Indicate which level you want to study in Japan.

Mark “/” on Master’s Studies if you want to do Master’s only.

Mark “/” on Doctoral Studies if you want to do Doctoral only.
Mark “/” on both Master’s and Doctoral Studies if you want to do both Master’s and Doctoral. MEXT Postgraduate 2022

Application Form: [POSTGRADUATE 2022] Social Science / Master’s Studies

*Valid in Malaysia only. / Natural Science / Doctoral Studies

APPLICATION FOR JAPANESE GOVERNMENT (MONBUKAGAKUSHO: MEXT) SCHOLARSHIPS 2022

Research Students

INSTRUCTIONS
1. The application should be typewritten if possible, or neatly hand-written in block letters.
2. Numbers should be in Arabic numerals.
3. Year should be written in the Anno Domini (AD) system.
4. Proper nouns (including address) should be written in full, and not abbreviated.
5. Please provideFor thoseaddress
present without surname,
and telephone number in Malaysia.
6. Use our format to help to speed-up thefor
write your father’s name short-listing process. Do not change our format.
“Family name” and your Write Christian name only if it appears in your
name for “First name”. passport, else write Chinese characters “小美” or “Xiao
1. Name in full, in your native language Mei” for “First name” and “-” for “Middle name”.
(Sex)
Abu Bakar , Siti Fatimah binti
陈 凯特林 小美
Tan Catherine Xiao Mei Male
Ramasamy Letchumy -
(Family name/ Surname) (First name) (Middle name) / Female
In Roman block capitals (Marital Status)
ABU BAKAR , SITI FATIMAH BINTI
TAN CATHERINE XIAO MEI / Single
RAMASAMY LETCHUMY -
(Family name/ Surname) (First name) (Middle name) Married

2. Nationality : Malaysian 2a. Do you have Japanese nationality? No

3. Date of birth : 1989 4 2 32

(Year) (Month) (Day) (Age, as of 1st April 2022)

4. Present status with the name of the university attending or employer

Support Engineer, XXXXXX Sdn. Bhd.
Lecturer, Universiti Malaya
Undergraduate student, Universiti Kebangsaan Malaysia Provide address with postcode
and state.
5. Present address and telephone number, facsimile number, e-mail address
Present address : No. XX, Jalan Wangsa, Bandar Baru Maju Jaya, Cheras, 68000
Selangor
Telephone/Facsimile number : +6012-XXX-XXXX, +603-XXXX-XXXX (Fax)
E-mail address : xxxxxxxxx@xxxxxxx.com Provide telephone numbers in
Malaysia only.
6. Field of study specialized (NOT list of subjects) in the PAST (be as detailed and concrete as possible)

The Embassy of Japan will not provide any

guidance on how to fill in items 6 and 7. Do
not leave blank.

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 The Embassy of Japan will not provide any
guidance on how to fill in items 6 and 7. Do MEXT Postgraduate 2022
not leave blank.

7. Proposed study program IN JAPAN.

(State the name & outline of your major field of study and the details of your study program This
section will be used as one of the most important references for selection. Statement must be
typewritten [font: Tahoma, size: 10pt] or written in block letters. Additional sheet of paper [maximum 3
additional sheets] may be attached ONLY IF NECESSARY. If you have good command of Japanese [JLPT
Level 2 or above], write in Japanese.)

i) Present field of study

ii) Your research theme after arrival in Japan

iii) Study programme in Japan in detail (STUDY/RESEARCH PROPOSAL)

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8. Education background
Certificate (i.e. UPSR,
Period of schooling
Year and Month PMR,SPM & etc) And
Level of Name and Address attended
of Entrance Diploma or Degree
Education of School (EXCLUDING
and Completion awarded with MAJOR
Remove Class)
SUBJECT
Elementary Name From 6 yrs
Education SRK Bandar Tasik January 1994 UPSR
and
1.Elementary Location To
School Kuala Lumpur December 1998 0 mths

Secondary Name From

Education: SMK Bandar Tasik January 1999 3 yrs PMR
and
You may add one more
1.Lower Secondary Location To 0 mths
row for different school
School Kuala Lumpur December 2001
attended for the same
education category.
Name From
SMK (P) Bandar Selatan January 1999 2 yrs SPM

Location To and
Kuala Lumpur
State SPM/ UEC/December 2004
A-Levels for “Upper
Secondary School” if do not have diploma, 0 mths
Name matriculation or foundation studies.
2.Upper Secondary XXX College From 2 yrs Diploma in
School June 2005 Information
Location and Technology
Kuala Lumpur To
June 2007 1 mths

“Graduate Level” is for undergraduate,

HIGHER
i.e. Bachelor’s degree only.
EDUCATION: Name From 3 yrs
1.Undergraduate YYY University August 2007 Bachelor Degree in
Level and Information
Location To Technology
Kuala Lumpur August 2010 1 mths

“Graduate Level” is for postgraduate,

Name yrs
i.e. Master’s or PhD only. State “NIL”
2.Graduate Level From
if not applicable. Do not leave blank.
and
Nil
Location To mths

TOTAL years of 16 yrs

schooling and
mentioned above 2 mths

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 MEXT Postgraduate 2022

9. TWO recent Employment record. Begin with most recent employment, if applicable. (DO NOT INCLUDE
INTERNSHIP OR PART TIME JOBS)

Name and address of organization Period of employment Position TYPE of work

XXXXXX Sdn. Bhd. From Support Engineer Provide computer
Lot 665, Jalan Wangsa, August 2010 technical support
Bandar Baru Maju Jaya To for customers
68000 Cheras, Kuala Lumpur current
Nil From
Summarize “type of work” in 15 words.
State “NIL” if not applicable.
To
Do not leave blank.

Date of application:

20 March 2021

Applicant’s signature:

__________________________________

Signature by hand
Applicant’s name
(in Roman block capitals): Name as in passport.
SITI FATIMAH BINTI ABU BAKAR
CATHERINE TAN XIAO MEI
LETCHUMY RAMASAMY

NOTE: Please read our guidelines carefully; follow the instructions and fill-in correctly
before submitting. Do not leave any column blank, if you do so, your
application may not be considered.

Attachment (please tick):-

/ REQUIRED One (1) copy of original or certified academic transcript (Bachelor’s/ Master’s only)
OPTIONAL One (1) copy of certified degree certificate (Bachelor’s/ Master’s only)
* Bachelor’s/ Master’s academic transcripts and degree certificates only. UPSR/ PMR/ SPM/ O-Levels/ STPM/ A-Levels/
Matriculation/ Diploma results, IC photocopies and resume/CVs are not required. Master’s student must submit one (1) copy each
of Bachelor’s and Masters’ academic transcripts.
ANNEX

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ASCOJA Recommendation

ASEAN Council of Japan Alumni (ASCOJA) aims to foster human resources that can provide
leadership as a bridge between Japan and home country even after returning home. In addition to
the specialized field of study in graduate school, ASCOJA members also have a chance to deepen
their understanding of Japan by learning Japanese language, culture, and through activities such
as experiencing customs and exchange with Japanese people during their stay in Japan.

MEXT Scholarship candidates who fulfill ALL the requirements below are eligible for the ASCOJA
Recommendation:

☑ Will depart to Japan as “Research Student” in April 2022

☑ Will proceed to Master’s Course (candidates taking PhD courses are not eligible)
☑ Will apply for a university in Tokyo or around the region (where student can participate in
ASCOJA’s activities without hindrance).

☑ Will receive 6 months of Japanese language preparatory education at Tokyo Japanese

Language Education Center before enrolling into graduate school.

If you are interested to join ASCOJA kindly tick ☑in the box below

☑ YES
□ NO
Signature:

(signature by hand)

Name: SITI FATIMAH ABU BAKAR

Date: 20 March 2021

This recommendation is OPTIONAL, and NOT compulsory.

Only candidates who meet ALL of the above requirements are eligible.