recruitment must bedone in an effective way in order to guarantee that outstanding' students are selected.
Application materials may be mailed from the Embassy of J apan, or can be downloaded from the
English website of MEXT (http://www.mext.go.jp/english/highered/1304786.htm).
In addition, applicants should be notified to seek information about the accepting universities through their
brochures or homepages (See the application material for the URL).
4 Acceptance of Application Forms
Applicants must observe the application period strictly and submit the necessary number of
documents (including copies of documents.). It must be verified whether or not all applications are
completed fully and correctly and if they lack any necessary documents. Students will be asked to
make corrections on their application if problems are found. After corrections are made, the forms
will, once again, be accepted. The following matters concerning acceptance need to beconsidered;
( I) The language used and the attached translation
Documents must be written in English. Attach an English translation if they are written in another
language.
(2) Applications
a Each year's prescribed forms must be used to apply. Fill out the forrns clearly (especially applicants
name) and put each application formand all other necessary documents in an envelope which is designated
by MEXT.
b Academic Record Inthe spaces designated for:
I) elementary education
2) secondary education
3) higher education
INFORMATION CONCERNING THE RECRUITMENT OF STUDENTS
- 2 -
The candidates who will be recommended to MEXT through Embassy of J apan and the J apanese
Ministry of Foreign Affairs should be selected by the following method;
1 Method of Screening
Each recommending institution can choose the candidates freely but must examine accurately each
applicants English ability, personality, reasons for applying, etc.
II SELECTION OUTLINE
Please write the names of the schools or institutions that you attended which correspond to the J apanese
education system of: 1) elementary school
2) junior/senior school
3) undergraduate/graduate university
* Caution: Write the exact number of years which the applicant was enrolled in each institution. If an
applicant skipped a year in any schools or institution, it must be mentioned.
(3) Reasons for applying and future plans
The essay concerning the applicants reason for applying as well as future plan after the completion of
Y LP must be explained concretely and specifically within three pages or so.
(4) Transcript of last attended institution
A transcript of all credited courses taken every year in the students undergraduate or graduate university
is necessary illeither a certificate of degree nor a diploma showing what ranking the student received when
the applicant graduated will be considered as a transcript. The system of grading/evaluation should be
clearly written out on the transcript.).
(5) Certificate of graduation (Attach an English translation)
Any of the following can be submitted: A certificate of graduation of the last attended institution, a
certificate of university entrance qualification (For example a certificate showing you took the High School
Equivalency Exam) and a certificate of degree (can be a copy of diploma).
(6) Medical certificate
Students must use the designated form and fill out (or have the doctor fill out) all that is required.
Recommending institutions must assign medical institutions for the physical examination.
Regarding previous illness, for example tuberculosis, mental disease, etc., please pay attention to the fact
that some students become sick after coming to J apan even though they didn't state any problems
beforehand. Consider this point carefully when recommending institutions interview applicants. If candidates
are disabled and need special care, it must be mentioned in the recommendation letter.
(7) [ncomplete application forms
Application forms which are not completed fully and correctly or that are lacking necessary
documents will not be accepted.
Ifapplicants cannot get the necessary documents because of their countries condition: certificates confirmed
by the issuing authority, the government in their home country, or Embassy of J apan can be used instead.
5 Conditions for Recruitment
Applicants must follow all application requirements. Personal exceptions will not beadmitted.
6 Applicants Staying in J apan
Applicants residing in their own country have first priority. However, if a student is already staying in
J apan for some reason (except for those studying in J apan privately) and wishes to apply to this program,
the applicant can be included if the recommending institution decides to choose the applicant as a candidate.
7 Applicant Who Has Already Been to J apan
Applicants who have been to J apan and caused problems in the past should not be recommended as
candidates.
- 3 -
,
Necessary Documents Number of Sets
C D Application for Admission (Prescribed Forms) I Original and 4 Photocopies (Except Photographs)
Photographs (taken within the past 6 months, 5 Pictures (Paste on Each Application )
6 x 4 em, the upper half of the body, the front
side, no hats)
Transcript (of All Years) of the Institution Last I Original and 4 Photocopies
Attended
Recommendation One Written by the 1Original and 4 Photocopies
Letters Recommending Authority
One Written by the Employer 1Original and 4 Photocopies
or from the Supervising
Professor of the University
the Applicant Attended
@) Medical C ertificate I Original and 4 Photocopies
C ertificate of the University Last Attended or a I Original and 4 Photocopies
C opy of the Applicants Diploma
An Essay Explaining the Applicant'S Reason for I Original and 4 Photocopies
Applying and Future Plans after the C ompletion of
YLP
The following is a list of the necessary documents
Applicants personality, learning ability, eagerness to study in J apan and learn J apanese, experience of
studying abroad, etc., should be written in the recommendation letter in detail by each recommending
institution.
Recommending institutions must submit all the necessary documents to MEXT through Embassy of J apan
and the J apanese Ministry of Foreign Affairs.
III RECOMMENDATION OUTLINE
2 Criteria for Selection
C andidates must meet the following criteria along with the required qualifications.
a C andidates must have excellent grades and have the ability to study intheir desired field.
b C andidates must be physically and 'mentally healthy.
(The students who had developed mental problems, malaria, tuberculosis, diabetes, hepatitis, etc., after
coming to J apan have usually suffered from the same disease in the past. Please take this into
consideration.)
c C andidates must have a verifiable identity.
d C andidates must be able to easily adapt to a new environment and a different culture.
e C andidates must have a rich international cultural understanding.
f C andidates must not have J apanese nationality and dual nationality between his/her country and J apan.
g C andidates must not be military personnel or military civilian employees.
Do not recommend students who meet the following criteria;
Students who are already enrolled in a J apanese university privately.
Students who will obviously have difficulty in continuing their studies for a certain period of time after
.coming to J apan (For example, those who have to do military service, those who are pregnant, etc.).
- 4 -
1 The First Screening
The candidates who are recommended by each recommending institution are selected by the
accepting institution. The selection will be based on the submitted documents and an interview will
be held in the home country. Ifa person to person interview is impossible, it will be conducted by
telephone. Accepting institutions will recommend candidates to the YLP committee established in
MEXT, based on the results of the first selection.
2 The Second Screening
The YLP committee conducts the second selection.
3 Announcement of Results
The result of the second selection will be notified to each recommending institution through Embassy
of J apan and the J apanese Ministry of Foreign Affairs.
4 No Change of Assigned University
A change of t~e assigned university will not be permitted. This must be explained in the result
notification and during the orientation to all candidates.
5 Waiting List
When the number of successful candidates is less than the fixed number because of declination etc., it
IV SELECTION AND ANNOUNCEMENT OF RESULT
,..Caution:
1 These documents must be written in English or attach an English translation.
2 Insert all necessary documents of the application forms with photographs. Use one envelope
designated by MEXT for each candidate. Insert copies of the proof certificate with the original copies of
necessary documents in one application form.
3 In the application material, candidates are requested to number the documents in the right
upper corner. In case this is not done by the candidate, the recommending institution should
number the document accordingly.
Deadline of recommendation
The nomination of candidates to MEXT should be made by the recommending institution before the date
that will be specified by the Embassy of J apan. [t is the responsibility of the recommending institution to
ensure that all necessary documents listed above are provided.
It is preferred that all the necessary documents for every candidate are submitted to the Embassy
of J apan all together. In case part of tbe necessary documents are lacking for a candidate, and that
need to be submitted later, make sure to confirm the deadline with the diplomatic mission. Ifthe
document is not submitted by the deadline, or cannot be expected to be ready. the case will be treated
as inaccepted (not possible to nominate).
(J) A Copy of Family Register I Original and 4 Photocopies
or Certificate of Citizenship
A Copy of Passport 5 Photocopies
English Proficiency Certificate 5' Photocopies
Reply to the Essay Questionnaire I Original and 4 Photoco_ies
Report of Theme and Background for the I Original and 4 Photocopies
Preparation of Research Paper (Only Applicable to
the Medical Administration Course)
Score of GMAT or Certificate of Equivalent 5 Photocopies
Examination (Only Applicable to the Business
Administration Course arbitrary is submitted.)
- 5 -
Many cases have occurred which selected students caused several problems after coming to J apan
because of the lack of procedure knowledge or misunderstandings. Consider the following points:
1 Visa
J apanese Government Scholarship student must obtain a visa of College Student in their own
country based on the instruction of the Minister of Foreign Affairs.
2 Airline Ticket
(1) Each grantee will be provided, according to his/her itinerary and route as designated by MEXT,
with an economy class air ticket from the international airport closest to his/her place of residence to
Narita International Airport (or following the itinerary normally used by the university where the
grantee is placed). A change in the departing airport due to a change of address will not be permitted.
(2) The airline ticket sent by MEXT has a fixed date and flight number. Visiting relatives or friends,
sightseeing, research or visits for study, etc., on the way to J apan is not permitted.
(3) The departure date and flight is fixed due to the hotels at a stopover location, flight transfer
circumstances, arrival procedures, and residency arrangements .. Therefore, changes of the ticket date
made by the applicant in the home country will not be permitted.
(4) The airline ticket sent by MEXT to the grantee cannot be transferred to another person, nor can
it be exchanged for money. Furthermore, rvlEXT is only responsible to supplying grantees with an
airline ticket and will not pay for costs associated with excess baggages, airport taxes or insurance fees.
(5) A ticket will only be provided for the grantee. Family members or so who will accompany the
grante~to J apan will not receive any funding.
3 Changes inthe Dateof Departure
(1) The flight fee will not be covered for any grantee who wishes to come before the designated
date by MEXT without permission from the Ministry. There will be no refund after arrival. In such
case the grantee will not be considered as a student of this program. Therefore, if students do come
before the appointed date, the traveling arrangements, the entrance procedures and the living
arrangements after arrival (all necessary procedures) will be the grantees responsibility.
(2) Departure date and night changes will not be accepted. However, if any change is required due
to personal illness, contact tvlEXT through Embassy of J apan. In such a case, the grantee must wait the
MEXT's contact after all procedures including residence, etc., are fully prepared. In J apan, all courses
will begin right after the arrival date. In case of any arrival delay, the applicants acceptance to this
program might be revoked.
(3) If the travel agency demands payment for the difference of flight fee due to any departure or
flight changes and if the grantee paid at the moment of departure, no refund will be given after arrival.
Therefore, when any changes occur, always contact J apan to find out the necessary procedures before
departure.
4 Withdrawal or Revocation of Acceptance
(I) If a grantee cannot arrive within the designated arrival period, it will bea great hindrance to the
grantees education at the university as well as the research program. Therefore, the acceptance to this
program will berevoked.
(2) If a grantee withdraws from the program after receiving the airline ticket, MEXT will collect it
V PROCEDURESAFTER SELECTION
is possible to select from fill-in successful candidates who were beforehand selected at the second
screening of the YLP committee.
However, please note that the YLP committee will not choose any more candidates as alternates after
the second screening.
- 6-
through the travel agency.
(3) Ifrecommending institutions send many grantees who withdraw from this program or
return to their home country due to personal reasons in the middle of the program, the
institutions participation itself will be reconsidered. Therefore, when recommending applicants,
make sure applicants will not withdraw from this program for any reason.
S StudentsAccompaniedbyFamilyMembers
(I) If a grantee wishes to be accompanied by their spouse or any family member. they must contact
the educational institution before departure. When the spouse will come together with the grantee, it
must be informed that there will be no increase of the scholarship and traveling fee.
(2) All entrance procedures for the spouse will be completely different fromthe those of the grantee.
Therefore. make sure to obtain a visa for the spouse before departure.
S GuidancebeforeDepartureDate
(I) All grantees studying abroad should research their foreign universities (partner university)
education system. Grantees should also learn basic J apanese language necessary for daily life. J apanese
climate, legal systemand culture before departure.
(2) All grantees studying abroad should prepare appropriately $2,000 US for living expenses for the
time being.
(3) If any personal problems occur after arrival, such matters should always be discussed with their
supervising professors first and then the Foreign Exchange Office at the university should be contacted
to.
(4) Recently, there are many students who return to their home country without permission.
Some must return due to mental problems. A thorough interview and instruction before
departure is very important to prevent this from happening. However, if this happens due to an
accident while studying abroad, contacts are made to family members of the student and
appropriate authorities in their home country based on the directions from J apan. All problems
will be dealt with by having a close contact between J apan and the home country. All conditions
and results concerning such matters should be reported.
(5) The J ASSO provides a general complimentary pamphlet "Student Guide to J apan."
(http://www.jasso.go:jp/studyj/sgtj.html)
- 7 -

* Caution: This schedule is preliminary. Detailed schedules will be announced separately through the
J apanese Ministry of Foreign Affairs and Embassy of J apan.
The Second Screening (Conducted by the YLP Committee in MEXT)
Announcement of Results
Airline Tickets to be Sent
Students Come to J apan
2014
Feb.
March.
Aug.-Sept.
Sept.-Oct.
Early Nov.
Sending of Application Forms
Recommendation of Candidates by Recommending Institution,
Documents to be Submitted
The first Screening by Accepting Institutions
2013
Late J une.
By Oct.31th
VI YEAR-LONG SCHEDULE
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7. Commencement of the Program
October 2014
6. Curriculum
(I)Basic Concept ofYl.P programs
Each YL P course has been speciaUy designed to contribute to the development of national leaders in various fields by
seeking to take advantage of J apan's experiences of exchange with both Western and Asian countries and to establish a
"human network" through education related activities.
(2) Course Duration and Qualification
CoW"Seduration is for one year, resulting inthe conferring of a Master's degree in L aw from K yushu University.
(3) Language
All classes will be conducted entirely in English.
5. Recruitment and Selection
(1) Method of Recruitment
Recruitment will be conducted through specially designated recommending institutions. Please enquire at the J apanese
Embassy for fi.other information on the recommending institutions.
(2) Screening Procedure
C D First screening by the recommending institution
Second screening by the host university (in this case, K yushu University)
Final screening by theYL P Committee established by MEXT
4. The Number of Students
15students maximwn per year.
3. Host University
K yushu University, Graduate School of L aw.
2. Eligible Countries and Participants
Participants are selected from the sixteen countries listed below. They should be legal professionals, who are expected to play
an active role as future national leaders in their respective countries.
Target Countries: P. RChina, Rep. of K orea, I ndonesia, Malaysia, Philippines, Thailand, Vietnam, L aos, Myanmar,
Cambodia, Mongolia, Singapore, I ndia, South Africa, Turkey and Bhutan (J 6 Countries)
1.General Objectives of the YIP
The Young L eaders' P rogram (YL P) aims to contnbute to the fostering of future national leaders inAsian countries by
providing graduate level educational opportunities in J apan. Moreover, the YIPseeks to deepen participants' awareness and
understanding of J apan and to help form a regional network among national leaders that contnbutes to the establishment of
friendly relationships and improved policy planning activities among Asian and countries, The YIPis one of the J apanese
Govemment's (Monbukagakusho: MEXT*) Scholarship Student schemes.
*MEXT= The Ministry of Education, Culture, Sports, Science and Technology
1. OUTLINE
J APANESE GOVERNMENT (MONBUK AGAK USHO: MEX1) SCHOlARSHI P FOR 2014
YOUNG LEAD ERS' PROGRAM (L AW)
"
4. Scholarship Benefits
( 1) Allowance
242,000 yen (inFY 20 13. The amount is subject to change.) per month will be awarded toeach grantee during the term of the
scholarship, with the understanding that the scholarship will be suspended in cases where a grantee is absent from the
university for an extended period. The amount of the monthly stipend is subject to annual review and may change.
Scholarship will be cancelled for a grantee inthe following cases. Furthermore, ifscholarship payments were made during
the period the following cases applied, the grantee may be ordered to return scholarship payments received during that
period.
C D Ifany ofhis/her application documents is found to be falsely stated;
lfhe/she is inbreach ofhislher pledge made to the Minister of MONBUK AGAK USHO (MEXl);
@Ifit becomes definitive that the grantee will not be able to complete his/her course within the standard course term
because of'hisher poor academic achievement or suspension;
- 2 -
3. Term of Scholarship
One year from October 2014 to September 2015.
2. Qualifications
To be eligible, all of the following conditions mustbemet:
(1) Nationality
Applicants must be nationals of a country that is participating in the YLP (see above). Applicant who has J apanese
nationality at the time of application will not beeligible.
(2) Age
Applicants must, inprinciple, be under 40 years old as of Ist October 20 14(i.e. born on or after 2 October 1974).
(3) Academic Background
Applicants must be college graduates who have attained a high level of academic achievement intheir undergraduate study.
(4) English Ability
A minimum TOEFL (paper-based) score of 550, TOEFL -CBT score of213, or TOEFL -iBT score of79-80, or equivalent
(5) Work Experience
At least 4 years of work experience inthe applicant's home country ina law office or inthe legal section of a company or
government department, This work experience must be full-time and after graduation fromuniversity.
(6) Health
Applicants must have no infectious diseases and must be ingenerally good health.
(7) Visa Requirement: Selected applicants must acquire "College Student" (ryugaku, {i'$) visas before entering J apan.
They then enter J apan with the "College Student" (ryugaku, fi$) residence status. Applicants who are already inJ apan
under a visa other than College Student are required to change it to College Student by the end of the month preceding the
start of the scholarship. Applicants who change their resident status to any status other than "College Student" after their
arrival inJ apan wiJ l immediately lose their status as a J apanese government scholarship student
(8) Others: Any applicant who meets any or all of the following conditions is not eligible. [fidentified after the start of the
scholarship period., the applicant will be required to withdraw from the scholarship:
ill The Applicant isan active member of the military or a civilian employed by the military at the time the scholarship period
isdue to begin.
The Applicant is unable to travel to J apan within the dates set by the receiving university
@The Applicant is currently enrolled in a J apanese university under the resident status of"ColJ ege Student," or if he/she
plans to enroll at a J apanese university as a privately-financed international student between the time of application for this
scholarship and the time the scholarship period isdue to begin.
L Field of Study
L aw (K yushu University, Graduate School of L aw)
MEXT will offer scholarships to foreign students who wish to study in J apanese universities as Y L P students inlaw for the
academic year 20 14 under the J apanese Government (MEXl) Scholarship Program. The conditions are as follows:
)
"
I I . I NFORMATI ON FOR APPL I CANTS
.
-3-
-----------------,---------- I Original and 4 Photocopies;
(4)@Reconunendation Letter fromthe Recommending authority I Original and 4 Photocopies;
(5}@Two recommendation Letters from the Employer or from the supervising Professor of the university the applicant last
attended(prescribed form) I Original and 4 Photocopies;
(6)GX;ertificate of Health (to be issued by the medical institution designated by the J apanese Embassy of the country in which
theapplicant resides) I Original and 4 Photocopies;
(7)@ACopy of theOfficial Diploma or Certificatesof Graduation from the University the applicant lastattended
-------------------------------------5 Photocopies;
(3~fficial Transcript or CertifiedAcademic Record of the university theapplicant attended
--------------------------------5 Originals;
7. Application Procedure
Applicants must submit the followingdocuments to their recommending authorities by thedesignateddeadline. (please note:
submitted documents will not bereturned.)
(1)CDAppLicationfor Admission (prescribed form) l Original and 4 Photocopies(except photographs);
(2) Photographs (6 x 4 ern, taken within the past 6 months, should beaffixed on each of the 5application forms)
6. Languageof instruction
All lectures and practical training at universitieswill be conducted entirely inEnglish.
5. Selection
(1) Based on the recommendation of specified institutions, the participating university will select initial candidates fromamong
applicants by means of an interview, a review of the submitted documents and a short essay. Ifit is not possible to hold an
interviewin the applicant's home country, an interview may be conducted by telephone or theI nternet
(2) Those who have been selected initially by the participating universities will be put forward to the Y LP committee
established by MEXT for the final selection.
" @)I fhislher resident status of "Co !lege Studenf' as provided fur in Paragraph 1-4of Appendix to the I mmigration Control
. and Refugee RecognitionAct changes to any other status;
lfhe/she is provided withanother scholarship(except for a scholarship designated for research expenses);
@The request fromthegovernment and/or other state institutions of applicant'shome country;
(2) Transportation
C D Transportation to J apan
Eachgrantee will be provided, according to his/her itinerary and route as designated by MEXT, with an economy class air
ticket from the international airport closest to hisIher placeof residence to the Fukuoka I nternational Airport (or following the
itinerary normally used by the university where the grantee is placed). Expenses such as inland transportation from hislher
placeof residence to the nearest intemational airport airport tax, airport usage charges.. special taxes on overseas travel and
travel expenses within J apan will be borne by the grantee (the place of residence of the grantee shall in principle be the
address stated inthe application form).
Transportation fromJ apan
The grantee who is going back to the student's home country within the fixed period after the expiration of the scholarship
will be supplied, upon application, with an economy class air ticket from Fukuoka I nternational Airport to the international
airport nearest to the student's home address. Such expenses as inland transportation from his/her home address to the
international airport, airport tax and special taxes on the travel will NOT be provided (The address in the country of the
grantee's nationality statedinthe application is in principleconsidered as the"home address'').
Any aviation and accident insurance to and from J apan should be contracted bythe applicant at his or her own expense.
The airport the grantee departs fromor returns to must be an airport of thecountry ofhislher nationality.
(3) School Fees
Fees for matriculation, tuitionand entranceexaminations at a university will be paid by theJ apanese government
(4) Accommodation
Students can apply for a room at Kyushu University accommodation. (Please note: The number of roorns is limited and
successful candidates are not guaranteed aroom).
- 4 -
8. Notes
(1) For more detailed information on this scholarship program, please contact the appropriate officeat the J apanese Embassy.
(2) A grantee will be deprived of the scholarship inany of the following cases:
a. A false statement has been made on the application documents.
b. A violation of any article of the pledge to the J apanese Minister of Education, Culture, Sport, Science and Technology has
occurred.
c. A grantee has been subjected to disciplinary action by the university or has failedto reach the required academic standard.
dAt the request from the government and/or other state institution of the applicant's home country
(3) Before coming to J apan, it is advisable to learn enough J apanese language for daily life and to have some information on
J apanese climate, customs and manners, university education, etc.
(4) Please note that the stipend for October will only be given to students at the end of the month. I t is highly recommended for
grantees to bring approximately US$2,OOOorthe equivalent to cover immediate needs upon arrival inJ aI EL
comer.
--------------------------------- 5 Photocopies;
(I O)EngHsh Proficiency Certificate (fOEFL or other equivalent test score.) --------- 5 Photocopies;
(11)@Answers to each of thedesignated essay questions 1Original and 4Photocopies;
(12)Others
C D Use A4paper as the standard for all submitted documents, which inprinciple should be typed. Handwritten documents
should be written clearly.
These documents should all be written inEnglish, Ifwritten inanother language, attach an Englishversion translated by
a public institution. Caution is necessary as many applications are not written in English and do not come with an
English translation, particularly recommendation letters and diplomas.
@ Recommendation letters written by a workplace supervisor or an academic advisor from one's university should be
written separately by two of them and must use the stipulated format At least one and preferably two should be written
by your direct boss at work.
@ Reason for application and future plans will be important factors inselection, so submit a small essay of three pages
explaining as much as possible what you expect from this program and what kind of job you seek inthe short- and
l?ng-terms.
I f you submit test English proficiency scores from TOEFL or lEL l'S, please submit scores obtained roughly within the
past two years. Ifyou submit other certifications, please submit documents illustrating how to convert the score to
TOEFL or lEL TS.
@ Ifyou have a book or dissertation, submit a separate overview.
(/) Y our application may be rejected if the above application is either incomplete or inaccurate, or ifsome documents are
missing.
Write the numbers I through lOin line with the item number for the items above on each document inthe upper right
(8)@An Essay explaining applicants future plans after the completion of the Y lP I Original and 4Photocopies;
(9) A Copy of the (VApplicant's Family Register, @Photocopy of Passport or COCerti1icate of the Citizenship
- 5 -
(3)Other Elective Classes
I ntroduction to EU Law
I nt'l Economic and Social Law
I nt'l Economic Law and Practice
World Trade Law
Int'lMaritime Law
I nt'l Arbitration
-Consurner Protection Law
-LP and Private I nternational Law
-I nt'l Civil Litigation
-Contemporary I ssues in Competition Law
J ap. Constitutional & Administrative Law
White Collar and Corporate Crime
(2)Recommended Classes for Yl.P
J apanese Case Law &Practice
Reception of European Legal Systems and Concepts inJ apan
J apanese Law in Comparative Perspectives
Law &Economics of Contracting &Organizations
I nt'l Law in TodaysWorld
Comparative Corporate Law
Financial Services &the Law
I nternational Business Law
(1 ) Foundational Classes
I ntroduction to Legal and Political Studies
Legal Research Methodology and Writing
Thesis Workshop
The following is an indicative list of classes offered in recent years and issubject to change.
I D. I ndicative Courses
The fotJ owing classes are offered within the framework of the YI P. They are divided into three categories: Foundational
Classes, Recommended Classes for YI P &Other Elective Classes.
I I . Participants
As a one-year Master's program in law, this course is primarily geared towards persons who have worked in the legal
department of govemment ministries &business, as well as judges, public prosecutors, lawyers and other law-related
professions. I n particular, the program is suited to lawyers or government officials working on international trade issues or
commercial transactions.
I. Overview
The primary focus of the YI P in Law at Kyushu University is international economic and business law. The program has
been specifically designed to expose students to both theoretical and practical perspectives on a wide range of contemporaI y
legal issues related to international trade and commercial transactions. Courses taught within the framework of the YIP
focus on "cutting edge" topics driven by the research interests of an international fuculty. As such, the program aims to
provide students with the necessary intellectual skills for pursuing a law-related career in an increasingly global economic
environment.
Young Leaders Program (Law)
Curriculum Guidelines
"
- 6 -
V1.FurtherirUonnation
For further information on theY LP program:
http://www./aw.k:yushu-u.acjplprogramsineng/ish/
For further information on Kyushu University:
http://www.kyushu-u.acjp/
And yet, perhaps the most important feature of Fukuoka for the foreign resident is its people. Known throughout J apan for
their friendliness, the people ofFukuoka have long enjoyed good relationships with visitors from abroad. For the foreigners
living among Fukuoka's 1.7million residents, life isboth comfortable and stimulating.
Kyushu University is the largest university in Kyushu and one of the most prestigious national universitiesinJ apan. Founded
in 1911 as one of seven original I mperial Universities, it continues to be a focal point for academic and educational
excellence. Graduate study in Kyushu University provides well-motivated students with the opportunity to study in a
dynamic academic atmosphere and to enjoy life inone of J apan's fastest growing cities.
I n 2006, Newsweek named Fukuoka as one of the "Ten Most Dynamic Cities" in the world, identifying an energetic
regional economy, excellent infrastructure, and the proximity and openness to Asia as key features behind its continued
growth. InJ une 2008, the Financial Tunes reported a survey of world cities that ranked Fukuoka as the 17thmost livable city
in the world, and awarded the city aspecial commendation for it's downtown district
V. Fukuoka &Kyushu University
Located in the heart of East Asia, midway betweenTokyo, Shanghai and Seoul, Fukuoka is the largest city in Kyushu, the
southernmost of J apan's four main islands. I t is a thriving modern metropolis that has not sacrificed itsunique local character
and charm. Historically known as Hakata, it has long been one of J apan's key ports for commerce with the rest of Asia, and
today thespirit of Hakata lives on, for thegrowing continental ties of recent years haveenabled thecity to establish itself as a
major regional.center.
Students arealso provided with various swnmer internship opportunities at Tokyo based law firms and/or largecorporations.
These internships provide students with the unique chance to experience international conunerce and legal practiceinJ apan.
rv. I nternships
Each Y LP student will be assigned to a Fukuoka-based law fum for around 2 weeks (in February - March) to experience
legal practice in J apan. The interns will attend court hearings and accompany the lawyers for consultations with clients.
During the internship students will visit other law-related institutionsand will engage in discussions with servingjudges.
I n addition, to coursework students are expected to complete a Master's thesis (50 pages minimum),
For an up-to-date curriculum see: http://www.law.kyushu-u.acJ plprogramsinenglishl
of
Bioethics and the Law
Nature, Business and the law
I nt'l Sports law
J apanese I ntellectual Property Law Practice
Creative Economy, I nnovation & the law
EU Private Law
Facts and Theories of Conflict Management
* Irpossible. writeanemailaddress whereyoucanbecontactedforperiodsthal includethetimebeforeyoucometoJ apan. your stay inJ apanandthe
periodafter you return home.
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Day (a) Month (J l) Year (~)
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* Personal data entered in this application will only be used for scholarship selection purposes. and contact information
such as o-mall addresses wi11only beused for forming related humannetworks after the student returns hoee and for sending
of information by the J apanese Government.
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Re l a t i o n s h i p :
( a wa r d e d / a p p l y i n g ) Na me :
14. [ s t h e r e a n y o n e i n y o u r f a mi l y wh o h a s b e e n a wa r d e d o r i s a p p l y i n g f o r a J a p a n e s e Go v e r n me n t S c h o l a r s h i p ? If y e s , h i s / h e r n a me
mu s t b e p r o v i d e d h e r e .
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Na me Re l a t i o n s h i p Ag e
(B;; 4r.) (lit .fI 'i) ({J :. ft;)
13. Ac c o mp a n y i n g De p e n d e n t s ( P r o v i d e t h e f o l l o wi n g i n f o r ma t i o n i f y o u p l a n t o b r i n g a n y f a mi l y me mb e r s t o J a p a n . )
f;iJ (*~16'i. (I ll13T~*{l-. f'lJ i*-rli! m~~llSv'~~I.:RCAT~': ~.)
*Al l e x p e n s e s i n c u r r e d b y t h e p r e s e n c e o f d e p e n d e n t s mu s t b e p a i d b y t h e g r a n t e e .
($) ttj3J WJ f*~I::! IZ,J ! t.dUtl:l:~t~"Ctl7*~(l)1\m"'t'~~.
OR
S c o r e o f I E L T S
( I E L T S (1);r.::77)
S c o r e o f T OE F L
( T OE F L os : ::77)
E x c e l l e n t Go o d P o o r
(11) (J il) (1'iif)
F r e n c h
(1,.~)
Ge r ma n
(~i! )
S p a n i s h
(NI M-)
12, F o r e i g n l a n g u a g e p r o f i c i e n c y : E v a l u a t e y o u r l e v e l a n d f i l l i n wi th a n X wh e r e a p p r o p r i a t e i n t h e f o l l o wi n g b l a n k s . Ab o u t E n g l i s ~1
r e p o r t y o u r s c o r e o f T OE F L o r I E L T S .
(:9I-lAIilflUJ a-c.a(d5(l)? x .. ~3.I': X FfJ Hc}d"'~':~. t:.t:'\", ~Htl,:-?"'''nj:, T OE F L X lj: I E L T S (l).A::q a-~ T~': ~o )
'.
Applicant' 5name
(in RomanBlock Capi tels) :
(lf1f.~~:f,)
Applicant's sianature:
(llIfJ :t-J H.)
Dale of appl ication:
(Illft"FJj B)
I understand and accept all the matters stated in the Application for Japanese Government OIONBUKAGAKUSHO:IlEXT) Scholarship for 2014,
.,
and hereby apply for this scholarship.
(:tL.li2014"FIlB*~R'f (~i5ft~) ~~ ~ljJ =:iG.~h.-n'o"~T~':-T~t.,':-lfImL.1tT.)
Please note, the submission must address the above issues specifically, and must be solely the
product of your own efforts. Wereserve the right to disqualify any statement written by, or with the
help of, someone other than the applicant.
4. Include any further information about yourself that you feel may be relevant to the Admissions
Committee when considering your application. (This might include other relevant professionaJ
experience, academic publications, prizes, scholarships awarded, membership of professional
societies, as well as any other significant personal achievements). (max. 600 words maximum)
3. Please provide a recent example of a law that has been enacted in your home country. Describe
the background and reasons for the legislation, the substance of the new law &any limits or
problems that thenew law has created. Please feel free to choose an example fromany field of law
(substantive or procedural, public or private). (max. 800 words).
2. As a YLP student, you would be expected to write a 50 pages Master's thesis in an area of
international economic and business law or comparative law. Please write ashort research proposal
for your thesis describing the issues you would like to research. It might also be helpful to know
how researching this topic might contribute to your long-term career plans (max. 800words)
I. Write a personal statement describing your background, career goals and - in particular- your
reasons for applying to the Young Leaders' Program. Inaddition, please explain how participating
in the YLP would contribute to your long-term career development (max. 600 words)
Please answer ALL of the following questions:
The submission must be typed. Please use A4 sized paper or 8 1/2" x 11" paper. Limit your
responses to the maximum number of words designated for each question. Use standard double
spaced lines with a 12 point font. Your name should appear at the top of each separate sheet of
paper. The number of the question should also be clearly written. Staple the pages together and
submit them along with other application materials.
As part of the application process you are required to submit aStatement of Purpose. This statement
will provide the Admissions Committee with more detailed information about you and your reasons
for applying to the Young Leaders' Program inLaw. The submission offers you the opportunity to
present yourself more fully to the Committee and provide us with greater information on your
candidacy.
Essay Questions (Law)
- 1-
6. Curriculum (Refer to the "Curriculum Guidelines" on page 5 and 6)
(I ) Basic Concepts
The curriculum is suitable for developing national leaders in each field, seeking lO take advantage of J apan's experiences of
exchanges with both Westem and Asian countries and establish a human network through various activities such as special
lectures and internships.
(2) COlU"Se Duration and Qualification
Course duration isprincipally one year, resulting inthe conferring of a Master of Business Administration (MBA).
5. Recruitment and Selection
(I ) Method of Recruitment
The recruitment will be conducted through recommending authorities, Please ask the J apanese Embassy for further
information,
(2) Screening Procedure
CDFirst screening by the recommending authorities
~econd screening by each host university
@Final screening by the Y L P committee established by MEXT
4. The Number ofY L P Scholarships
A maximum of 15students.
3. Host University
Hitotsubashi University, Graduate School ofI nternationaJ Corporate Strategy (Hitotsubashi rCS)
The Master of Business Administration (MBA) program at Hitotsubashi I CS is designed to prepare srudents for work in the
business world Courses focus on strategy, marketing, accounting/finance, etc. All classes are taught in English, and in
contrast with other designated universities, Y L P participants at Hitotsubashi rcs are completely integrated into the regular
program; in other words, they must follow the same academic calendar and meet exactly the same academic requirements as
all other students. Course grades are rendered on a strict forced curve, and students must meet overaU minimum grade
standards in order to graduate.
2. EligibleCountries and Participants
Participants are selected from the countries listed below. They should be entrepreneurs, business managers, and so on, who
are expected to play active roles as futurenational leaders intheir respective countries,
Target Countries:
Australia, Brunei Darussalam, Cambodia, I ndia, I ndonesia, laos, Malaysia, Mongolia, Myanmar, the Philippines,
P.R. China, Rep. of K orea, Singapore, Thailand, Vietnam (15COlU1tries)
1. Objectives
The Y OlU1gL eaders' P rogram (Y L P) aims to contribute to the fostering of future national leaders inAsian and other countries.
Inaddition, while deepening the participants' understanding about J apan, it should help form a network among national
leaders, contributing to the establishment of friendly relationships and improved policy planning activities among Asian and
other countries, including J apan.
The Y L P is one of the J apanese Government (Monbukagakusho: 1\1EXT.) Scholarship Student programs.
MEXT=The Ministry of Education, Culture, Sports, Science and Technology
I OUI L I NE
J APANEsE GOVERNMENT (MONBUK AGAK USHO: MEX1) SCHOlARSHI P FOR 2014
Y OUNG L EADERS' PROGRAM (Y L P) I N BUSI NESS ADMI NI S1RATI ON
- 2 -
4. Scholarship Benefit
(1) Allowance: 242,000 yen (inacademic year 2013; theamount is subject to change) per month will be given to each grantee
during the term of the scholarship, with the understanding that the scholarship will be suspended in cases where a grantee is
absent fromthe university.
Scholarship will be cancelled for a grantee inthe following cases. Furthermore, if scholarship payments were made during
the period the following cases applied, the grantee may be ordered to return scholarship payments received during that
period.
3. Term of Scholarship
One year fromSeptember 2014toAugust 2015.
(5) Graduate Management Admissions Test (GMAl) score: Although not strictly required, thesubmission of the GMAT score
is highly desirable. A GMAT score taken within the past five years is one of several admissions criteria that helps the
admissions committee determine the business aptitude of the applicant
(6) Professional Experience: At least3 years of full-timework experience.
(7)Health: Applicants must have no infectiousdiseases.
(8) Visa Requirement: Selected applicants must acquire "College Student" (ryugaku, W/~) visas before entering J apan.
They then enter J apan with the "College Student' (ryugaku;M~) residence status. Applicants who are already in J apan
under a visa other than College Student are required to change it to College Student by the end of the month preceding the
start of the scholarship. Applicants who change their resident status to any status other than "College Student' after their
arrival inJ apan will immediately losetheir status as aJ apanese government scholarshipstudent
(9) Others: Any applicant who meets any or all of the following conditions is not eligible. ifidentified after the start of the
scholarship period, theapplicant will be required to withdraw fromthescholarship:
CD The Applicant is an active member of the military or acivilian employed by the military at the time thescholarship period
is due to begin.
The Applicant is unable to travel to J apan within thedates set by the receiving university
@The Applicant is currently enrolled ina J apanese university under the resident status of "College Student," or if he/she
plans to enroll at aJ apanese university as a privately-financed international student between the timeof application for this
scholarship and the time thescholarship period is due to begin.
2. Qualifications
(1) Nationality: Applicants must be nationalsof acountry participating intheY LP Program,
(2) Age: Applicants must be, in principle, under 35 years old as of September 1,2014 (i.e.,born on or after September 2, (979).
(3) Academic Background: Applicants must becollege graduates who have achieved excellent results.
(4) English Ability: a minimum TOEFL (paper-based) score of 600 or TOEFL-CBT scoreof250 or equivalenl
1. Field of Study
Business Administration (Hitotsubashi University,Graduate School of I nternational Corporate Strategy)
MEXT will offer scholarships to foreign students who wish to study in J apanese universities as Y LP students in business
administration for the academic year 2014 under the J apanese Government (MEX1) Scholarship Program. The conditions
are as follows:
I T OOD RMATI ON FORAPPUCANTS
7. Commencement of theProgram
September 2014
(3) Language
All instruction will be conducted in English.
- 3 -
t2) Photographs (6 x -t em, taken within the past 6 months. should be affixed on each of the 5 application forms)
.----- ----------- 5 Originals
(3) ~Otl~;:;iaJ Transcript or Certified Academic Record from both undergraduate and postgraduate studies at the university the
applicant attended ------------------------------1Original and 4 Photocopies
(4) :I DRecommelldation L etter from the Recommending authority
---------------------------------------------------1 Original and -l Photocopies
(5) QJ r\\0recomrnendanon L etters from the! Employer or from ihe supervistng Professor of the university the applicant
attended (prescribed [ol1n)--------------------------------------- 1Original (each) and -t Photocopies leach)
----I Original and -t Photocopies (except photographs) -------------------.---
7. A ppl icarion Procedure
Applicants must submit the following documents to their recommending authorities b) the designated date. (The submitted
documents will not be returned.)
(L) CDApplicarion for Admission (prescribed form)
6. Education at University
All lectures and practical training at universities will be conducted in English.
5. Selection
(I) Based on recommendations from authorities, the participating university will select initial candidates from among applicants
by means ofan interview and a review of the submitted documents. lfit is impossible to hold an interview in the applicant's
home COLU1try, an interview will be conducted by telephone.
(2) Those \"ho have been selected initially by the participating universities will be put forward to Ole Y l.P committee
established by MEXT for the final selection.
CD Ifany ofhisher application docwnents is foundto be falsely stated;
I fhe/she is in breach ofhis/her pledge made to the Minister ofMONBUK AGAK USHO(MEXT);
@If it becomes definitive that the grantee will not be able to complete hisher course within the standard course term
because of'hisher poor academic achievement or suspension;
@lfhislher resident status of "College Studenf' as provided for in Paragraph 1-4 of Appendix to the I mmigration Control
and Refugee Recognition Act changes to any other status;
I f he/she is provided with another scholarship (except for ascholarship designated for research expenses);
@The request from the government and/or other state institutions of applicants horne country
(2) Transportation:
CDrransportation to J apan: Each grantee will be provided, according to h.isI her itinerary and route as designated by MEXT,
with an economy class air ticket from the international airport closest to his/her place of residence to the Narita
I nternational Airport (or following the itinerary normally used by the university where the grantee is placed). Expenses
such as inland transportation from his/her place of residence to the nearest international airport, airport tax, airport usage
charges, special taxes on overseas travel and travel expenses within J apan will be borne by the grantee (the place of
residence of'the grantee shall in principle be the address stated in the application form).
@Transportation from J apan: The grantee who is going back to the student's home country within the fixed period after the
expiration of the scholarship will be supplied, upon application, with a tourist class air ticket from the New Tokyo
I nternational Airport to the international airport nearest to the students home address. Such expenses as inland
transportation from his/her home address to the international airport, airport tax, and special taxes on the travel will NOT
be provided. (Theaddress in the country of the grantee's nationality stated in the application is in principle considered as
the "home address. ")
* Any aviation and accident insurance to and from J apan should be contracted by the applicant The airport the grantee
departs from or returns to must be an airport of the country ofhislher nationality.
(3) School Fees: Participants wiU be exempted from fees for the entrance examination, matriculation, and tuition.
(4) Accommodations:
lfY L ? students so desire, they may reside ina single room of the accommodation provided by Hitotsubashi University.
- 4 -
8. Notes
(1) For more detailed information on this scholarship program, please ask the appropriate office at the J apanese Embassy in
your country,
(2) Each recipient is advised to learn the J apanese language used in daily life and to acquire some information on J apanese
weather, climate, customs, and conditions in J apan, as weU as about the difference between the J apanese legal system and
that ofhislher home country prior to departing for J apan.
(3) lt is highly recommended for grantees to bring approximately the equivalent of at least USS2,OOO in convertible currency
to cover immediate needs upon arrival inJ apan.
(6) @X;ertificate of Health (to be issued by the medical institution designated by the J apanese Embassy)
--------------------------1 Original and 4Photocopies
(7) @A true certified copy of an Official Diploma or Certificate of Graduation from both undergraduate and postgraduate
studies at the university theapplicant attended 5Photocopies
(8) @An Essay explaining theapplicant's aspirations and future plans after thecompletion of theY l.P
--------------,---------1 Original and 4Photocopies
(9) (J)A Copy of the applicant's Family Register, Photocopy of the Passport, or <tcertificate of the Citizenship (any of
these 5Photocopies
(10) English Proficiency Certificate (fOEFL or other equivalent test score. No submission is needed for applicants from
Australia, and applicants who have graduated from a four-year university where the language of instruction is
English) 5Photocopies
(11) Answer to the Essay Questions I Original and 4Photocopies
(12)(fixJ MAT score 5Photocopies
GMAT score taken within the past five years is highly desirablealthough not strictly required. lfthe applicant has not taken the
GMA T, we encourage theapplicant to takethe test no later thanOctober 31, 2013.
(13) Others
<D Use A4paper as the standard for all submitted documents, which in principle should be typed. Handwritten documents
should be written clearly.
These documents should all be written in English. I f written inanother language, attach an English versiontranslated by
a public institution. Caution is necessary as many applications are not written in English and do not come with an
English translation, particularly recommendation lettersand diplomas.
@ Recommendation letters written by a workplace supervisor or an academic advisor from one's university should be
written separately by two of them and must use the stipulated format At least one and preferably two should be written
by your direct boss at work.
@ Reason for application and future plans will be important factors in selection, so submit a small essay of three pages
explaining as much as possible what you expect from this program and what kind of job you seek in the short-and
long-terms.
@ I f you submit test English proficiency scores from TOEFL or I ELTS, please submit scores obtained roughly within the
past two years. I f you submit other certifications, please submit documents illustrating how to convert the score to
TOEFL or I ELTS.
I f you have a book or dissertation, submit a separateoverview.
(J) Y our application may be rejected if the above application is either incomplete or inaccurate, or if some documents are
missing.
Write the numbers Ithrough lOin line with the item number for the items above on each document in the upper right
comer.
- 5 -
Foundation Week
Strategy
Corporate Finance
Organizational Behavior
KnowledgeTheory
Marketing
Business, Government and International Economy
Operations Management
Intensive Business Writing
Quantitative BusinessAnalysis
Accounting
Financial Reporting
Business Ethics
International Business
KnowledgeWeek
Global Citizenship
Strategy Simulation Week
J apanese Culture
Ill COLl!SeS
IRequired Courses (44crcdits)
11 Participants
Itisnecessary fortheparticipants tohaveat least3yearsof work experience. This work experiencecanbeinawiderangeof
fields,but has to be full-time. The classes will all beinEnglish, so itis necessary tohaveagood command of thelanguage.
Selection will bebasedon anoverall evaluationof acandidate's work experience. GMAT score, Englishability, thequality
of theessays, recommendations fromsuperiors, andaninterview.
I Basic Concepts
1 The Y L P in Business Administration is built around thevision to seek the"Best of theTwo Worlds' in management
methods, onethat was developed inJ apan andtheother developed inEuropeandtheUnited States. Its objectives include
learning about "Knowledge Management" and "Operations Research" led by.J apan, and also "Entrepreneurship' and
"Corporate Finance," fields inwhich theWest isthecurrent leader. Theultimateaim is toconstruct aglobalized universal
management model.
2 The Y L P will be aforumwhere future business leaders of Asia can interact withstudents fromJ apan, Europe, and the
United States. The learning method will incorporate case studies, exercises, simulations, and experiments which are
popular inthe West, as well as small-group seminars with professors, which areJ apanese strong points. In addition, the
students will go out into thereal business world by visiting companies, 'utilizing the latest technologies, participating as
business professionals, andother such types of actionlearning.
3 A one-year MBA programhas beenestablished, that foUowsglobal standards withgraduate requirements similar tothe
normal two-year MBA program. Y L P students inBusiness Administration faUunder theone-year MBA programandare
required totakeaminimum of 66 credits inorder tomeet graduation requirements.
Y OUNG L EADER'S PROGRAM IN BUSINFSS ADMINIS1RA1l0N
CURRICUL UM GUIDL INES
-6-
IV Further information
Toobtain information about Hitotsubashi University's Graduate School of International CorporateStrategy,pleaseaccess the
Web siteat wwwics.hit-u.acjp/
All inquiries must besubmitted viafax(+81-34212-3006) ore-rnail(ics-info@ics.hit-u.ac.jp).
Change Management and Leadership
Strategy inEmerging Markets
'Ibpics in Business Ethics
Applied Corporate Finance
Topics in Finance "
'Ibpics in Knowledge Management
Problem Solving
Dynamic Competitive Strategy
Organization inEmerging Markets
Executive Coaching
'Ibpics inInnovation
Knowledge Generation
'Ibpics in Operation
Company Analysis
Human Resource Management
Competitiveness and Clusters
Negotiation
Customer Behavior
Field Study
J apanese Language
Independent Research
Service Management
Systems Thinking
Marketing Research &Analysis
Career Development
Financial Institution
Control
Venture Capital
Equity Investments
Entrepreneurial Business Planning &Management
Brand Strategy and Design
J apanese Business and Economy
International Finance
Microeconomics
Financial Institutions
Doing Business inAsia
2 ElectiveCourses (minimum 22credits)
Seminar
-1-
tr possible. wrue an email address where you can be contacted for periods that include the urne before you come to J apan, your Slay InJ apan and
the period after yOUreturn home.
(iiftiiUtf>lllJ . i.J BiIti-8Al>:it'$CP-~~~I.:bt:: ') ItH~lt '!):. c~I'l-:t!\~h,!) E-mail 7 rVA~ICAT'!)': c.)
E-rnaiI address Facs i",t Ie number Telephone number
5. Present home address and telephcne number, faesimi Ie number. E-"", iI address
(!l1.f:tm~{}1tUs.jjf~. 77 'l? ~~-J }XliE ;1-/1-7"" VA)
Address
E-mail address Faes imi Ie nUliber Telephone number
'_ 1
(l;~ (6 x 4CII
4. Present status: with the name of the univers ity enrolled In, or of the eJ lployer
(l.J !..m (t*:Ic$~~liilJ tMe~ ~'{'teAT'!):' t.J
&at.*.~~~~~O')~~~~, 77'l~A~~X~E~-~7~v~)
Present status
Year (~)
~ your passport photograph
taken withIn the put 6months.
Write your name and nationality
in block leuers on the back of
the photo.
Age: o s of September 1,2014
(2014 ~ 9}J I B ~t.E0')~8)
Oay (8) Month (JI)
3. Dale of birth(1:.~}J B)
19
.- .
, ,
, .
DYes, [have (Ii\.,)
oNo. Idon't have (\.'\.';0
2- 2. Possession of japanese nallonal i ty
(B;;js::1J I,,~:tfi' '5~I')
2. Nationality
(1El fir)
(Family name/suCRtlJ lle) -----.(,..Fr:ir:-:s-=-t-:n:-:u""'"'e)r--------n(M:ni'::J d'Tdl'"'e~nlIJ I)=eT'} ----
(Mari tal Status)
oSingle (*.tt)
oMarr ied(Ill")
In Roman Block Capital Letters (if written in the passport, follow that form)
(c-'?~, .I<A~- H!U'G~I"'5~Ii. -t.t1.I.:~b-tt'!):, t)
(Fanll [y nilJ :le/surnBlle) -----.(f.,..,...1r--s-=-t-n--a--J lc'"'}r--------nOlT!I":J d.'Tdl'"'e,-,..-nu=:'eT'} ----
(Sex)
oMale (J J )
oFellBle (:9;')
1. Name in full, in native language
(jr~ (131J .1J !
INSTRueTIONs (ICA.tO')tt;t:)
1. The application should be typewritten if possible, or neatly handwritten in block letters. (OOIl'::ICAT'!):'J :.)
2. Numbers should be in Arabic figures. (~I~JJffl~z.JJJ\"'5:'J:.)
3. Year should be written In the Anno Domini system. (~.f}r1i'~"('liMJ :t''5:' J:.)
4. Proper nouns should be written in Iul l, and not be abbreviated. (~=A'~SI1I~T~"('1E~~:tl~.1i);l:~,-fjJ~lIIi~tl~':.t.)
Personal data entered in this application will only be used for scholarship selection purposes, and contact info~tion
such as e"1ll8il addresses wi 11only be used for forlling related huean networks after the student returns homeand for sending
information by the J apanese Goverruaent.
(;;js::f1'I mtf'.:fc~~.t1.t::IiJ .A.m9IH.:"?~'"('Ii. ;;js::~~~O')iB~O')t::~I.:ltmt' '5liU'li, ~I:: E;f.-/1-7 }-:vAWO')ilM~I':"?~'"(,I;I:.
~1liIt.i'':~lt'!)1!o'l~#0')*';I t-'l-~~t'!):. t.&a,ejll':J t,~a~ ~I') ~rttJ 9!l~~{!t''5t1.M-'.:{lffl ~/l~'. )
Y o ung L e a de r s ' P r o gr a m Appl i c a nt f o r 2014 ( Bus i ne s s Admi ni s t r a t i o n)
(1"~~. !J -~-X 7"o~7.b.ii~~) (t'~-*A=Z-A)
APPLICATION FOR J APANESE GOVERNMENT (MONBUKAGAKUSHO: MEXT) SCHOLARSHIP
- 2-
Notes: 1. Exclude kindergarten education or nursery school education. (~fill:i'l' ~tfmti.'ili~h.tl~'.)
2. Preparatory educa t ion for urn vers i ty adaiss ion is included in upper secondary school. (~\bi<J>~ r*~'f.{;;f'{~J ~io/~
~'f.il':~*.h.~. )
3. [f the applicant has passed th<l university entrance Qualification examination. indicate this in the blank with *-1. (f;k
1f:":'f:1J ffll.~!I?<J I:.1}~ t,- c it\~~I':li. b?~z. *-1.''::3C)\. T-5 z.c.)
4. Anyschool years or levels skipped should be indicated in the fourth colWlUl(Dip!oma or Degree awarded. Major Subject. Skipped
years and levels}. (Example: Graduated high school in two years. etc.)
(It\bi<J >-5 rjit'CJ mJ H,n\~~.g.''::I;J :. 1:'(7)l1i?::$~T~~1nlIU- i(7)f- +UL' J if!. ~m~I3.1RtJ m(1)~iSC.J 1I1:.~tt~
'::l:. (gil: ,lj&3fj!~?:1R'CJ .f&1::J : "J l!iMZ;S.)
* ( f the blank spaces above are not sufficient for the information required. please attach a separate sheet.
tt) J :lill::t!f~~nltH~~1}I':li. iIj~'t81Iml.:!C)\. VOM1T~':: c.)
Level of Education (e. g..

Elementary. Secondary (Lower;

Name and Address of School Year and lionth Diploma or Degree Awarded.
and Cpper). Undergraduate,
:
of Entrance and
Period of Schooling
Major Subject
Graduate

Cocapletion
(~W v-"Iv : m~(/J'~), '1 >: (*~~It)
*('1>$, j(Ij&), j(Ij~ (*'~,:
($&~Ik{}FJ T!Eit!!) ()\.~IktJ~~m ($1u:. ~~. ~l!tfl.El)
*$~) } :
: Name

Froll! years

(&~)

()\.f:)

(~)

:



Location To and

(ffli"i1!l) ( ~; n

months

(J l)

Name

years

: Frolll
(~&~)

(~)

()\.$)

Location

and

To
(fflfi1!l)


months
:
:

(lit~)
(.I'D
:





:
Name

years

: From

(~&~)
:
()\.~)

(fj!)
:

Location
To
and :
(P )fi".Ii!l)
months
:
(l itR E >

(.F!)
:

:

Name
:

From

years
:

(~&~)

(fj!)

()\.~)

Location

and

To
(mi".ItIl)


months

(zp.)
(J l )

:
:
Name
:
years

($&:f,)
:
From
(fj!) :
()\.~)

:
:
: Locat ion
To

and
(PJ iifltll) IDOnths

(l?!=1I)

(J l )

Total years of schooling mentioned above years

W..l:a-iin~L- t:~$&~.{f}1f:fj!Iic) (~)
6. Educational background (~)
- 3-
Excellent Good Poor
(EI) (ll) (::r-or>
Rending
(~tr~lJ )
Writing
(l!f < ttgn)
Speaking
<a5-rliElJ )
10. J apanese language proficiency' Evaluate your level and fill in with an X where appropriate In the following blanks
(B *J !~-e17~ElC!.I'fllj(1)?;t. 1~'l:\lQI.:xf./l!-reA-r-o:: ~.)
Period
< J 9 I r J l )
Extracurricular and Regional Activities
(iI~r.!iIJ XliJ :tl!%\.'O')I'iUh>
9 Extracurricular and regional activities (m~r.!iIJ J XI~u!!~11~\.'C1)I6"')
8. State the titlos or subjects of books or papers (includine the craduation thesIs authored by the applleant), if any, "ith the n811e
and address of the publisher and the date of publication (a s~~ry of the papers sl~uld be included.>
(?flf. ra~(l:ft1lUa~~~tt.>DIi>tt.t!-{:'O')M~. Ii1l;&tt~. 1:I:11\i~J ! B. tfj~~mHCJ d.,. X. 1j,)~0') ~1$f:t0'):: ~.)
Nameand Address of Organization Period of Eoploycent Division/Section Position Type of 'ork
I
(.ib~.s'i:& ViJ f~J &) (t1J ~1J I1IIJ ) (M) (&a;t,) (H~W:)
From
to
From
to
From
to
From
to
From
to
7. Employment record (begin "ith the most recent employment, if applicable) (e)
- 4-
14. Person to be notified in the applicant's home country, in case of elDergency:
(~~.O)~O)-taOO0)i!J !:~$'t)
i) Name in full:
( ~~) - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
ij) Address: with telephone number. facsimile number. E-mail address
({1:m: ~15:J i:~. 77-;t'/ 7.'Ifi:-l},RliE;I-;v7rv7.~!CAO):.t.) -----------------
iii) Occupation:
(Ql ~)
iv) Relationship:
(*"C (7)M fJ f.)
Name Relationship Age
( ~ ~) ( m .fiIi) (~ ~)
13. Accompanying Dependents (Provide the followinginformation if you plan to bring any family members to J apan. )
(lI]f*~~1I (ilII:l3-rOl;I~. filIf4!'f-~O)~~DSlo'otk}~I.:1t.A-rO:' c.)
All expenses incurred by the presence of dependents must be borne by the grantee. He/She is advised to take into consideration various
difficulties and the great expense that will be involved in finding living quarters. Therefore, those whowish to be accompanied by their families are
advised to come alone first and let their dependents come after suitable accommodation has been found.
(
(it) fi'}';ial(*,I.::~,l!t,d!.'"1-r-<-Cil~1;O)j\m i.'~01)<. ~~fflO)m~~)j.....,'t 0:' c lim~mlli.'~ I) .~.1SI-b1MtI.::lIJ iOil': )
"toO)i.'~~1)'t;tJ ~~~n~~'. :.O)~tJ. 1W$1;li*-r*~"('.~rHll.-, ~~tlm~~)j.""'lt~Ut. *~~,*U1fT-ItO:'l:.
Relationship:
(awarded/applying) Name:
12. [s there anyone in your family who has been awarded. or is applying for a J apanese Government Scholarship? If yes. his/her name
must be provided.
(~~O)cpl.::OOJ t~!iilAil~1;I:.!*J fl ~n -Clo'o~. b I.-<lilfllftcpO)#D{itJ O'. b 1.-. itJoll ~t!. -to)~0).a; H~,-ncA. +0:' c.)
OR
G MAT SCOf e
(G.W,T 0)7. =:17)
[ELTS Socre
(lELTS 0)7. =z 7)
TOEFL Score
(TOEFL0)7.=z 7)
Language Excellent Good Poor
Cifmt) ( . ) (a) ('!'PI)
11. Foreign language proficiency: Evaluate your level and fill in with an X where appropriate in the following blanks. For English.
report your TOEFL or [ELTS scores. Those who apply for the B us iness Administration course should also report their G MAT score.
(~OOm~jJ ~13c.~{dfi0)?;t. I1<~Hilfl,::xl'fJ ~reA.-to:' C. ~tf.I.-. ~fltl'::""'P-CI"i. TOEFl.J {l"ilELTS0)7. =:17HeA-t 0:' C. ~t.:..
1::'~*7. =Z-7.;E\8~t;tGM AT0)7. =:I 7MeA-to:' c.)
- 5-
Ap p l i c a n t ' s name
( i n Ro ma n Bl o c k Ca p i t a l s ) :
(IfItnt~~)
Ap p l i c a n t ' s s i g n a t u r e :
(IfIrJ 1t~)
Da t e o f applic.ation:
(lfIit~J J a)
r u n d e r s t a n d a n d a c c e p t all t h e ma t t e r s s t a t e d i n the Ap p l i c a t i o n f o r a J a p a n e s e Go v e r n me n t ~GAKUS HO: WE XT ) S c h o l a r s h i p f o r
2 0 1 4 , a n d h e r e b y a p p l y f o r t h i s s c h o l a r s h i p .
(Ufi 2 0 1 4 iFlfa*~J I'f (.1C8Il"~) 9!~~f~~.~IlI.::re.~i1. -n'o lPla-T....:.-c7NH ..-c1fl11t L.~T.)
5. How did you become interested 10 the Young Leaders' Program in Business
Administration at Hitotsubashi University? Please identify specific information
sources including publications, the internet, students, faculty, friends, etc. (This
question is for informational purposes only, and your response will have nobearing
on your candidacy)
SUPPLEMENTARY INFORMATION
4_ (OPTIONAL) Is there any other information that you believe would be helpful to
the Admissions Committee in considering your candidacy? (maximum 300words)
3. The mission of the Young Leaders' Program in Business Administration is to
develop leaders capable of initiating, implementing, and managing innovation.
Describe a specific situation in which you led innovation or change in an
organization. Explain the impact this experience had on the organization as well
as on your own valueslbeliefs. (maximum 300 words)
2. Successful leaders are able to learn from failure. Describe your biggest
non-academic setback, disappointment, or regret to date. What did you learn from
that experience? (maximum 300 words)
.1. You are who you are through your life experiences. Tell us about yourself, your
upbringing, individuals who have had the greatest impact in your life, events that
have influenced who you are. What has become most important toyou personally?
We want to know you as a person. Looking ahead, what are your future
professional goals, your business dreams? What excites you? Howhas this led to
your application to the International Business Strategy Program? We want to
know about the career path you have in mind. (maximum 1,000 words)
Your essays must be typed. Please use A4-size paper or 81/2" X ll"paper. Limit your
responses to the maximum number of words designated for each question. Use
standard double-spaced lines. Your name should appear at the top of each separate
sheet of paper. The number of the essay question should precede every essay. Staple
the essays together and return them to the Admissions Committee with other
application materials.
The following essay questions will provide the Admissions Committee with more
information about you and your reasons for applying to the Young Leaders' Program.
These questions give you the opportunity to present yourself more fully to the
committee and provide us with better insight about your candidacy.
Essay Questions
Business Administra tion
~:ti1i(!~~
Office/Institution:
F J T 1 ' l &
Address:
~ S il i ~ ~
Physician's Name in Print,_: _
~.~
S ignature: _
13ft
Date: _
No 0 Yes 0
7. ~mi~Q)~U. ~$' #(.ma~~t:>~J ttl fI..- - C, ~fl 1)~l fiO)tJ ;:~t;l :1f~I~ rl I~l .::iI.:t ; - 0b 0)c,~.btv~T~\?
In view of the appl icant's history and the above findings. is it your observation that his/her heal th status is adequate to pursue studies in J apan?
6. ~,*~Q)~.~~~- cr~~\. (MI.!.I~(/.t~\~t>, - t- Q)~::fCA< e~~\o)
Pl ease give your impression of the appl icant's heal th. (II you do not have a particul ar opinion. pl ease write as such.)
.$0
anemia
~i:t E S R : __ .;.;mm'H r. WBC c o u n t:_ _ ....; / c mm
H emogl obin: __ .... gm/dJ . GPT: _
Other communicabl e disease,....O( . . )
H eart disease O( )
Psychosis.....D( . . )
TubercuJ osis D( ) Mal aria D( . . )
Epil epsy D( . .) Kidney disease O( . . )
Diabetes D( . .) Drug al l ergy D( . . )
Functional disorder in extremities O( )
None.....O
5. I1t iE Laboratory tests
~ BR Urinal ysis: gl ucose ( ). protein ( ). occul t bl ood (
4. gf~1iE
Past history : Pl ease indicate with +or - and fil l in the date 0( recovery
(II the appl icant has not contracted any of the disease, pl ease chech "None".) (~'-rtt.t>"~ L/.t~ '~I';l:, l.t 1..- 1.:: 7"x. ':I?T- 0':' c. )
DYes (Di,... s".,ea ... s,._e _
DNo
3. ml "iS ~cpQ)~~
Disease currenUy being treated
Describe the condition of appl icant's l ungs.
- Date
Fil m No.
DlE ~Normal
D"'~ Impaired
f4*D;~- oti ~
":',0 El ectrocardiograph :DlE ~Nonna1
OA~ lmpaired
,c.'tt
Cardiomegal y:
.n;~ DlE ~Nonna!
Lungs: D~~ Impaired
(4) ~ 11 OlE ~Nonna1 ~ ili DlE ~Normal
H earing; Ot- r Impaired S peech: DA~ Impaired
2. If!P- 1fQ)w.i5I.:""?~\- C,.~t X.~il EQ)*S .a- fC.AL- C< tf.~~'. X.bQ)13 ftt>fi!ATo':' t (67J I w....I:Il frO)~l E~.WJ .)
Pl ease describe the resul ts of physical and X- ray examinations of the appl icant's 'chest X- rays (X- rays taken more than six months prior
to the certification are NOT val id).
.if With gl asses or contact l enses
I A Bol RH ~ I ~se ~~.R=ar
~ft"~Q)fl ~ DlE *Nonna!
Col or bl indness OI4m- Impaired
(R) (L)
(3) m tJ
Eyesight (R) (L)
ant Without gl asses
f* 1ft
Weight kg
(1) ~ ~
H eight em
(2) Ifn. f mH
Bl oodpressure __;Il 1Il 1IH r- ==.a __;mnVH g Bl ood Type
1. k~:i:
Physical Examination
D.J J Male ~~J J 13
D~ Femal e Date of Birth: _
Middl e name first name
~
N~e:~~~~~ ~
fanul y name,
CERTIFICATE OF H EALTH (to be compl eted by the examining physician)
f.:j;1jl:m)U;l:9n~H':~IJ aJ l ",.::tcl tt"o,:, c.
Pl ease fil l Out (PRINI'ffYPE) in J apanese or Engl ish.
3. Please provide a short list of specific activities which demonstrate the applicant's salient
talents and strength, e.g., leadership, creativity.
Oless than once a month
03 or 4 times a week 01 or 2 times a week 01 or 2times a month Oevery day
2. Howoften have you observed the applicant? (Please tick one box)
1. Howlong and in what capacity have you known the applicant?
The person whose name appears above is applying for admission to the Young Leaders' Program.
Please provide your recommendation on your own letterhead or stationery. The Admissions
Committee values the recommender's direct contact with the candidate. In your letter, please
answer the following questions as candidly and specifically as possible:
Please return this formand your recommendation to the applicant in a sealed envelope, with your
signature across the seal. The applicant will submit the sealed, signed envelope to us as part of the
completed application package.
The Admissions Committee is aware of the time and care necessary to prepare this form. We
gratefully acknowledge your help.
Tothe Recommender
(Middle) (Given) YourName (Family)
Please complete only the top portion of this form. Your recommender should complete the rest of
the form.
Tothe Applicant
Recommendation Form
6. Please discuss observations you have made concerning the applicant's innovative/creative
capabilities.
5. Please discuss observations you have made concerning the applicant's interpersonal skills.
4. Please discuss observations you have made concerning the applicant's leadership abilities.
(Please tell the reason to judge that the applicant has a possibility to be a leader in your
home country.)
I nadequate Below
Average Good Verygood ExceUent Outstanding Exceptional
opportunity
avera~
to observe
G30ttan .
(Middlethird) (Thpthird) (Topl5%) (Top100"') (Thp5%) (Top2%)
Leadership potential
I nterpersonal skills
I magination and
creativity
Motivation and drive
Personal integrity
Self-confidence
Personal maturity
Sense of humor
Sell-discipline
I ntellectual ability
Emotional energy
AnalyticaJ /quantitative
ability
Ability in oral
expression
Time management
8. Please give us your appraisal of the applicant in terms of the qualities listed below:
What reference group are you using to make your appraisal?
7. Please comment on specific ways the applicant could improve professionally.
Home Address:
Business Address: __
Organization _ Position or Title _
Date _
Recommender's Name (please print) _
Recommender's Signature
o Home TelephoneNumber _
o Business TelephoneNumber _
Please provide telephone numbers. should the Admissions Committee feel a need to contact you regarding the
reference.
9. Please write if you have any comment. .