The Designated Regional Universities

* Country code: 82-

[Appendix 2]

C.G.P.A. Conversion Table

[Form 1]

2017 ґлЗС№О±№Б¤єОГКГ» їЬ±№АО ЗРєОАеЗР»э Бцїшј­

(Application for 2017 KGSP for an Undergraduate Degree)

∙ Please type or print clearly in English or Korean.

∙ English Name Spelling MUST be exactly the same as in your passport

∙ Please state a date in the following order: year, month and day (ex. January 30, 1994 Ўж 1994/01/30)

Ўа Checklist (Submission of Documents)

∙ Please put a Ўо in the appropriate box, Type or Print clearly

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Ўа АОАы »зЗЧ (Personal Information)(English Name Spelling MUST be exactly the same as in your passport)

Ўа ѕрѕоґЙ·В (Language Proficiency)

Ўа ЗР·В (Education: including Elementary School): Please list most recent first

Ўа °нµоЗР±і јєАы (High School Grades; Only for the semesters attended)

Ўа °ЎБ·»зЗЧ (Family Background)

Ўа ЗС±№±в°ьїЎј­ јцї© №ЮАє АеЗР±Э (Previous Scholarship Awards Received from Korean institutions)

Ўа °ъ°Е ЗС±№їЎј­АЗ °ЕБЦ ¶ЗґВ Гј·щ »зЅЗ (Previous Visits to Korea)

Ўа ГЯГµАО ёнґЬ (List of Recommenders)

THE ANSWERS I HAVE GIVEN ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. IF MY ANSWERS CONTAIN ANY KIND OF FALSEHOOD, I WILL TAKE ANY LEGAL RESPONSIBILITY.

[Form 2]

ј­ ѕа ј­

(Pledge)

іЄґВ ґлЗС№О±№ Б¤єОГКГ» ЗРєО АеЗР»эАё·Ој­ ґЩАЅ »зЗЧА» БцЕі °НА» ј­ѕаЗХґПґЩ.

(1) ЗС±№ і» ґлЗРАЗ ЗРДў µоїЎј­ Б¤ЗС ±ФДўїЎ µы¶у ГЦј±А» ґЩЗШј­ ЗРѕч°ъ ї±ёїЎ АьідЗСґЩ.

(2) ЗС±№АЗ »зИёБъј­ё¦ А§№ЭЗПБц ѕКµµ·П ЗаµїЗТ °НАМёз, ёрµз Б¤ДЎИ°µї(Б¤ДЎёсАыАЗ БэИёЎ¤ЅГА§їЎАЗ Вь°Ў, Б¤ДЎ°б»з, Б¤ДЎАыАО ін№®Ў¤ј±ѕрАЗ №ЯЗҐ µо)А» ЗПБц ѕКґВґЩ.

(3) ЗС±№їЎј­ Г¤№«ё¦ Бш °жїм(±№і» °ЕБЦ±в°Ј і») є»АОАМ ГҐАУБц°н єЇБ¦ЗСґЩ.

(4) ЗС±№ѕоїјц №Ч ЗРА§°ъБ¤ јцЗР°ъ °ь·ГЗПї© ±№ёі±№Б¦±іА°їшАМ Б¤ЗС №жД§їЎ ѕо¶°ЗС АМАЗµµ Б¦±вЗПБц ѕК°н µыёҐґЩ.

(5) ±№ёі±№Б¦±іА°їшАМ Б¤ЗС ЗР»зЗаБ¤ Б¶ДЎ»зЗЧїЎ Аы±Ш ЗщБ¶ЗП°н АМё¦ БШјцЗСґЩ.

(6) ЗБ·О±Ч·Ґ їоїµ»у ЗКїдЗП°ЕіЄ Её Б¤єО ±в°ьАЗ їдГ»АМ АЦґВ °жїм є»АОАЗ °іАОБ¤єё (АМё§,

ї¶фГі, јТјУ ЗР±і µо) »зїлїЎ µїАЗЗСґЩ.

»у±в »зЗЧА» А§№ЭЗС °жїм, АеЗР»э Бцїшј­·щАЗ ±вАз»зЗЧАМ ЗгА§»зЅЗ·О ЖЗёнµИ °жїм, ґлЗРїЎј­ ВЎ°иГієР, јєАыєТ·® µо јцЗРґЙ·ВАМ ѕшґЩ°н АОБ¤µИ °жїмїЎґВ АеЗР±Э Бц±ЮА» БЯБц ґзЗПґх¶уµµ АМАЗё¦ Б¦±вЗПБц ѕКА» °НАУА» ј­ѕаЗХґПґЩ.

As a grantee of the 2017 Korean Government scholarship program for an undergraduate course, I pledge to abide by the following rules;

(1) To refrain from violation of university regulations, and to fulfill my obligations as a student to the best of my ability.

(2) To behave in a manner appropriate to the 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 abide by NIIED's policy concerning the Korean language course and the degree course without any objection.

(5) To abide by all of the terms and regulations set by NIIED.

(6) To agree to the use of my personal information (name, contact number, institutions I belong to, etc) when it is needed for the operation of the program or upon the request of other governmental institutions.

If I am proved to have violated any of the above articles, to have made a false statement in my application documents or to have failed to comply with academic standards or the rules of university, I shall accept the decision of NIIED, even though it may include the suspension or revocation of the scholarship.

[Form 3]

АЪ ±в јТ °і ј­

(Personal Statement)

<БцЅГ№®: АЪ±вјТ°іј­ё¦ 2ЖдАМБц АМі»·О ј­јъЅДАё·О АЫјє(A4, ґЬёйАё·О АЫјє)ЗПµЗ, ѕЖ·Ў і»їлА» ЖчЗФЗПµµ·П ЗПёз, і»їлА» АЯ ѕЛѕЖєј јц АЦµµ·П ЕёАМЗОА» ЗП°ЕіЄ АОјвЗПЅГїА. АМ БцЅГ№®Ає јчБц ИД »иБ¦ЗПЅГїА.>

<Instructions: please write not exceeding 2 pages on an A4 size format, one-sided only. The essay should contain the following things and must be clearly typed or printed in black ink. Please remove the instructions after reading it. >

- Motivations with which you apply for this program

- Personal background in family and education

- Significant experiences you have had; risks you have taken and achievements you have made, persons or events that have had a significant influence on you

- Extracurricular activities such as club activities, community service activities or work experiences

- If applicable, describe awards you have received, publications you have made, or skills you have acquired, etc.

[Form 4]

јц ЗР °и И№ ј­

(Study Plan)

<БцЅГ№®: ЗС±№ѕо ¶ЗґВ їµѕо·О 3 ЖдАМБц АМі»·О A4 ±Ф°ЭїлБцїЎ ґЬёйАё·О АЫјєЗПЅГїА. јцЗР°иИ№ј­ё¦ АЫјєЗП±в АьїЎ ЗР±і ј±»эґФ°ъ јцЗР ёсАы°ъ °иИ№їЎ ґлЗШ »уАЗЗПЅГ±ж ±ЗАеЗХґПґЩ. АМ БцЅГ№®Ає јчБц ИД »иБ¦ЗПЅГїА.>

<Instructions: Please type or print in Korean or English not exceeding 3 pages on an A4 size format, one-sided only. It is advised that you discuss your academic goals and plans with your teacher before filling out this form. Please remove the instructions after reading it.>

[Form 5]

Letter of Recommendation

∙ Type or print in English or Korean, not exceeding 2 pages in length.

To be completed by the applicant:

Please fill in your name and other information below. If possible, let your recommender know your study plan in Korea when ask him/her to write this letter. Please note that recommendation letters that are not sealed and signed will not be accepted.

ApplicantЎЇs Name:

Current/Last (High) School:

Date of Birth (yyyy/mm/dd) E-mail:

-----------------------------------------------------------------------------------------------------------------------

To be completed by the recommender:

Your frank and candid appraisal of the applicant will be highly appreciated in the process of selection of Korean Government Scholarship recipients and the admissions to a Korean university. Please make 3 photocopies of the letter after writing it and sign all copies (1 original and 3 photocopied letters) respectively. And please return them sealed in an official envelope which is signed across the back to the applicant; otherwise, they are not valid.

Name: E-mail:

Title, Position and Institution:

Address:

Telephone:

How long have you known the applicant and in what context?

Please assess the applicant's qualities in the evaluation table given below. Rate the applicant compared to other individuals whom you are familiar with.

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Please provide us with comments on the applicantЎЇs performance record, potential, or personal qualities which you believe would be helpful in considering the applicantЎЇs application for the proposed degree program.

[Form 6]

АЪ °Ў °З °­ Бш ґЬ ј­

(Self Medical Assessment)

Please provide accurate information for the following questions.

Note: Applicants are not required to undergo an authorized medical exam before passing the 2^nd round of selection; however, all candidates must take a comprehensive medical exam after the 2^nd round of selection (see FORM 7); all grantees must take another comprehensive medical check-up (including HIV, TBPE drug test) after coming into Korea in accordance with the requirements of the Korea Immigration Service and the KGSP. If the results show that any grantee is unfit to study and live overseas, he/she may be disqualified.

THE ANSWERS I HAVE GIVEN ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. IF MY ANSWERS CONTAIN ANY KIND OF FALSEHOOD, I WILL TAKE ANY LEGAL RESPONSIBILITY.

Date(yyyy/mm/dd): . .

[Form 7]

АЗ»з №Я±Ю °З°­ БшґЬј­

(Certificate of Health)

This certificate will be highly appreciated in the process of selection of Korean Government Scholarship recipients and the admissions to a Korean university. Please attach evidential documents which prove that the result of the following examinations is true and correct; otherwise, it is not valid.

Personal Information

Full Name:

Sex:

Date of Birth:

Nationality:

Physical Examination

Blood Pressure: Systolic Diastolic mmHg

Vision: Right 20/ Left 20/ Color Vision

Corrected: Right /15 Left /15

Dental Evaluation: Good ( ) Fair ( ) Poor ( ) Needs Attention ( )

Clinical Evaluation:

If Abnormal:

3. Chest X‐ray Examination

Date taken:

Findings:

Laboratory Examination

Hemoglobin: Gm/dl

Urine: S.G. Sugar Micro

Hepatitis B:

Stool for Parasite Oval:

Serological Test for Syphilis:

Other:

In my opinion his/her health condition is;

Excellent ( ) Good ( ) Fair ( ) Poor ( )

This is to certify that the above named applicant has gone through a general medical examination and the findings indicated here are true and correct to the best of my knowledge.

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