2020 GKS-U Application Guidelines (Korean Embassy Track)
2020 GKS-U Application Guidelines (Korean Embassy Track)
2020 GKS-U Application Guidelines (Korean Embassy Track)
1. Objectives
The Korean Government Scholarship Program for undergraduate degrees is designed to provide
international students with opportunities to study at higher educational institutions in Korea for
Bachelor-level degrees, which in turn will contribute to promoting the international exchange in
education and to deepening the mutual friendship among countries.
※ Only those who hold citizenship of the countries below are eligible to apply.
Country Quota Country Quota Country Quota Country Quota
Afghanistan 1 Equatorial 1 Morocco 1 Tajikistan 2
Guinea
Angola 1 Ethiopia 3 Mozambique 1 Tanzania 1
Azerbaijan 1 Fiji 1 Myanmar 3 Thailand 3
Bangladesh 1 Gabon 1 Nepal 1 Timor-Leste 2
Bhutan 1 Ghana 1 Nigeria 1 Trinidad and 1
Tobago
Bolivia 1 Guatemala 1 Pakistan 1 Turkey 1
Brazil 4 India 3 Panama 1 Turkmenistan 2
Bulgaria 1 Indonesia 5 Paraguay 1 Uganda 2
Brunei 1 Iran 2 Peru 1 Ukraine 3
Cambodia 2 Japan 2 Philippines 2 Uruguay 1
Canada 1 Jordan 1 Poland 1 Uzbekistan 3
Chile 1 Kazakhstan 3 Russia 3 Venezuela 1
Colombia 3 Kenya 3 Rwanda 1 Vietnam 10
Congo(DRC) 1 Kyrgyzstan 3 Senegal 1 Yemen 1
Dominican 1 Laos 2 Singapore 2
Republic
Ecuador 1 Malaysia 3 Sudan 1
Egypt 1 Mexico 4 Sri Lanka 1
El Salvador 1 Mongolia 4 Sweden 2
One placement is reserved for overseas Koreans within each of the highlighted country’s
scholarship quota. (e.g., For Brazil, 1 placement is reserved for those of overseas
Koreans, and 3 placements are available to general applicants.)
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3. Academic Programs: Bachelor’s Degree Program (4 years) after preliminary Korean
Language Program (1 year)
Scholars must take the mandatory Korean language training at a language institution that
will be designated by NIIED. The institution will be specified in the letter of invitation
after the announcement of final successful candidates.
Scholars must attain a certain level on TOPIK (Test of Proficiency in Korean) as required
by NIIED before the completion of the one-year Korean language program. Otherwise,
scholars are not allowed to proceed to the degree program.
Scholars with level 5 or 6 on TOPIK will be exempt from the language program and must
begin their Bachelor’s degree program from March 2020.
Scholars who receive TOPIK level 5 or 6 during the first 6 months of the language
program may start their degree program in the September 2020.
4. Available Universities and Fields of Study : 4-Year Bachelor’s degree programs offered at
63 universities below.
1 Ajou University 18 Hallym University 35 Kookmin University 52 Sogang University
Andong National Korea Polytechnic Sookmyung
2 University 19 Handong Global University 36 University 53 Women's
University
3 Busan University of 20 Hannam University 37 Korea University 54 Soonchunhyang
Foreign Studies University
4 Chonbuk National 21 Hanseo University 38 Kumoh National 55 Soongsil
University Institute of Tech University
5 Chonnam National 22 Hanyang University 39 Kyung Hee 56 Sungkyunkwan
University University University
6 Chosun University 23 Hoseo University 40 Kyungpook National 57 Sunmoon
University University
Ulsan National
7 Chung-Ang 24 Incheon National University 41 Kyungsung 58 Institute of
University University Science and Tech
(UNIST)
8 Chungbuk National 25 Inha University 42 Myongji University 59 University of
University Seoul
9 Chungnam National 26 Inje University 43 Namseoul University 60 University of
University Ulsan
10 Daegu University 27 Jeju National University 44 Pai Chai University 61 Woosuk
University
11 Daejeon University 28 Jeonju University 45 Pukyong National 62 Yeungnam
University University
Korea Advanced Institute of Pusan National
12 Dankook University 29 Science and Technology 46 University 63 Yonsei University
(KAIST)
13 Dong-A University 30 Kangwon National University 47 Sangmyung
University
14 Dongguk University 31 Keimyung University 48 Semyung University
(Gyeongju)
15 Dongguk University 32 Kongju National University 49 Seoul National
(Seoul) University
Seoul National
16 Dongseo University 33 Konkuk University 50 University of Science
and Technology
17 Ewha Womans 34 Konyang University 51 Silla University
University
Attention! Any degree program which takes more than 4 years to complete is NOT AVAILABLE
under this scholarship program. All applicants cannot choose such degree programs (Examples:
medicine, dentistry, architecture, and pharmacy)
For more details on the available fields and majors, refer to the “University Information” file that
is available to access in the GKS Notice board, on the Study in Korea website
(www.studyinkorea.go.kr). All applicants must choose a major listed on the “University
Information”.
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5. Qualifications: Prospective applicants must meet all of the following conditions.
(1) CITIZENSHIP: An applicant and his or her parents must be citizens of one the countries
listed on the above chart in #2 of this guideline.
Attention! Neither the applicant nor the parents should hold the Korean citizenship.
(Exception: For overseas Korean applicants holding Japanese citizenship, if their parents
hold ‘Permanent Residency Permit’ within Japan while holding Korean citizenship, are
eligible to apply.)
Applicants and their parents who had previously held Korean citizenship must submit the
document that proves their renunciation of Korean citizenship.
(2) AGE: An applicant must be under age 25 as of March 1, 2020 (Should be born after March,
1, 1995).
(3) HEALTH: An applicant must be in good health, both physically and mentally.
Those with disabilities, but in good mental and physical health, are eligible to apply.
Those with severe illness are NOT ELIGIBLE to apply.
(4) LEVEL OF EDUCATION: An applicant must have graduated or be expected to graduate
from a high school as of March 1, 2020
Those who have already achieved a Bachelor’s degree or a higher degree are NOT
ELIGIBLE to apply.
Those who have graduated or are expected to graduate from a high school in Korea are
NOT ELIGIBLE to apply.
(5) GRADES: An applicant must maintain the overall grade point average (CGPA) equivalent to
or higher than any ONE of the followings:
2.64 on a 4.0 scale;
2.80 on a 4.3 scale;
2.91 on a 4.5 scale;
3.23 on a 5.0 scale; or
Score: 80 points or above on a 100 point scale or be ranked within the top 20% throughout
the entire high school period.[see Appendix 3]
If an applicant’s high school has an evaluation system different from the above scales, see
7-(2)-⑨.
(6) An applicant should never have been awarded with any scholarship programs from Korea for
an undergraduate degree program.
(7) An applicant must have no limitations in travelling abroad
(8) Applicants who have proficiency in the Korean or English language will be given preference.
(9) Descendants of the Korean War veterans will be given preference.
(10) Engineering and Science majors will be given preference.
(11) Applicants from low income families or underprivileged backgrounds will be given
preference.
(12) Applicants who are confirmed to be ‘third generation’ overseas Koreans will be given
preference.
(13) An applicant is restricted to apply either for the Embassy, the Regional University, or the
Associate Degree track.
Applicants who apply for more than one track will be automatically disqualified and
their applications will be eliminated.
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6. Scholarship Benefits
(1) Scholarship Period: March 1, 2020 ~ February 28, 2025 (1-year Language + 4-year Degree
Program)
(2) Scholarship Benefits
① Airplane Ticket or Airfare: The scholarship covers an economy class flight with the
shortest route between a scholar’s country and Korea. A one-way ticket to Korea will be
offered to each scholar at the beginning of the scholarship program; another one-way
ticket from Korea will be offered for those who complete their studies under the
scholarship program.
② Monthly Stipend: 900,000 KRW per month
③ Tuition: The university entrance fee and tuition fee is covered by NIIED and the host
university.
④ Settlement Allowance: 200,000 KRW upon arrival
⑤ Scholarship Completion Grants: 100,000 KRW upon completion of studies only for
scholars returning back to their countries
⑥ Korean Language Training: The full cost for the 1 year is covered by NIIED and the
language institution.
⑦ Medical Insurance: Scholars are covered by health insurance for major accidents and
illnesses during their scholarship period.
⑧ Korean Proficiency Grants: Scholars with level 5 or 6 on TOPIK will receive 100,000
KRW won per month during the degree program.
(3) Notes
① NIIED does not cover the expenses for the domestic travel both in a scholar’s home
country and in Korea.
② Airfare for entry into Korea will not be provided to a grantee that has been staying in
Korea as of the date of announcement of successful candidates
③ NIIED does not cover flight travel insurance of scholars entering Korea and returning
back to their countries.
④ The medical fee is to be reimbursed through the insurance company to a scholar after he
or she pays first. However, the expense for dental care or chronic disease will not be
covered.
⑤ In case a scholar withdraws from the scholarship program within the first 3 months after
entering Korea, he or she must return all the scholarship benefits offered, which includes
the entry airfare, settlement allowance, monthly stipend, tuition, language training fees,
Korean proficiency grants, and medical insurance.
⑥ The return flight ticket and the Scholarship Completion Grants will not be offered for
those who withdraw from the scholarship program.
⑦ If a student temporarily leaves Korea during the language program, the allowance will
not be given during the period student was absent in Korea. The allowance will not be
given if a student’s leave of absence period exceeds 30days during the degree program.
7. Required Documents
(1) Required Documents: 1 set of the original documents below, and 3 sets of the photocopies
of the original
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① Completed Application Form (Form 1)
② NIIED Pledge (Form 2)
③ Personal Statement (Form 3)
④ Study Plan (Form 4)
⑤ Two Recommendation Letters (Form 5)
Must be from two separate recommenders.
The letters must be written by someone who can give in-depth assessment on the
applicant’s abilities, including a high school teacher, principal, or academic advisor.
⑥ Completed Self Medical Assessment (Form 6)
⑦ Graduation Certificate of High School or Provisional Graduation Certificate
Those who are expected to graduate by March 1, 2020 may submit a provisional
graduation certificate of high school.
⑧ High School Grade Transcript (including a description of the school’s grading system)
⑨ Certificates of Citizenship of the Applicant and Parents (Examples: a birth certificate, a
government-issued certificate indicating the parent-child relationship, a family register,
or parents’ passport copies)
⑩ Awards (Optional)
⑪ Applicants with certified scores on their proficiency in Korean or in English may be
given preference. Some examples include the following:
Proficiency in Korea: TOPIK (Test of Proficiency in Korean)
Proficiency in English: TOEFL, TOEIC, or IELTS Academic (TOEFL ITPs are not
acceptable)
⑫ DD214 or other relevant document to prove the family member’s service at the Korean
War
(applicable to Descendants of the Korean War Veterans Only)
⑬ Overseas Korean Proof Documents and supporting documents indicating the generation
status
(applicable to Overseas Koreans Only)
⑭ Certificate of Health (Form 7, only for candidates who successfully pass the 2nd round
of selection)
The certificate of health must be completed and signed by a doctor.
⑮ Copy of the Applicant’s Passport (only for candidates who successfully pass the 2nd
round of selection)
(2) NOTES
① The total 4 sets of application documents (1 set of the original & 3 sets of the
photocopies) should be placed in separate envelopes. The original set must be marked as
“Original” on its envelope. Recommendation letters should be sealed by the
recommenders and submitted with the seals unbroken.
② Original documents should be submitted. However, if copies are submitted, copies must
be authenticated by the issuing institution, confirming that they are the same with the
originals.
③ The applicant’s name on the application form MUST be identical to the applicant’s
passport name.
④ If there is any inconsistency in the applicant’s name or birth date on submitted
documents, further evidential document must be submitted as verification.
⑤ Any applicant, who submits a provisional graduation certificate at the time of applying,
must submit his or her official graduation certificate of high school upon arrival in Korea,
no later than March 1, 2020.
⑥ The application documents must be arranged in the same order as written on the
“Checklist” in the FORM 1. Each document may be stapled. However, DO NOT staple
the entire application documents altogether, or put each document in a separate folder.
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⑦ Application form and all other materials should be filled out either in Korean or in
English. Any document issued in languages other than Korean or English MUST include
official notarized translations.
⑧ All documents submitted must be A4 sized. If the document is smaller, attach it to A4
sized paper; if bigger, fold it to make it A4 sized.
⑨ The high school grade transcript must contain a description of the school’s grading
system. In case the transcript does not have information on the applicant’s rank or
percentile score, an applicant must submit an additional official certificate issued by the
high school, confirming that the applicant’s academic achievement meets the
requirement written on 5-(5) above.
⑩ All documents must be numbered and labeled on the top right corner.
(Example. ⑦ Graduation Certificate of High School)
⑪ Mailing address should be stated in full including the postal-code.
⑫ Submitted documents will not be returned to the applicant. The applicants are advised to
make their own copies of all application documents.
⑬ Incomplete or incorrect documents will result in the disqualification of an applicant.
① For details on the application deadline and the submission of application documents,
applicants should contact the Korean Embassy, the Korean Education Center, or the
Korean Cultural Center in their home countries, or in the neighboring countries if there is
no Korean diplomatic missions in one’s home country.
② The first round of selection will be conducted by the Korean Embassy: All applications
submitted to NIIED by individual applicants or by the foreign embassies in Korea will
NOT BE ACCEPTED and will be discarded.
9. Selection Procedures
Period Details
[1st ROUND]
early September
Each Korean Embassy (KE) announces call for applications.
2019
Applicants must check the announcement from KE, including the deadline.
NIIED announces the final successful candidates on the GKS Notice board at
January 9, 2020
www.studyinkorea.go.kr.
January ~ early KE informs the scholars of their scheduled entry to Korea.
February Scholars must check their entry flight itinerary and make preparations to enter
2020 Korea.
February 24 ~ 25
Entry to Korea
2020
※ NOTES
① Applicants must follow the NIIED’s regulations throughout the application procedure.
② Applicants must choose up to 3 different universities and write their choice in the Forms
1, 4, and 5. Applicants must choose only ONE department (or major) for each university,
as listed on the “2020 University Information” file.
③ When choosing the preferred universities and majors, please contact your preferred
universities in advance for further information. (See Appendix 2 for university contact
information.)
④ After the announcement of the 2nd round result, NIIED will forward the candidates’
documents to the applicants’ intended universities as written on the application forms. All
applicants must double-check their choice of universities in order to ensure that their
application documents are reviewed by RIGHT and CORRECT universities.
⑤ Additional documents might be required to be submitted depending on the university or
department, especially for majors in the field of fine arts, music or physical education. If
asked so, the applicants must submit the requested documents to the university.
⑥ Attention! A candidate who fails to receive admission to any one of the three universities
will NOT BE SELECTED as a GKS scholar.
⑦ Transferring or changing a university is NOT allowed after the confirmation of an
applicant’s final choice of a university.
⑧ Regardless of university admission, all scholars must achieve the TOPIK level 3 as
required by NIIED before the completion of the 1-year Korean language program. Any
scholar who fails to do so cannot proceed to his or her degree program.
10. Other Important Information
(1) Entry
① Scholars must arrive in Korea between February 24th and 25th, 2020. In case a scholar
does not enter Korea by these dates, his or her scholarship will be canceled.
② Prior to arrival, all scholars should study about Korea, Korean language and culture. In
particular, we advise grantees learn as much Korean as possible since most classes at a
Korean university are taught in Korean. Below are some websites that scholars will find
useful when preparing for their studies in Korea.
11. Contact
(1) Application & Document Submission: Korean Diplomatic Missions (See Appendix 1)
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2020년 GLOBAL KOREA SCHOLARSHIP
대한민국 정부초청 외국인 학부장학생 모집요강 (공관추천용)
1. 목적
외국인 학생에게 대한민국 고등교육기관에서 수학할 기회를 부여함으로써 국제교육교류 촉진 및
국가 간 우호증진을 도모하고자 함
2. 초청인원 : 68개국 125명 (아래 국가의 국적을 소지한 자만 프로그램에 지원할 수 있음)
가나 1 베네수엘라 1 엘살바도르 1 케냐 3
가봉 1 베트남 10 예멘 1 콜롬비아 3
네팔 1 부탄 1 우루과이 1 타지키스탄 2
라오스 2 세네갈 1 이란 2 터키 1
모잠비크 1 아프가니스탄 1 칠레 1 페루 1
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<지원가능대학>
1 강원대 11 금오공과대 21 배재대 31 성균관대 41 우석대 51 제주대 61 한서대
5. 지원자격
(1) 추천대상국 국적 소유자 (본인 및 부모)
※ 본인 및 부모 모두 한국 국적을 소유하지 않은 자이어야 함
※ 재외동포 배정인원으로 지원하는 경우, 부모가 일본 ‘특별영주권’을 취득한 경우에 한해
예외적으로 부모 국적 요건 제외
(2) 2020년 3월 1일 현재, 만 25세 미만인 자 (1995년 3월 1일 이후 출생한 자)
(3) 한국에서의 장기간 유학이 가능할 정도로 신체적으로 정신적으로 건강한 자
※ 위 (3)항을 충족하는 장애인도 지원할 수 있음
※ 질병 치료 중인 자는 지원할 수 없음
(4) 2020년 3월 1일 현재 고등학교 졸업자
※ 한국 내 고등학교 졸업자 및 학사 학위 이상 소지자는 지원할 수 없음
(5) 고등학교 전(全)학년 성적 평균 평점(GPA)이 다음의 조건 중 하나 이상을 충족하는 자:
※ 4.0 만점에 2.64 이상
※ 4.3 만점에 2.80 이상
※ 4.5 만점에 2.91 이상
※ 5.0 만점에 3.23 이상
※ 백분율 환산 점수가 80점 이상 혹은 성적 상위 20% 이내 [Appendix 3]의 환산표 참조
※ 만약 지원자의 고등학교 성적 기재 방식이 위와 다른 경우, 7-(2)-⑨ 참조
(6) 한국에서 동일 과정의 장학금을 받은 사실이 없는 자
(7) 해외 여행에 결격 사유가 없는 자
(8) 한국어 또는 영어 능력 우수자 우대
(9) 한국전쟁 참전용사 후손 특별 우대
(10) 이공계 전공 우수인재 특별 우대
(11) 가정형편 등 사회, 경제적 배려 대상자 우대
(12) 재외동포 지원자 중에서도 ‘3세대 이후(3세대 포함)’ 재외동포 우대
(13) 지원자는 공관 또는 지방대 이공계 전형 중 하나만 지원 가능
※ 공관과 지방대 이공계 전형에 중복지원하면 2 차전형 심사대상에서 제외
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6. 장학금 지급
(1) 지급기간: 2020.3.1 ~ 2025.2.28 (한국어연수기간 1년, 학위과정 4년)
(2) 지급내역
① 항공권 또는 항공료: 최초 입국 시 및 최종 귀국 시 한국과 당해국 최단거리 국제공항간
일반석 항공권 또는 항공료 지급
② 생활비: 매월 900,000원
③ 학비: 입학금과 매 학기 등록금 전액 지원
④ 정착지원금: 최초 입국 시 200,000원
⑤ 귀국준비금: 최종 귀국 시 100,000원
⑥ 어학연수비: 어학연수비 전액 지원
⑦ 의료보험: 장학기간 중 질병, 상해, 사고 등에 대한 보험료
⑧ 한국어능력우수자 (TOPIK 5급 이상 취득자)에게는 학위과정 진학 후 월 100,000원 지급
(3) 유의사항
① 장학생의 자국 내 이동 및 한국 내 이동 항공료는 지원하지 않음
② 장학생 확정 선발 통보일 기준 한국에 체류 중인 자는 입국항공료를 지급하지 않음
③ 입국 및 귀국여행에 따른 보험료는 지원하지 않음
④ 의료비는 장학생이 병원 또는 약국에 선납 후 보험사를 통해
⑤ 한국 입국 후 3개월 이내 중도 포기한 경우, 장학금 전액(입국 항공료, 정착지원금, 생활비,
한국어 연수비 등)을 반납하여야 함
⑥ 중도 포기자에게는 귀국항공료와 귀국준비금을 지원하지 않음
⑦ 한국어 연수기간 중 일시출국기간의 생활비, 학위과정 중 학기당 30일초과 일시출국기간의
생활비는 지원하지 않음
7. 제출 서류: 아래 서류 원본 1부 및 사본 3부
(1) 제출 서류
① 지원서 1부 (Form 1)
② 서약서 (Form 2)
③ 자기 소개서 (Form 3)
④ 수학계획서 (Form 4)
⑤ 추천서 2부 [Form 5, 추천인 (지도교사, 출신학교장, 지도교수 등) 2명으로부터 각 1부]
⑥ 자기 건강 진단서 (Form 6)
⑦ 고등학교 졸업증명서 1부 또는 고등학교 졸업예정증명서 1부
(2020.3.1 현재 고등학교 졸업자에 한함)
⑧ 고등학교 성적증명서 1부 (학교의 성적시스템에 대한 설명서 포함)
⑨ 본인 및 부모의 외국 국적을 확인할 수 있는 증명서
(출생증명서 또는 가족관계증명서, 부모 여권 사본 등)
⑩ 수상실적 등 (해당자에 한함)
⑪ 한국어 또는 영어 공인 성적 증명서 (소지자에 한함, 한국어-TOPIK / 영어-TOEIC, TOFLE,
IELTS
Academic *기관 TOFLE 등 효력이 제한적인 어학능력 시험은 인정되지 않음)
⑫ 한국전쟁 참전용사 후손 입증 서류 (해당자에 한함)
⑬ 재외동포 입증서류 및 세대입증서류 (해당자에 한함)
⑭ 의사가 발급한 영문 건강증명서 (Form 7, 2차선발전형 통과자에 한함)
⑮ 본인 여권 사본(2차선발전형 통과자에 한함)
(2) 유의사항
① 서류 원본과 사본 3부는 각각 별도의 봉투에 넣어 제출하도록 함: 추천서는 개봉하지 말고
추천자가 밀봉해 준 대로 제출하여야 함
② 모든 서류는 원본이어야 함. 만약 원본을 제출할 수 없는 경우, 당초 서류 발급
기관으로부터 원본과 같다는 확인을 받은 복사본을 제출할 수 있음
11
③ 지원서의 영어 성명의 철자는 반드시 여권의 것과 같아야 함
④ 지원서류에 기재된 지원자의 성명이나 생년월일 등이 일치하지 않을 경우, 이를 증빙하는
추가 서류를 제출하여야 함
⑤ 고등학교 졸업예정자로 지원 당시 고등학교 졸업예정증명서를 제출한 자는 한국 도착 후
즉시 고등학교 졸업증명서를 제출하여야 함
⑥ 지원서류는 FORM 1의 체크리스트 순으로 제출하여야 하며, 서류 1종을 스테이플로 철할 수
있으나, 서류 전체를 스테이플로 철하거나 투명 파일에 하나씩 끼워 제출하지 않도록 함
⑦ 신청서를 비롯한 모든 서류는 한국어 또는 영어로 작성해야 하며, 한국어 또는 영어로
작성되지 않은 서류에는 반드시 공증번역본을 첨부하여야 함; 공증본은 원본 앞에 정렬함
⑧ 모든 서류는 A4 규격으로 제출하여야 함. 만일 서류가 A4보다 작을 경우 별도 A4 용지에
부착하여 제출, A4보다 클 경우 A4 규격에 맞도록 접어서 제출하여야 함
⑨ 성적증명서에는 성적시스템에 대한 설명서가 반드시 포함되어야 하며, 만약 성적증명서에
지원자의 석차나 비율이 표시되어 있지 않은 경우, 지원자의 성적이 지원자격(상기 5항-(5))을
충족한다는 확인서(고등학교에서 발급)를 추가 제출하여야 함
⑩ 모든 서류의 상단 우측에 서류명을 적어야 함 (예) ⑦ Graduation Certificate of High School
⑪ 주소는 우편번호를 포함한 전체 주소를 적어야 함
⑫ 제출한 서류는 반환하지 않음. 지원자는 모든 지원서류의 복사본을 만들어 보관하기 바람
⑬ 제출 서류의 기재 내용이 부정확하거나 미비 서류가 있는 경우에는 선발 대상에서 제외함
9. 선발 절차
일정 선발 절차
[공고] 각 주재국 한국대사관(이하 KE)은 KE 장학생 후보 선발 계획 발표
9월초
→ 지원자는 KE 장학생 후보 선발 계획 확인
[1차 선발 전형] KE 장학생 후보 선발
9월초 ~ 11월초
→ 지원자는 KE의 장학생 후보 선발 계획에 따라 원서 제출 및 면접 응시
11.4. KE는 1차선발전형 통과자를 본원에 추천
[2차 선발 전형] NIIED 장학생 선정 위원회 개최, NIIED 2차선발전형 결과 발표
(☞ www.studyinkorea.go.kr (NOTICE)
11.7. ~ 11.18.
※ 2차선발전형 통과자는 여권 사본, 의사발급건강증명서를 KE에 제출 (KE는 동
서류를 NIIED에 2019.12.4까지 송부)
[3차 선발 전형] 대학 입학 전형
- (~11.22.) 2차 전형 통과자의 대학입학 전형서류 대학에 송부(NIIED)
11.25. ~ 12.26
- (~12.19.) 대학별 입학전형 실시(서류심사 및 면접 등), 합격자 발표(대학)
- (~12.26.) 3차 전형 통과자는 진학대학을 결정하여 NIIED 및 대학에 통보
2020.1.9. 최종 합격자 발표(NIIED)
KE는 최종 합격자에게 입국 일정 통보
2020.1월~2월
→ 최종 합격자는 입국 일정 확인 및 입국 준비
2020.2.24~2.25. 한국 입국
12
④ 2차선발전형 결과 발표 후 본원은 지원서에 기재한 진학 희망 대학 및 전공에 의거하여
대학입학 전형 서류를 대학에 송부하므로, 지원서 작성시 대학 및 전공을 신중하게 선택하여
기재하여야 함
⑤ 대학 입학 전형 시, 특정 대학 또는 학과(미술, 음악, 체육 등)의 방침상 추가 서류를
제출하여야 하는 경우 해당자는 대학의 요청에 따라 추가 서류를 제출하여야 함.
⑥ 지원한 대학 중 어느 대학으로부터도 입학허가를 받지 못할 경우, 장학생 선발 대상자에서
제외되므로 신중하게 대학을 선택하기 바람
⑦ 최종 진학 대학을 결정한 후 대학을 변경할 수 없음
⑧ 대학에 입학허가를 받았어도 한국어연수가 종료되기 전까지 TOPIK 3급을 취득하지 못하면
학위과정에 진학할 수 없음
10. 기타 유의사항
(1) 입국
① 선발된 장학생은 2020.2월말까지 입국하여야 함. 지정된 기일 내에 입국하지 않을 경우
장학생 자격이 취소됨
② 장학생은 입국 전에 한국 및 한국 문화 등의 사전 연구가 필요함. 특히 대부분 대학의
수업이 한국어로 진행되므로 한국어를 사전 학습하여 주시기 바람.
▪ 한국어학습 http://www.sejonghakdang.org (세종학당->KOSNET 배우기)
▪ 한국 내 대학 http://www.studyinkorea.go.kr
▪ 한국문화이해 http://korea.net
▪ 재외한국공관 http://www.mofat.go.kr
▪ 입국 및 체류 http://immigration.go.kr
(2) 숙소
① 장학생은 수학대학의 기숙사에서 생활하게 됨
② 기숙사비는 본원에서 지원하는 생활비에서 공제함
(3) 장학금 지급중단 및 3개월 이내 장학금 취소
① 다음의 경우에는 장학생 자격을 상실하고 장학금 지급을 중단함
- 지원서류가 허위로 작성되었거나 사실과 다른 것으로 드러났을 때
- 국립국제교육원에 서약한 사항을 위반했을 때
- 국립국제교육원이 정한 학사행정 조치사항에 따르지 아니한 때
- 수학기관으로부터 징계처분을 받았거나 정치활동을 한 경우
- 장학생으로서 품위를 손상시키는 행동을 한 때
- 한국어연수 종료 전까지 NIIED가 정한 일정 TOPIK 급수에 도달하지 못한 때
- 무단 수학 중단으로 학위과정 재학 중 해당 학기에 수강 신청한 과목 학점의 2/3 이상을
취득하지 못한 때
- 외국대학과의 학점교류 등으로 출신국 또는 제3국으로 출국한 때
- 휴학기간 종료 후 정당한 사유 없이 복학하지 않은 경우
- 경고 3회 이상 받은 때
- 중도포기 했을 때
11. 문의처
(1) 프로그램 지원 및 지원서 제출: 출신국 주재(또는 관할) 한국대사관(또는 한국교육원)
[Appendix 1 참조]
(2) 대학 입학: 63개 한국 대학 [Appendix 2 참조]
(3) 기타
- http://www.studyinkorea.go.kr (국립국제교육원 Website: http://www.niied.go.kr)
[English version : Global Korea Scholarship – GKS NOTICE]
13
- 이메일 상담 : [email protected]
[Appendix 1 - Contact Points - Application for the Program]
Korean Embassies
※ Applicants from the countries marked with * should apply for the program through the APPROPRIATE Korean
Embassy (or Korean Education Center). (see Remarks)
Korean Universities
N University Person in Tel Fax E-mail address
o. Charge
HYUKIN
1 Ajou University 82-31-219-2925 82-31-219-2924 [email protected]
KWON
2 Andong National University Heo Yeonghui 82 54-820-7102 82 54-820-7108 [email protected]
Busan University of Foreign
3 Kim Tae-jin 82 51 509 5329 82 51 509 5340 [email protected]
Studies
Chonbuk National CHOI, HYE
4 82-63-270-4757 82-63-270-2099 [email protected]
University SEON
[email protected].
Chonnam National
5 Eunhui CHA 82-62-530-1277 82-62-530-1269 kr
University
[email protected]
[email protected]
6 Chosun University Sung-woo Lee 82-62-230-6498 82-62-608-5229
c.kr
7 Chung-Ang University Yong-Hwa Jang 82-2-820-6117 82-2-813-8069 [email protected]
Chungbuk National [email protected]
8 Soyoung Jeong 82-43-261-3293 82-43-268-2068
University r
Chungnam National [email protected]
9 Yim Jeeyoung 82-42-821-8055 82-42-823-5875
University c.kr
KIM, YONG
10 Daegu University 82-53-850-5685 82-53-850-5689 [email protected]
SIK
SAMYOUL
11 DAEJEON UNIVERSITY 82-42-280-2124 82-42-282-8533 [email protected]
JUNG
82-31-8005- 82-31-8021- [email protected].
Dankook University Lee, Byoungmin
2154 7120 kr
12
82-31-8005- 82-31-8021- skim5385@dankook.
Dankook University Kim, Sunho
2109 7120 ac.kr
13 Dong-A University Brian Kay 82-51 200 6442 82-51 200 6445 [email protected]
[email protected],
Dongguk University, Jeong,
14 82-54-770-2847 82-54-770-2385 stardream@dongguk.
Gyeongju Seonghoon
ac.kr
YEONSU
15 Dongguk University, Seoul 82-2-2260-3440 82-2-2260-4945 [email protected]
JANG
[email protected]
16 Dongseo University Lee Yoonseo 82-51-320-2746 82-51-320-2094
r
YOUNG YEON
17 Ewha Womans University 82-2-3277-6730 82-2-3277-7175 [email protected]
LEE
18 Hallym University Lee Hanseo 82-33-248-1341 82-33-248-1349 [email protected]
19 Handong Global University Esther Kim 82-54-260-1806 82-54-260-1769 [email protected]
20 Hannam University Oh Seung-hwan 82-42-629-7747 82-42-629-7838 [email protected]
[email protected].
21 Hanseo University Kim Dong Ho 82-41-660-1302 82-41-660-1301
kr
isonglee32@hanyang
Hanyang University Songlee Eom 82-2-2220-2446 82-2-2220-1798
.ac.kr
22
minj0510@hanyang.
Hanyang University Minjung Jeon 82-2-2220-2444 82-2-2220-1798
ac.kr
16
23 Hoseo University JIHYE KIM 82-41-540-9522 82-41-540-9524 [email protected]
24 Incheon National University Jeehee Sung 82-32-835-9856 82-32-858-7141 [email protected]
Soo Hwan, [email protected]
25 INHA University 82-32-860-8250 82-32-863-2930
MUN r
PARK CHO
26 Inje University 82-55-3203605 82-55-3335208 [email protected]
RONG
[email protected]
27 Jeju National University Taeyoung Kim 82-64-754-8241 82-64-702-0563
.kr
Mr. Hyukjoo
82-63-220-2887 82-63-220-2075 [email protected]
Lee
Mr. Jeong Sang
Jeonju University 82-63-220-2122 82-63-220-2075 [email protected]
28 Seo
(http://www.jj.ac.kr)
Mr. Jae-hyun
82-63-220-3285 82-63-220-2075 [email protected]
Kim
Mr. Sungkwan
82-63-220-2705 82-63-220-2075 [email protected]
Choi
KAIST [email protected]
29 Song Ko 82-42-350-4803 82-42-350-2420
(http://www.kaist.edu) c.kr
Kangwon National intn1947@kangwon.
30 Junyong Lee 82-33-250-7194 82-33-259-5522
University ac.kr
MinShick
31 Keimyung University 82-53-580-6557 82-53-580-6025 [email protected]
Yoo(Mr.)
[email protected]
32 Kongju National University Pyunghwa Lee 82-41-850-8054 82-41-850-8058
r
MINKYUNG
33 KONKUK UNIVERSITY 82-2-2049-6208 82-2-2049-6214 [email protected]
LEE
[email protected]
34 Konyang University Yoon Hyuna 82 41 730 5134 82 41 730 5383
c.kr
enterkmu@kookmin.
35 Kookmin University Kim, Jinhee 82-2-910-5835 82-2-910-5830
ac.kr
Korea Polytechnic Won Seok 82-31-8041- 82-31-8041-
[email protected]
University Chang 0802 0799
36
Korea Polytechnic 82-31-8041- 82-31-8041-
Chang-Yeol Oh [email protected]
University 0801 0799
37 Korea University Michelle Kim 82-2-3290-5159 82-2-922-5820 [email protected]
Kumoh National Institute of
38 Minah Kim 82-54-478-7216 82-54-478-7222 [email protected]
Technology
Kyung Hee University
Kim, Songeun 82-31-201-3968 82-31-201-3969 [email protected]
39 (Global Campus)
Kyung Hee University
Oh, Dasom 82-2-961-9286 82-2-961-2230 [email protected]
(Seoul Campus)
Kyungpook National
40 Kim, Boo Tae 82-53-950-2433 82-53-950-2419 [email protected]
University
41 Kyungsung University Sarah Cho 82-51-663-4065 82-51-663-4069 [email protected]
Myongji University So Young Kang 82-2-300-1511 82-2-300-1516 [email protected]
42
Myongji University Tenny Kim 82-31-330-6862 82-31-338-9356 [email protected]
Namseoul University SINJAE PARK 82-41-580-2778 041-582-2290 [email protected]
43 YOONJUN
Namseoul University 82-41-580-2772 041-582-2290 [email protected]
CHOI
17
Mr. Justin Jung
44 Pai Chai University 82-42-520-5243 070-4850-8306 [email protected]
Ik, Hwang
Pukyong National
45 Jungeun Kim 82-51-629-6846 82-51-629-6910 [email protected]
University
International
Student
46 Pusan National University 82-51-510-3636 82-51-510-3851 [email protected]
Admission
Team(GKS)
Sangmyung
Changsup Yoo 82-2-2287-7059 82-2-2287-0017 [email protected]
University(Seoul)
Sangmyung
Kyungrack Park 82-2-2287-7085 82-2-2287-0017 [email protected]
University(Seoul)
47
Sangmyung
Younggun Jung 82-41-550-5079 82-41-550-5028 [email protected]
University(Cheonan)
Sangmyung
Hajin park 82-41-550-5107 82-41-550-5028 [email protected]
University(Cheonan)
[email protected]
Semyung University Yujin Shim 82-43-64-91185 82436447177
r
48
kyowon88@semyung
Semyung University Kim Kyowon 82-43-649-1182 82-43-644-7177
.ac.kr
49 Seoul National University Ms. Song Hee 82-2-880-6971 82-2-873-5021 [email protected]
Seoul National University Sarah Yelim admission@seoultech
50 82-2-970-9214 82-2-970-9229
of Science and Technology Choi .ac.kr
Mr. Kim,
51 Silla University 82-51-999-5512 82-51-999-5519 [email protected]
Minsung
Jae
[email protected].
52 Sogang University Hyung(Tony) 82-2-705-8621 82-2-705-8620
kr
Kim
Sookmyung Women's admission@sookmyu
53 Jinhee Lee 82-2-710-9813 82-2-710-9285
University ng.ac.kr
82-41-530-
54 Soonchunhyang University Lim Jaesam 82-41-530-1693 [email protected]
1381
Soongsil University Jongwon Ahn 82-2-820-0021 82-2-820-0022 [email protected]
55
Soongsil University Yechan Kim 82-2-828-7354 82-2-814-7362 [email protected]
56 Sungkyunkwan University EunJin Kim 82-2-760-0027 82-2-760-0030 [email protected]
18
[Appendix 3]
4.0 Scale 4.3 Scale 4.5 Scale 5.0 Scale 100 Points Scale
19
[Form 1]
□ Checklist (Submission of Documents) Please put a √ in the appropriate box, Type or Print clearly
Official
Original 3 Copied
Notarized
Required Documents Document Documents
Translation
Yes No Yes No Yes No
① 지원서 One Complete Application Form N/A
② 서약서 One NIIED Pledge N/A
③ 자기소개서 One Personal Statement N/A
④ 수학계획서 One Study Plan N/A
⑤ 추천서 2 부 2 Recommendation Letters (from 2 different recommenders) N/A
⑥ 자 가건 강진 단서 On e S elf M edi c al As s e ss me nt N/A
⑦ 고등학교 졸업증명서 One Graduation Certificate of High school
⑧ 고등학교 성적증명서 One High school Grade Transcripts
⑨ 본인 및 부모 국적 증명서 One Certificate of Citizenship (Applicant & Parents)
⑩ 수상실적 (해당자만) Awards (Optional)
⑪ 한국어 또는 영어 능력 공인 인증서 (해당자만) C. of Korean Proficiency N/A
One Certificate of Korean or English Proficiency
(If applicable) C. of English Proficiency N/A
⑫ 한국전쟁 참전용사 후손 입증 서류 (해당자만)
Korean War Veterans Documents (If applicable)
20
⑬ 재외동포 증명 서류 (해당자만) Overseas Korean Documents (Overseas Koreans only)
□ 인적 사항 (Personal Information) (English Name Spelling MUST be exactly the same as in your passport)
자국어
(Native
성명 language) 성(Family Name) 이름(Given Name) Middle Name
(Full Name) 여권 사진
영어* (Passport Photo)
(English) 3cm ×4cm
성(Family Name) 이름(Given Name) Middle Name
생년월일(Date of Birth:
성별 □ Male
yyyy/mm/dd)
(Gender) □ Female
결혼여부(Marital Status) □ Single □ Married
출생지
여권번호
(Place of
City/Province and Country (Current Passport Number)
Birth)
국적 여권 유효기간
(Nationality) (Passport Expiration date)
주소 ※Please write in ENGLISH ONLY including street address, city, country and postal code.
(Mailing
Address)
자택 전화
(Home) (Phone) Country Code / Area Code / Phone Number
휴대전화 ________________________________________________________________________
(Cell Phone) Country Code / Cell Phone Number
이메일
(E-mail)
주소 ※Please write in ENGLISH ONLY including street address, city, country and postal code.
(Mailing
Address)
출신고등학교 전화
(High School) (Phone) Country Code / Area Code / Phone Number
팩스
(Fax) Country Code / Area Code / Fax Number
한국어 (Korean)
영어 (English)
□ 학력 (Education: including Elementary School): Please list from the most recently attended school.
입학일 졸업일
기관명 소재지
(Entrance Date) (Graduation Date)
(Institution) (Location: city/country)
( yyyy/mm/dd) (yyyy/mm/dd)
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□ 고등학교 성적 (High School Grades; Only for the semesters attended)
학년 2학년 (2nd year) 3학년 (3rd year) 백분율
(School Year) 1학년 (1st year) TOTAL
(100 percentile)
Grades (G.P.A.) C.G.P.A.: /100
RANK RANK: /100
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): . .
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NAME OF THE APPLICANT SIGNATURE OF THE APPLICANT
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[Form 2]
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As an applicant for 2020 Global Korea Scholarship for Undergraduate Degree, I agree to abide
by the following;
※ Please read each article, check each box and sign below.
(1) The information I have provided in this application forms are true and accurate and all
documents I submitted to the National Institute for International Education (hereafter NIIED)
are genuine. ☐
(2) I understand that all the documents submitted to NIIED for GKS will not be returned
(4) I will respect and uphold the values of the Korean culture and society. ☐
(6) I will not participate in any form of political activities (such as organizing or joining a
political party, attending political meetings, publishing articles and declarations, and
(8) I accept NIIED’s decision concerning graduate degree, research program and the Korean
language program. ☐
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Date(yyyy/mm/ dd) Syamsul Hasanatul Najmi (Signature)
(9) I understand that once I am selected as a GKS scholar. I am not permitted to change the
university, either for the Korean language program or for the degree and research program. ☐
(10)I will abide by the academic regulations and requirements of NIIED, Korean language
institution, and university. ☐
(11)I understand that if I have any dependents that will accompany me to Korea, I am responsible
for all matters concerning those dependents such as visa issuance and that NIIED will not
(12) I give permission to NIIED, the Ministry of Education of Korea, the Ministry of Foreign
Affairs of Korea, the Ministry of Justice of Korea, and affiliated institutions to use the contact
information provided in my application for the purpose of visa issuance, communication,
conducting surveys, and sharing information as needed. I give authorization for photos and
video of me to be taken during GKS orientation and used in any promotional or educational
materials. ☐
(13)I hereby authorize NIIED to verify the information disclosed in this application form and the
documents required by GKS as well as to collect any other information deemed necessary by
GKS to determine my suitability as an applicant from any institution, organization or
individual issuing said information and/or documentation. This includes but is not limited to
(14)I hereby understand that all information provided to NIIED will be stored in secured servers
where access will be limited to GKS team and its affiliates. I understand that all reasonable
efforts will be made to protect confidential and sensitive information. By signing below and
(15)I understand that failure to uphold any of the above statements may be grounds for
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termination of my scholarship offer. ☐
I confirm that I read all of the above conditions. I also understand that the violation of any
one of the above might result in suspension or cancellation of the scholarship.
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[Form 3]
자 기 소 개 서
(Personal Statement)
I have completed high school for three years. I entered high school by writing tests and interviews
with several teachers. After being accepted into this school, I was majoring in sciences. I am one of the
students interested in international relations between countries. Also, I always attend seminars related to
scholarships abroad. At school, I also take part in sports extracurricular activities such as basketball and
English clubs. In basketball, I can and deserve to take part in provincial basketball events, even though my
team does not win but I am happy to be able to enter the finalists for several rounds. At the English club here
I meet many foreigners because every year a foreign club is brought in from various countries and it makes
me know a lot of languages and cultures.
In high school, I got assessment was one of the grades that had a stable and increasing graph so
that I got the top 40 rankings of 400 students from the 2019 class. Because of that, I got a letter of
recommendation from the school to choose the best university in Indonesia. After a few tips and ways taught
by my teacher to select a university, I decided the number one best university in my province; West Sumatra
called Andalas University. Moreover, I am interested in majoring in social science. Because of my interest in
social science, many of my friends protested why I took social. My reason is because in our school not only
learn about natural science but also learn about social science, maybe from my many friends choosing like
natural science then it will be risky for me to get the opportunity to come at the university I want, and I also
have many suggestions from my friends to not to take social science as a major but after I heard my advisory
teacher explain my assessment, that my highest score was in social science and languages and my advisory
teacher also suggested taking faculties such as international relations, law, politics, communications. Finally, I
put my choice in law. A few days after that it was released on the university's website that I am 17-year-old
Hasanatul Najmi came from a high school called MAN 2 PADANG and was accepted into the student
recommendation school program. I am delighted because this is the first pathway for student admission to a
university at a time when high school is still carrying out its study program. The tuition fees that I pay are also
different from other students because, for this program, the tuition is less.
I come from a middle-class family. I am very grateful to get this program because I do not have to
pay expensive tuition. My father worked in the administration department of a university, and my mother was
an elementary school teacher. They supported me to be broad-minded merit. I live in a small town called
Padang, located in West Sumatra, and I find it difficult to access anything here when I am preparing
documents to apply for a Korean Government Scholarships scholarship. In my city there is no TOEFL IBT, and
it is just as difficult if I want the IELTS and TOEIC exams because here does not provide a place, and that too
must be met with the quota of the test applicant so that I can carry out the exam, as well as the TOPIK test, I
can speak Korean but I can't know to what extent do I speak Korean because it is only in Jakarta where the
TOPIC test is, and it really requires a high cost for hotel and other plane tickets.
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We know that Indonesia and South Korea have established diplomatic relations for 45 years, and in
2017 commerce between Indonesia and South Korea has increased by 20%, and also has a commerce target
of 30 billion USD in 2022, and also Indonesia with Korea has formed the cooperation called E-Government to
build a cooperation strategy in the framework of reform and bureaucracy which is the first time in Asia, and
now Indonesia and Korea have established cooperation in the formation of KFX fighter aircraft. According to
my goals, I want to be an Indonesian diplomat in South Korea, where there are currently many Indonesian
citizens living in South Korea, maybe it could be because of culture, marriage, vacation, business, and others.
And with a diplomatic representative that is protecting Indonesian citizens, whos live in South Korea. To
protect our citizens, the most important thing is to understand their hearts so that they are comfortable.
Along with that, and is also supported by knowing quite a lot about Korea such as from their
language and culture, I chose the Korean government scholarship program to support and reach my goals
because in University of Korea Department of Political Science and International Relations concentrates on
theoretical investigations and seeks practical plans regarding various issues such as an ideal political system
and order for Korean society and dynamic international situations, and the achievements of the department
have been widely acknowledged. Moreover, the department has made significant accomplishments in
cultivating outstanding research personnel and policy experts. The graduates of the department have taken
active roles in areas such as academia, politics, political relations, diplomacy, related departments of
international organizations, financial circles, journalism, and civic groups.
DATE(yyyy/mm/dd):2019/09/17 . .
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[Form 4]
수 학 계 획 서
(Study Plan)
<지시문: 한국어 또는 영어로 3 페이지 이내로 A4 규격용지에 단면으로 작성하시오. 수학계획서를 작성하기 전에
학교 선생님과 수학 목적과 계획에 대해 상의하시길 권장합니다. 이 지시문은 숙지 후 삭제하시오.>
<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.>
수학 희망 대학
(Preferred Universities) Seoul National University Korea University Sungkyunkwan university
희망 전공 Political Science and Political Science and Political Science and
(Preferred Departments) International Relations International Relations Diplomacy
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B. 학위과정 수학 계획 (대학 및 전공 선택 이유, 학업 목표와 계획, 수학 후 계획을 기재하고, 진학
majors), your academic goals, specific plans (including timeline) to achieve them, and future plan after completion of your
study. In case that preferred departments (or majors) of the preferred universities are different, please mention about them
separately.)
DATE(yyyy/mm/dd): . .
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[Form 5]
Letter of Recommendation
To the applicant: Please fill in your name and the other required information below. In turn, deliver or email this
form to the person who will write this letter. NOTE: Request your recommender to seal his or her letter of
recommendation in an official envelope and sign across the back flap upon completion. Recommendation letters that
are not sealed and signed will not be accepted.
Confidential
Nationality:
Intended Major:
Recommender’s Name
Recommender’s Signature Date
Position or Title: University (Institution):
Address:
(zip-
code: )
Email: Tel:
*After completing the recommendation letter, please printout or make 3 photocopies of the letter you
wrote and sign all copies (1 original and 3 photocopied letters) respectively. Please enclose all 4 letters in
an official envelope and sign across the back flap; the recommendation letters that are not signed will
not be considered valid. Please return this form and your recommendation letters sealed in an envelope to
the applicant. Thank you!
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[Form 6]
자 가 건 강 진 단 서
(Self Medical Assessment)
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): . .
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[Form 7]
의사 발급 건강 진단서
(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.
1. Personal Information
Full Name:
Sex:
Date of Birth:
Nationality:
2. 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:
Classification Normal Abnormal Classification Normal Abnormal
Skin Heart
Head & Face Abdomen
Eyes Rectum
Ears Genitalia
Mouth & Throat Extremities
Nose & Sinuses Back & Spine
Neck Neurological
Chest & Lungs Mental
Other
If Abnormal:
4. 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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