邢唷>? ?欹€ 餜创bjbjqqxee? eee$P_*q:4 N Z x]z]z]z]z]z]z]$+b蚫瀅e;%^4 ;%;%瀅籢k'k'k';% 8ex]k';%x]k'k'蘌MhU罀輎?['淩4d]裗0_蠷iek'iehhUhU,iee擴b d?k'??b b b 瀅瀅k'b b b _;%;%;%;%ieb b b b b b b b b : Saga University Program for Academic Exchange (SPACE-E, SPACE-J)Starting in Spring 2015APPLICATION PACKAGE (Use this sheet as the cover of your application)Date: (Month) (Day) (Year)Name of Applicant:Home University:This application should be sent as a complete package containing all the documents specified in `$-h$, and be sent to the address below through the office responsible for student exchange at the applicant s home university. Application materials are NOT returned after review, and will not be used for any other purpose.Check List Check Forms No. 1-4 of this SPACE Application Package, ?No.3-A,3-B are only applicable for SPACE-E Program. No.3-C is only applicable for SPACE-J Program. One (1) letter of Recommendation ?Academic Transcripts, issued by the student s home institution ?Language Proficiency test result (i.e., TOEFL, TOEIC, IETS or Japanese Language Proficiency Test score sheets). ? Applicants for SPACE-E: Please submit the score sheet if you have any. Applicants for SPACE-J: You must submit JLPT score sheets or the result of the Japanese language section of the Examination for Japanese University Admission for International Students (EJU). One (1) copy of Certificate of Enrollment in the home institution, issued by the student抯 home institution ?Application for Certificate of Eligibility for a Status of Residence (#6) ?Certificate of Health000000000000000000000000000?A bank statement of the amount of money, yen-converted amount, to support the applicant s study abroad ? 5 identical photographs of the upper half of the applicant's body, plain background, 4cm3cm. Paste two photos on the application forms, and enclose a small transparent plastic bag containing the other three photos in the application package ?Center for Promotion of International Exchange, Saga University1 Honjo-machi, SAGA 840-8502, JAPANPhone: +81-952-28-8169 Fax: +81-952-28-8819 E-mail: HYPERLINK "mailto:space@cc.saga-u.ac.jp"space@cc.saga-u.ac.jpHP: HYPERLINK "http://www.irdc.saga-u.ac.jp/"http://www.irdc.saga-u.ac.jp/Application is due in this office by:March 15, 2015 for Fall 2015 No.1-ASaga University Program for Academic Exchange (SPACE-E, SPACE-J)Fall 2015APPLICATION FOR ADMISSION(1) Program you apply for: ?SPACE-E or ?SPACE-J (Mark either)(2) Name: (as it appears on your passport)  (Family) (First) (Middle)Name in Chinese Characters  (3) Current Address: (4) Sex: Phone: Permanent Address: ? Male ? Female Phone: Fax: E-mail: Emergency contact (name, relationship): (address/phone number/ e-mail/fax): (5) Marital Status: (6) Date of Birth: ? Single ? Married (Month) (Day) (Year) (7) Country of Present Citizenship: Passport information: Number: Date of issue: Issuing authority: Date of expiration: (8) I would like to be a SPACE student of the faculty at Saga University that I checked immediately below. ? Faculty of Culture & Education ? Faculty of Economics? Faculty of Agriculture ? Faculty of Science & Engineering(9) As of April 1st 2014 (for the student who applies for Spring 2014), I am an undergraduate student of the department, institution, major, as I have specified below:Home Institution: Department: Major: Specialization: Note: If you are not an undergraduate student on the specified day, you cannot apply for the SPACE-E program.The last academic year that you have completed by April 1st 2014 (for the student who applies for Spring 2014) is:? the 2nd year, the sophomore year ? the 3rd year, the junior year.No.1-BSemester Periods: ______ (month) to _____ (month); ______ (month) to _____(month) ; ______ (month) to ______ (month) . The home institution is in vacation in the other periods.(10) My expected date of completion/graduation is ______(year) ______(month).(11) The duration of stay that I would like is from April 1st, 2014 to:____ (month) ____ (day) ____ (year)That is, I would like to stay for ? one semester / ? one year (two semesters)(12) Language Proficiency Requirements SPACE-E: The classes of the elective subjects in SPACE-E are conducted in English, and your presentations in the Field Work on Japanese Affairs I & II should be made in English. If you take an Independent Study, your language proficiency of Japanese or English is required to be good enough. Please submit your score of TOEFL. Also you might want to submit the score of the level of Japanese Language Proficiency Test if you have taken. SPACE-J: You MUST submit JLPT score sheets or the result of the Japanese language section of the Examination for Japanese University Admission for International Students (EJU).TOEFL Score: Japanese Language Proficiency Test: Score: ____ of Level: LanguageProficiencyExcellentGoodFairJapaneseEnglish(other) (13) Educational background (beginning with the last high school you attended):InstitutionName of institutionMajor field of studyEntrance and Completion (Year)High schoolCollege/UniversityNo.1-C (14) Which do you prefer to live, in International House (Dormitory) or in a Private Apartment?? International House ? Private apartment Note: This question doesn t guarantee that you can live in the option you chose.I certify that all of the information provided on these documents is complete and true to the best of my knowledge, and I agree to comply with the rules and regulations of Saga University if admitted to the SPACE program.Date: Signature: (Month) (Day) (Year) No. 2ESSAY(Write Approximately 500 words in English. Use a typewriter or a word processor.)SPACE-E: Please write in ENGLISH. SPACE-J : Please write in JAPANESEFull name lT: Major at your home university'Yf[g0n0\;e: Briefly summarize your motivation for applying for the SPACE program.SPACE?????k0躝逺W0_0t1u?!|Tok0饛y0f0O0`0U0D00Briefly describe your plan of study after returning to your home university upon the completion of SPACE.0SPACE??????B}H0f0'Yf[k0;bc0f0K0?n0f[夳u?!|Tok0饛y0f0O0`0U0D00 No. 3-APre-Registration in the SPACE-E ProgramI would like to enroll at Saga University in the following courses, subjects or independent study, as I checked the boxes below.I. Obligatory [2 credits per semester]:( Field Work on Japanese Affairs I or II [2 credits]II. Electives [4 credits or more per semester]:Note: You are required to take four (4) credits or more from among the following lecture/discussion subjects or independent study each semester.A. Subjects of lecture/discussions [4 credits or more per semester]:Spring 2014( Culture and Chemistry(Developing WEB Pages on Japan( Field methods in Linguistics(Development Economics( Introduction to Science and Engineering B( Environment Soil Physics(Bio-related ChemistryB. Independent Study [2 credits or less per semester]:If you are a SPACE student of Faculty of Culture & Education or Faculty of Economics, Independent Study is OPTIONAL. If you are a SPACE student of Faculty of Science & Engineering or Faculty of Agriculture, Independent Study with your supervisor is COMPULSORY. You need to write a research field and topic and professor抯 name on your application form. You can find the lists of professors together with their class titles or research fields of the faculties of Saga University at the URL as follows:HYPERLINK "http://www.irdc.saga-u.ac.jp/ja/interest/space.html"http://www.irdc.saga-u.ac.jp/ja/interest/space.htmlNote: You can choose 慖ndependent Study? You need to fill the form 3-B on the following pages if you would like to take an independent study.( Independent Study ( Faculty of Culture & Education( Faculty of Economics( Faculty of Science & Engineering( Faculty of AgricultureC. ( Japanese Language Courses: There are six levels and remedial classes.D. 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You can find the lists of professors together with their research topics of the faculties of 1) Culture & Education, 2) Economics 3) Science & Engineering and 4) Agriculture of Saga University at the URL as follows:http://www.irdc.saga-u.ac.jp/ja/interest/space.htmlThe professors in the lists basically can accept one SPACE student, but some professors may not be able to do so in some year without notice.I would like to take Independent Study as follows:( The semesters of my registration for Independent Study in the faculty which you specified in item (8) on No. 1-A are:? Spring 2014 ( The field and topic in which I would like to take Independent Study are: Field: Topic: ( The professor under whose supervision I would like to study is:Professor s Name: ( I would like the specified faculty of Saga University (faculty) to choose a particular professor according to the field and topic that I specified immediately above.Note: Each professor can accept only one SPACE student for Independent Study.The selection of your supervisor at Saga University will be based on the content of your study specified here. You are not allowed to change your study field after submitting this form. No. 4(SPACE-E, SPACE-J)The Applicant s Intention of Studying Abroad Either With or Without Receiving a ScholarshipI hereby confirm that the applicant, (Name:)________________________________, of (Home Institution:)___________________________________, would like to study abroad in the SPACE program at Saga University, as his or her intention is specified below, having checked either A ( or B (, as marked in (.A ( 0The applicant will study abroad in the SPACE program with tuition and fees exempted at Saga University even in the case that he or she does not receive a JASSO scholarship. If this is the applicant s intention, he or she should submit a bank account statement with his or her SPACE application packet that proves that it is sufficient for him or her or his or her supporter to pay 65,000-yen to 90,000-yen (about 800 dollars) per month, which is computed from 55,000-yen for his or her monthly living expenses, and, possibly 10, 000-yen to 35,000-yen for monthly rent. See Housing in Campus Life in the SPACE brochure for the availability of rooms in the university dorm.B ( 0The applicant will study abroad with the tuition and fees exempted in the SPACE program at Saga University only if he or she receives a JASSO scholarship. Note that every JASSO scholarship recipient should rent a private apartment by him- or herself and pay 25,000-yen to 35,000-yen for monthly rent, as there is no university dorm available for those who receive a JASSO scholarship.Please be truthful of your intention that you specify above. The above information on the applicant s intention does not affect Saga University s decision as to which students are to receive a JASSO scholarship. The tuition and fee exemption is specified in the Academic/Student Exchange Agreement between your university and Saga University. The number of JASSO scholarships that SPACE students receive differs every year without notice.Signature of Director in Charge of International Student Exchange:_______________________________, Date: ____________________________________________________ [print name]______________________________________ [Title]Phone Number: _________________________________E-mail address: _______________________________________________________________________ [Division]______________________________________ [University] Instructions for Filling in Parts 1-3 ofApplication Form #6 for Certificate of Eligibility, which follows this pageFill in the application form.N.B. Part 1: Write  No in #15 Accompanying persons if any ____.Part 2-3: Be specific in (1)-(4) #26, which regards the method of financial support to your studying in SAGA University for the academic year. 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