BQ orAa Dl)C v A BAa TAO D.~I HQC THAI NGUYEN CQNG HOA xA HQI CHiT NGHiA VI'¢T NAM DQc l~p - T\f do - H~nh phiic s6:33 t-IBHTN-HTQT vIv thong baa hoc bong cua Chinh phu HanQu6c Thai Nguyen, ngay 03 thdng 3 ndm 2015 Kinh giri: - Cac co sa giao due thanh vien - Cac don vi tnrc thuoc Tren co sa hop tac gitra Dai hQCThai Nguyen va Dai hoc Keimyung, Han Quoc, tnrong Dai hoc Keimyung thong bao v~ chuang trinh hoc bong cua Chinh phu Han Quoc nam hoc 2015 hoc tai Dai hoc Keimyung danh cho can be>,giang vien, sinh vien cua Dai hoc Thai Nguyen theo cac nganh hoc sau: - Khoa hoc xa he>iva nhan van (Luat, Du lich, Quan li giao due, Tam li hoc, Thu vien, K~ toan ... ); - Khoa hoc tir nhien (Sinh hoc, Sire khoe cong d6ng, Moi tnrong, Dinh dirong, Y Duoc ... ); - K1 sir (Ki~n true, May tinh ... ); - Van h6a nghe thuat (Am nhac, Thi~t k~... ). Giam d6c Dai hoc Thai Nguyen d~ nghi cac don vi trien khai rong rai toi toan th€ can be>,giang vien quan tam va chuan bi h6 sa theo huang d~n (tai lieu dinh kern); d6ng thai cac img vien lien h~ voi Ban Hop tac quoc t~ d€ c6 thu gioi thieu cua Giam d6c Dai hoc Thai Nguyen. MQi thong tin chi ti~t xin lien h~ Chuyen vien T? Nguyet Trang, email: [email protected], di~n thoai 0280 3851690. Tran trong earn an.!. No'i - / 1l!t~Il: Nhu tren; Website; LUll VT, HTQT. ~~~~~GIAM DOC BANHTQT REGISTRATION NUMBER .. "'. (Check List for Application Documents) .° , 0 ~ *]1 ~ (Institute ~~;q(Confirmer) 1) *Do not write in this area. of Application): : ~ (Signature) Name of Applicant: ;uCg •.•. iv-'-'e"'n1'-!fi.,...lr""stc-'-n,."a"'-m"'eL) 2) Country 3) Desired Degree Program : ----'-Cf:"'a""m.....,ilcz.y/"'las""-'-t ....,na"'m.."e><.l.) : _ 00 Master's (*Please tick (-1) in the appropriate Do Doctoral o Research box.) Application Submission(Y IN) Documents Check List Yes 1. Personal data (Attachment 2. Self Introduction #2) .\ 3. Proposal(Attachment ~. Pledge (Attachment (Attachment 6. Personal Medical Assessment 8. Official Transcript (Attachment of graduation #4) of graduation of previously #6) from undergraduate from undergraduate 9. Diploma or certificate 10. Official transcript '1 .~ #3) #5) 7. Diploma or certificate institution institution from graduate attended graduate institution institution(s) 11. Certificate of Employment 12. Certificate of TOPIK score (original copy), if applicable 13. Certificate of TOEFL or IELTS score (original copy), if applicable 14. Published papers, if applicable 15. Awards, if applicable 16. Copy of passport Certificate 17. certificate, Certificate 18. Adoption (possible to submit after selection) of citizenship of applicant ex) the applicant's Passport copy or Certificate of Loss of Korean citizenship Documents 1 / TJ #3) 4. Letter of Recommendation(1) No I #1) (Attachment Study Plan (Attachment Research _ (only for overseas of nationality and his/her Parents' Birth expatriation, etc. (only for former Korean Citizenship Korean adoptees) holders) Attachment # 1 Gj'" ~t.J1.!flett1l"Q:}«~T.i!};AJ 3':~) Al~At% 2}-~ (Only for Applicants (including research scholars) who apply for this program via a Designated University) Korean Government Scholarship Program (KGSP) Application Form for Graduate Study *Please tick eJ ) a box that applies to you. 1. ~~]I;gf o ;?; LH 1. (Institute of Recommendation) CH 2,f ~~.g.~ o (Korean University) (Type of Recommendation) gJ \:!.!"~~(General) 3. AI~ J1t~ o 6:l (Degree Course of Application) J.J J1t~ (Master's) 0 !;:!{ N J1t~ (Doctoral) 0 ~F?·llf~ (Research) 4. £:l gt JlI ~ (Desired Field of Study) e.!~ N:2.I JlI ~ (Humanities and Social Sciences) o Afe!~ 2,f JlI ~ (Natural Sciences and Technology) o 011xii ~ JlI ~ (Arts and Physical Education) 5. e!;?;0le!* e!~IAf (TOPIK5.g. 6.g. ~:;Af) E2,f ~e.! o (Only for TOPIK LevelS and Level 6 holders) *TOPIK LevelS and 6 holders must start their studying from Sep 1,2015) o DSep 1,2015 ~ ~ Ng (Personal Data) Please read theform carefully. All applicants must complete all sections only bv tvpine. 01 ~(Given name) : ~'6! o Male ~(Family name) : (Full Name) o Female * Name should be spelled the same as in the passport and in English. I Id(yyyy) ~Id~~ (Date of Birth) ~Jf (Country) ()j~ (Passport) ~(mm) -.-. e!~x-l i1~of2:l =--, -. (Information concerning applicant's most recent education) ) I (Citizenship) (Date of expiry) (Date ofIssue) (Contact Information) *only applicant's own (Photo 3*4) o Married LfOI(Age: ::;:lA~ I (Number) ~(dd) o Single Address: Tel. ( ) E-mail: i1 §~ gj (Oll~)2{ 6Hg~Jf/.s:.AI (Country/City) jj} (Name of previously attended Univ.) ~~ 2{~ (Academic Degree recently awarded) 0 Bachelor i1§~~{:::~Ail~ (Title of graduation dissertation, if available) 1 o Master (Academic Major) OJ o,!::~ -,=-, (Language Proficiency) Published papers, if available(one or two) ~Oj~<S1 OTOEFL OIELTS Score: (English Proficiency) Korean Language Proficiency (onlv TOPIK) Level: 01 02 03 04 05 06 Score: Awards, ifavailable (one or two) CH0' D'1 -,= (Name ofUniv.) AI@~~CH~ (Applying University) "" -, 2;l -, JIll- (Academic Career) (Period) ';I-d~ -,-r= (Faculty) 2,'".:w.~ (Name ofUniv.) ~:ilf~ ~~ (Department) (Academic Major) oH@~Jf Ci~fEO~ (Country) (Academic Major) ~~2{Sf1 (Diploma or Degree) 0 A; A; =-, (Transc ripts) *01* ~Jle! JI All (only terms attended) 1st year School Year 2nd year 5th year 4thyear 3'd year ~l! ]J;j Term 1. 2 3 1 2 3 1 2 3 1 2 3 1 2 3 Bachel- / / / / / / / / / / / / / / / or Master / / / / / / / / / / / / / / / JI ll- ~~ ~g e1=?~~ (Occupation or Research Career) JI ~ D'1 = (Institution or company) (Period) ~ ~t!~* A; =0 (GPA) (converted score) ~ 1100 AI • I HNl ~ (Position) C,Cf01 OOt::::l-r Cl (Operation or Duty) 0 :ilfJi e1:~ OilAl ~ Ji -r A ...L.,CC!:: JI ll- -, A; -, (Purpose of Stay) .52 (Period) xjl¥f Af@1 Ji "T" A ...L. CC!:: 'xjl¥f~~Jm AI Q1 (City or Region) (Organization Concerned) (Previous Visits to Korea) ~~~ *011 (Previous Scholarship Awards Received from Korean institutions) AI ~ ~ AI~JI~~ ta(yyyy) Applicant's * 011 JIl!- Q!l (Amount) (US$/year) (Sponsor) (Period) ( / ) 0 ( / ) 0 ~(mm) ~(dd) (signature) Name: * GPA(Grade POint Average) must be converted on a maximum scale of 100 points (converted POints) * See Attachment * Fill out both the records of Bachelor's & Master's in the case of those applying for Doctoral programs 2 .#7 ---* .~ Attachment #2 ~ JI :1:JH (SelfIntroduction) tvoe or print clearlv within J oaee usine black ink. (in Korean or in Enelish) (*10 points) o Your course of life, your view of life, study background, your hopes & wishes, etc o Your education and work experience, etc., in relation to the KGSP program o Your motivations for applying for this program o Reason for study in Korea * Please I 3 Attachment #3 2,'-gj)jl~ * Please (Study Plan) type or print clearly within 1 page using black ink. (*10points) Goal of study & Study Plan/" Future Plan after Study I 0 Goal of study, title or subject of research, and detailed study plan I 0 Future plan in Korea or another country after study in Korea 4 .>; Attachment #3 e!::r:il} AU (Research Pro posal) * Please type or print clearly within 1 page using black ink. (*10 points) l!cq Ij!!OI ¥~~ ~~ ~AIOjI ~11OltJAI.2. [!] <2!-=?-~Ail Research Topic [!] <2!-=?-~~ Research Objectives 00 <2!-=?-LH% Please submit additional Detailed Research Plan [!] <2!-=?-'2ftgJ [!] <2!-=?-QI 71 [H B..J!~ Expected [!] <2!-=?-~ ~ Research Methodology Results ofthe Research Research Timetable 5 sheets ifmore space is needed. Attachment #4 Letter of Recommendation To the applicant: Please fill in your name and the other required information who will write this letter. NOTE: Request your recommender sign across the back flap upon completion. Recommendation below. In turn, deliver or email this form to the person to seal his or her letter of recommendation in an official envelope and letters that are not sealed and signed will not be accepted. Confidential Name of Applicant: l./Cg"'i.!.v""en"-"n"'am......."e:.L) -.lC-"fa"'m"'I"'·lyJ....!'n""a"'m"'eCL) _ Nationality: _ Desired Degree Program: D 0 Do Doctoral Master's Desired Major: To the recommender: assistance, * Please 1. The person named above has applied for the 'Korean Government Scholarship Program'. We ask for your and would appreciate your frank and candid appraisal of the applicant. type or print clearly using black ink. How long have you known the applicant and in what relationship? , .Please assess the applicant's qualities in the evaluation . t he same sc hool vear Wit wi h him/h ar e/ were in 00 year I er. Truly Exceptional Classification Top 2% table given below. Rate the applicant Excellent Very Good Good Below Average Top 10% Top 25% Middle 50% Lower 25% Academic Achievement Future Academic Potential Integrity ResponsibilitylIndependence Creativity/Originality Communication Interpersonal Skills skills Leadership I. What do you consider to be the applicant's compared to other classmates strengths? 6 N/A who 2. What do you consider to be the applicant's weaknesses? / ~ How well do you think the applicant has thought out plans for graduate study? 5. Please comment on the applicant's performance record, potential, or personal qualities which you believe would be helpful in considering the applicant's application for the proposed degree program. Recommender's Name ---; ,Date Recommender's Signature _ -r-t- _ Position or Title: _ University (Institution): _ Address: _ (zip-code: Tel: _ Fax: _ Please return this form sealed in an official envelope and signed across the back to the applicant. We greatly appreciate your timeliness regarding this letter for your recommendee. 7 Attachment #5 "Korean Government Scholarship Program for Graduate Study" Pledge (A1 Q.j= A1) As an applicant for the 2015 "Korean Government Scholarship Program (KGSP) for Graduate Study", I pledge to abide by the following rules: (1) To refrain from violation of university regulations and to fulfill my obligations as a KGSP scholar to the best of my ability. (2) To behave in a manner appropriate to Korean culture and society, and not to participate in any form of political activity (such as organizing a political party, joining a political party, attending political meetings, publishing political articles and declarations, organizing or participating in demonstrations of a political nature, and so on). (3) To accept responsibility for paying any debts incurred in Korea (4) To agree with NIIED's decision concerning the graduate program and the Korean language course (5) To abide by all terms and regulations set by NIIED. (6) To permit NIIED to use my personal information for the KGSP. If I am proved to have violated any of the above or to have made a false statement in my application documents, I shall accept any resolution or penalty made by NIIED, even when it may/might result in suspension, revocation or withdrawal of my scholarship. I was informed and fully understand that KGSP scholars are not permitted to transfer schools for the entire duration of scholarship after confirming their host institution including Korean language institution. (yyyy). (mm). (dd). (signature) Applicant's Name: 8 Attachment #6 PERSONAL MEDICAL ASSESSMENT Applicants are not required to undergo an authorized medical exam before passing the 2nd Selection with NIIED; however, all successful candidates must take a comprehensive medical exam when its' orientation (including an HIV and TBPE drug test**, etc) in accordance with the requirements of the Korea Immigration Service and the KGSP. If the results show that the applicant is unfit to study and live overseas more than 3 years, he/she may be disqualified. **The TBPE (tetrabromophenolphthalein Gender: I I ethyl ester) drug tests are for evaluating past usage of stimulant drugs. HEIGHT I cm WEIGHT I kg When and for what reason did you last consult a physician? (Please explain in the adjacent space.) QUESTION o YES Have you ever had an infectious disease that posed a risk to public health (such as, but not limited to, tuberculosis, HIV and other STDs)? 1. allergies? 0 2. high blood pressure? 3. diabetes? 4. any type of Hepatitis? o Have you ever suffered from or been treated for depression, anxiety, or any other mental or mood disorder? (If you have received treatment, please explain and attach an official medical report.) o Have o you ever been addicted to alcohol? Have you ever abused any narcotic, stimulant, hallucinogen or other substance (whether legal or prohibited)? o Ifnecessary, are you prepared to undergo physical tests to verify the answers given in response to questions 0 and 0 above? o Have you been hospitalized in the last two (2) years? o Have you had any serious injury, ailment or sickness in the last five (5) years? o Do you have any visual or hearing impairments? o Do you have any physical disabilities? o Do you have any cognitive/mental disabilities? o Are you taking o Are you any prescribed medication? on a special diet? o On average, how many standard servings of alcohol do you consume each week? . 9 NO IF YES, PLEASE EXPLAIN Attachment #7 GP A Conversion Table 4.0 Scale I 4.3 Scale ,I 4.5 8<aI. I 5.0 8<aI. 3.97 - 4.0 I 4.26 - 4.3 ._ 4.46 - 4.5 I 4.95 - 5.00 ::: ~:~~---rl.!--~-. ::::~::: I ::: ~ 3.84-3.87 4.12-4.16 4.31-4.35 I 4.79-4.83 4.08 - 4.11 4.26 - 4.30 3.80 - 3.83 3.75 - 3.79 3.71 - 3.74 ---------------, 3.67-3.70 I I I I I . 4.03 - 4.07 ,. 3.98 - 4.02 ------------- I 4.21 - 4.25 4.16 - 4.20 r----------~- I I I I --1 ....~.~~.~?~?u..s.~!~ .... I 100 ~:-F.-----:-:---------' 4.73 - 4.78 I 4.68 - 4.72 I 4.62 - 4.67 I I I I 1f-- -I 97 96 9_5 94 J,--------- ---- 3.93-3.97 4.11-4.15 I 4.57-4.61 I 93 I ----~I-------' 3.62 - 3.66 I 3.89-3_92 4.06-4.10 I 4.51-4.56 I 92 3.58 - 3.61 I 3.84 - 3.88 4.01 - 4.05 I 4.45 - 4.50 I 91 I I 3.41 - 3.48 I 3.65 - 3.74 3.81 - 3.90 I 4.23 - 4.33 I '------_·_-+----------+---------+-----------+1----------- 3.49 - 3.57 I 3.75 - 3.83 3.91 - 4.00 4.34 - 4.44 j 90 ,-------+--------r-------+-------~-------II 3.32 - 3.40 3.56 - 3.64 3.71-3.80 3.24 - 3.31 3.46 - 3.55 3.61 - 3.70 3.15 - 3.23 I 3.37-3.45 3.51-3.60 3.07 - 3.14 I 3.27 - 3.36 3.41 - 3.50 I 89 4.12 - 4.22 88 4.01 - 4.11 87 I I 3.90 - 4.00 86 3.79 - 3.89 85 I 3.68 - 3.78 I---------r-------------~----·-----r------~--------f 2.98 - 3.06 L 3.18-3.26 3.31-3.40 I-------~· 84 ---~-----------~------------r-----------i I 3.09 - 3.17 2.81 - 2.89 I 2.99 -3.08 3.11 - 3.20 3.45 - 356 82 2.72 -2.80 I 2.90 - 2_98 3.01-3.10 3.34 - 3.44 81 2.80 - 2.89 2.91 - 3.00 3.23 - 3.33 80 2.90 - 2.97 2.64 - 2.71 3.21 - 3.30 3.57 - 3.67 83 -·-f-------+-------~----------I 10 1
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