Administered By: Kei Kei(Cambodia) Human Resource Co., Ltd

Administered by: Kei Kei(Cambodia) Human Resource Co., Ltd

APPLICATION FORM

Instruction: Read General and Documentary Requirements.

Fill in all the required information. Do not leave any items blank. If item is not applicable, indicate “N/A”.

PERSONAL DATA:

Applicant’s Name in Khmer: ……………………………………………………… Latin: ………………………………………………………..

Nationality: ………………………..Sex: ………………… Age: …………… Date of Birth:…………………………………………………..

……………………………………………………………………………………………………………………………………………………………………….

Marital Status: SingleMarried Divorced

Current Address: …………………………………………………………………………………………………………………………………………...

……………………………………………………………………………………………………………………………………………………………………….

Contact number:…………………………………………….E-mail:………………………………………………………………………………...

FAMILY INFORMATION:

Name of family’s members / Relationship / Level of Education / Occupation / Monthly Income / Telephone

DETAILS OF APPLICANT’S EDUCATION

Name of School/ College / Location / Academic Year / Degree Received

General:

How did you know about TAKAI SCHOLARSHIP?

Internet KK Company’s Facebook  IFL, Japanese Department  Other: ……………………………..

Have you applied for TAKAI SCHOLARSHIP in previous years? Yes No 
Have you ever studied Japanese? Yes No 
Have you ever gone to Japan? Yes No 
Have you ever got any scholarship? Yes  : scholarship name: ………………………………………….

No 

Are you currently employed? Yes No  Full or Part time? ______
On the space provided below, please prepare a person statement, indicating your interest and commitment to study Japanese, your career goal, and other information on significantfinancial difficulties you are experiencing, and why you feel you should be selected to receive the scholarship.

…………………………………………………………………………………………………………………………………………………………..

…………………………………………………………………………………………………………………………………………………………..

I do here by declare that the information given above is correct.

Note: All spaces are to be filled. Incomplete application is liable to be rejected.

-Copy of your recent transcript of grades or certificate for current or last school attended.

-Interview winners who pass an entrance examination of Institution of Foreign Languages, Japanese Department will receive full scholarship form TAKAI SCHOLARSHIP

Applicant’s signature: ______Date: ______

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