Application Form for JASSO Scholarship

JASSO Scholarship

Minimum Grade Point Average (GPA): 2.30 out of 3.00 or 3.00 out of 4.00 Financial Condition

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To Central Office for PARE ProgramThe following student will apply for the JASSO Scholarship, since the applicant is considered to be facing financial hardship, and thus financial support by JASSO Scholarship is necessary for the applicant to participate in this program.

PARE ID No.

Name of Applicant (as shown in passport)Family Name

First Name

Middle Name

***************Applied ProgramPARE Summer/Spring School(3 credits)

Semester Long Dispatch(at least 2 credits)

Year Long Dispatch (at least 2 credits)

Others ( )( credits)

Period & Duration of Applied ProgramParticipation Period From:To:Duration

DateMonthYearDateMonthYearMonths

Days

***************Academic RecordsNumber of earned credits

Latest cumulative grade point average (GPA)/ 3.00

Financial Condition (Please check )[ ] I now receive a scholarship.Institution Name:

Amount of Scholarship:

[ ] I now do not receive a scholarship

[ ] I, my spouse, or both now receives an income.[ ] Total annual income > JPY 4.86 million

[ ] Total annual income < JPY 4.86 million

[ ] Neither I nor my spouse now receives an income

I hereby certify that the contents of this statement are true Date:

Signature:

Type out your Name:

I hereby confirm that the contents of this statement are trueDate:Signature:

Academic Advisor Name:

Date:Signature:

Name of the Person in Charge in Administration Office