F. No. 15-412020-F,5.

3
Government of India
Ministry of Human Resource Development
(Department of Higher Education)
External Scholarship Division

PUBLIC NOTICE

Japanese Government [MEXT] Scholarship Program 2021

(Undergraduate Students, College of Technology Students and Specialized Training

College Students)

The Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) is
offbring scholarships to Indian students under the Japanese Government Scholarship Program for
202lto study as Undergraduate Student, College of Technology Student and Specialized
Training College Student.

2. The Program-wise Field of Study is as under:

Undergraduate Students: the application can be made in the field

(i) of Social Sciences and
Humanities or Natural Sciences,

(ii) College of Technology Students: Under this programme, the preferred fields of studies are
(C) Information,
inl Mecfianical Engine"ering (B) Electrical and Electronic Engineering
(E) Architecture (F) Civil
Communication and fretwork Engineering (D) Materials Engineering
Engineering (G) Maritime Engineering (H) Other Fields

(iii) Specialized Training College Students: Under this programme, the preferred fields of studies
(D) Business (E)
are'(A) Technology (B) Personul Cur. and Nutrition (C) Education and Welfare
Fashion and Home Economics (F) Culture and General Education.

3. 't'he last date for submitting applications untler all three programs is 17 August
2020. Applicants should visit the website of the Embassy of Japan,
New Delhi for detailed
info,,ation, eligibility criteria, application form and other related information' A copy
of the
herewith'
application guidelines for all three scholarship programmes is enclosed

possibility that the

NOTE: Due to the ongoing situation related to covlD-l9, there is a
may entirely
application procedure could be stopped at a later stage, and the Embassy
cancel the selection of candidates of the aforesaid scholarship
program for the Academic
Year 2021.

Encl: Application Guidelines

K"^t.glat" J*
S ecti on orncer (E.,.lf;i t:l":L1[:]
Dated the 02nd of JulY 2020
Tele: 0l l-26172492
 APPLICATION GUIDELINES
JAPANESE GOVERNMENT (MEXT) SCHOLARSHIP FOR 2021
(UNDERGRADUATE STUDENTS)

The Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan offers scholarships to
international students who wish to study at Japanese universities as Undergraduate Students under the Japanese
Government (MEXT) Scholarship Program as follows.

1. DEFINITION OF “UNDERGRADUATE STUDENTS”

Those who are enrolled in an undergraduate course at a university, or who are receiving preparatory education in
the Japanese language and other subjects prior to placement at the university.

2. FIELDS OF STUDY
Those who apply for an undergraduate student must choose a “Field of Study (“Social Sciences and Humanities”
or “Natural Sciences”), “Course”, and “Major(s)” from the below table. Applicants may enter a first, second, and
third choice.

(1) Social Sciences and Humanities

Courses Majors
1. Law 2. Politics 3. Pedagogy 4. Sociology
Social Sciences and
5. Literature 6. History 7. Japanese Language
Humanities - A
8. Others (excluding “1. Economics” and “2. Business Administration” in Humanities B.)
Social Sciences and
1. Economics 2. Business Administration
Humanities - B
(Note) Applicants who choose “8. Others” may have difficulties in finding universities that can accept them
depending on their majors.

(2) Natural Sciences

Courses Majors
Science (1. Mathematics 2. Physics 3. Chemistry)
Electric and Electronic Studies (4. Electronics 5. Electrical Engineering
6. Information Engineering)
Mechanical Studies (7. Mechanical Engineering 8. Naval Architecture)
Natural Civil Engineering and Architecture (9. Civil Engineering 10. Architecture
Sciences - A 11. Environmental Engineering)
Chemical Studies (12. Applied Chemistry 13. Chemical Engineering
14. Industrial Chemistry 15. Textile Engineering)
Other Fields (16. Metallurgical Engineering 17. Mining Engineering
18. Maritime Engineering 19. Biotechnology)
Agricultural Studies (1. Agriculture 2. Agricultural Chemistry 3. Agricultural Engineering
Natural 4. Animal Science 5. Veterinary Medicine 6. Forestry 7. Food Science 8. Fisheries)
Sciences - B Hygienic Studies (9. Pharmacy 10. Hygienics 11. Nursing)
Science (12. Biology)
Natural
1. Medicine 2. Dentistry
Sciences - C
(Note) An applicant who chooses Natural Sciences and would like to choose more than one majors is required to
select up to three majors from within the same course (i.e. Natural Sciences A, B or C). However, an
applicant who selects Natural Sciences - C as his/her first choice may choose his/her second-choice major
from Natural Sciences - B or C and third-choice major from Natural Sciences - B as Natural Sciences - C
offers only two majors.

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3. PREPARATORY EDUCATION AND STUDY AT UNIVERSITY
(1) Preparatory Education
① Each grantee will be enrolled at a preparatory educational institution (Tokyo University of Foreign Studies
for the grantees who choose the above 2.(1) Social Sciences and Humanities and Osaka University for the
grantees who choose the above 2.(2) Natural Sciences) designated by MEXT for the first year of the
scholarship period. The preparatory course is a one-year intensive course in the Japanese language and other
subjects necessary for preparation for proceeding to university. Its curriculum mainly consists of education
in the Japanese language, and includes other subjects such as Japanese affairs, mathematics, English, and
social studies for those majoring in Social Science and Humanities, and physics, chemistry and biology for
those majoring in Natural Sciences.
② A grantee who has completed the preparatory education will go on to a university designated by MEXT
upon passing its entrance examination undertaken by the university. If a grantee is determined to be
incapable of completing the preparatory course, his/her scholarship will be cancelled and he/she will be
required to return to his/her home country.
③ If a grantee cannot enter the university even though he/she has completed the preparatory education, his/her
scholarship will be cancelled, and he/she will be required to return to his/her home country.

(2) University Education

① The university which a grantee will enter will be decided by MEXT in consultation with the university and
the preparatory educational institution and in comprehensive consideration of the results of the academic
examinations in the First Screening conducted at the Japanese Embassy or Consulate (hereinafter referred to
“Japanese diplomatic mission”) in the country of applicant’s nationality, academic achievement at the
preparatory educational institution, the grantee’s proposed major subject, and the receiving capacity or
region of the university. No objection by the grantee against the decision will be allowed.
② In principle, the academic year begins on April 1 each year and ends on March 31 the following year.
③ All classes will be given in the Japanese language (except where a grantee is directly placed at a university
which requires no Japanese language ability).
④ If a grantee attends the designated university for the prescribed number of years and earns the required
number of credits as determined by the university, he/she will be awarded a Bachelor’s Degree.

(3) Change of Field of Study, Transfer to Another University and Subjects to be Studied
① A grantee will not be permitted to change his/her course (Social Sciences and Humanities A and B, and
Natural Sciences A, B, and C).
② A grantee will not be permitted to transfer to another university during the period of the preparatory
education course or the undergraduate course.
③ A grantee must study compulsory subjects as determined by the preparatory educational institution and the
university even if he/she has already studied them at a university outside Japan.

4. DIRECT PLACEMENT
(1) Applicants who have sufficient Japanese language proficiency may choose to enroll directly in their university
without taking the preparatory education course. For cases where the undergraduate course of a university
does not require Japanese language proficiency at the time of enrollment and allows applicants to enroll
without going through the preparatory education, applicants may directly enroll in the said undergraduate
course. (These cases are called “direct placement”.) In such cases, enrollment may be either from the spring
term (grantees arrive in Japan in April 2021, and start from the spring term) or from the autumn term (grantees
arrive in Japan in September or October 2021, and start from the autumn term), depending on the university’s
academic calendar.
(2) The decision on universities for placement of applicants who desire direct placement shall be made by MEXT
in consultation with the relevant university. The university will examine the applicant’s academic achievement
(academic grades in high school, etc.), and determine whether the applicant has adequate language skills for
taking an undergraduate course in either Japanese or English by a language proficiency test score (such as the
Japanese-Language Proficiency Test (JLPT) for Japanese). In addition, some universities may conduct

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 interviews with applicants or other examinations.
(3) The period of consultation for direct placement will be from after the Second Screening to January 31, 2021.
The results of the direct placement vary according to the consultation results and the period when the results
are finalized as follows.
① The accepting university has confirmed the applicant’s acceptance during the consultation period: The
applicant will enroll in the accepting university under direct placement.
② The university has rejected the applicant’s acceptance during the consultation period: The applicant will be
required to enroll in the preparatory educational institution.
③ The accepting university has confirmed the applicant’s acceptance after the end of the consultation period:
The applicant will enroll in the accepting university under direct placement.
④ The university has rejected the applicant’s acceptance after the end of the consultation period: The
applicant has to withdraw from the scholarship selection.

5. QUALIFICATIONS AND CONDITIONS

MEXT accepts applications from international students for study in Japan who satisfy the following qualifications
and conditions. Its aim is to foster human resources who will become bridges of friendship between the grantee’s
country and Japan through study in Japan and who will contribute to the development of both countries and the
wider world.

(1) Nationality: Applicants must have the nationality of a country that has diplomatic relations with Japan. An
applicant who has Japanese nationality at the time of application is not eligible. However, persons with dual
nationality who hold Japanese nationality and whose place of residence at the time of application is outside of
Japan are eligible to apply as long as they choose the nationality of the other country and renounce their
Japanese nationality by the date of their arrival in Japan. The First Screening must be conducted at the
Japanese diplomatic mission in the country of which the applicant chooses the nationality.

(2) Age: Applicants, in principle, must be born on or after April 2, 1996. However, applicants who satisfy the
conditions for Academic Background stipulated in ③ below must be 18 years of age or older at the time of
admission to a university in Japan.
Exceptions are limited to cases in which MEXT deems that the applicant could not apply within the eligible
age limit due to the situation or circumstances of the applicant’s country (military service obligation, loss of
educational opportunities due to disturbances of war, etc.) Personal circumstances (financial situation, family
circumstances, state of health, circumstances related to applicant’s university or place of employment, etc.)
will not be considered for exceptions.
(3) Academic Background: Applicants must satisfy any one of the following conditions. However, applicants
desiring direct placement must satisfy either the following ①, ③ or ④ condition.
① Applicants who have completed 12 years of schooling in countries other than Japan. (Applicants who will
meet the above condition by March 2021 are eligible. However, applicants wishing to enroll from the
autumn term through direct placement must be expected to complete 12 years of schooling by August
2021.)
② Applicants who have completed their studies at a school equivalent to a Japanese upper secondary school in
countries other than Japan. (Applicants who will meet the above condition by March 2021 are eligible.)
③ Applicants who have successfully passed an academic qualification examination that is equivalent to the
completion of 12 years of schooling in countries other than Japan. (Applicants who will meet the above
condition by March 2021 are eligible.)
④ Other than the above ①, ② and ③ conditions, applicants who are eligible for enrollment in a Japanese
university at the time of application.

(4) Japanese Language: Applicants must be willing to learn Japanese. Applicants must be interested in Japan and
be willing to deepen their understanding of Japan before and after arriving in Japan. In addition, in principle,
applicants must be willing to carry out their academic studies in Japan in Japanese.

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(5) Health: Applicants must submit a health certificate in the prescribed format signed by a physician attesting
that the applicant has no physical or mental conditions hindering the applicant’s study in Japan.
(6) Arrival in Japan: In principle, applicants must be able to arrive in Japan between April 1, 2021, and April 7,
2021. Departure from the home residence should be on or after April 1, 2021. If an applicant is to enroll in
his/her university from the fall semester through direct placement, he/she must be able to arrive in Japan
during the period specified by the accepting university within two weeks before and after the starting date of
the university’s relevant academic term for that year.
Excluding cases in which MEXT deems as unavoidable circumstances, the applicant must withdraw from this
scholarship program if the applicant cannot arrive in Japan by the end of the specified period above which
decided by MEXT or the accepting university.
(7) Visa Requirement: An applicant shall, in principle, newly obtain a “Student” visa at the Japanese diplomatic
mission located in the applicant’s country of nationality, and enter Japan with the residence status of “Student.”
Accordingly, even if the applicant already has other residence status (“Permanent resident,” “Long-term
resident,” etc.), the applicant must change it to the “Student” status and re-enter Japan. Moreover, the
applicant should be aware that after expiration of the status as a MEXT Scholarship student and even if the
student again applies for their original resident status of “Permanent resident” or “Long-term resident,” such
resident statuses might not be necessarily granted. The applicant should also be aware that the scholarship will
be cancelled if he/she arrived in Japan without a newly obtained “Student” visa.
(8) Non-Eligibility: Those who meet any one of the following conditions are ineligible. If identified ineligible
after being selected as a scholarship student, he/she must withdraw from the scholarship.
① Those who are military personnel or military civilian employees at the time of their arrival in Japan or
during the period of the payment of the scholarship;
② Those who cannot arrive in Japan by the last date of the period specified by MEXT or the accepting
university;
③ Those who are previous grantees of Japanese Government (MEXT) Scholarship programs (including those
who withdraw from the scholarship program after the arrival in Japan). The Monbukagakusho Honors
Scholarship for Privately-Financed International Students is not included in the Japanese Government
(MEXT) Scholarship programs;
④ Those who are currently also applying to another program under the Japanese Government (MEXT)
Scholarship system. This includes the programs for which scholarship payments will begin in FY2020,
although their final selection results have not been decided yet, and the programs for which scholarship
payments will begin in FY2021;
⑤ Those who are already enrolled in a Japanese university or other institution with a residence status of
“Student,” or who are going to be enrolled, or plan to enroll, in a Japanese university or other institution as
a privately-financed international student from the time of application to the MEXT scholarship program in
the applicant’s country until the commencement of the period for payment of the MEXT scholarship.
However, this stipulation does not apply to privately-financed international students who, even though they
are enrolled, or are planning to enroll, in a Japanese university or other institution, verifiably complete their
studies before the start of the scholarship payment period, return to their home country at the time of the
scholarship application, and newly acquire the “Student” residence status and come to Japan;
⑥ Those who are planning to receive scholarship money from an organization other than MEXT (including a
government organization of the applicant’s country) on top of the scholarship money provided by MEXT
after the start of the scholarship payment period;
⑦ Those who are expected to graduate at the time of application and cannot satisfy the condition of academic
background by the deadline given;
⑧ Holders of dual nationality at the time of application who cannot verify that they will give up Japanese
nationality by the time of the arrival in Japan;
⑨ Those who change their residence status to that of other than “Student” after their arrival in Japan;
⑩ Those who plan to, from the time of application for the MEXT scholarship program, engage in long-term
research (such as fieldwork or internship) outside Japan or plan to take a long-term leave of absence from

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 the preparatory educational institution or the university.

(9) Others: MEXT Scholarship will be granted those who are willing to contribute to mutual understanding
between Japan and their home country by participating in activities at schools and communities during their
study in Japan while contributing to the internationalization of Japan. They shall also make efforts to promote
relations between the home country and Japan by maintaining close relations with the university attended after
graduation, cooperating with the conducting of surveys and questionnaires, and cooperating with relevant
projects and events conducted by the Japanese diplomatic mission after they return to their home countries.

6. PERIOD OF SCHOLARSHIP
(1) A grantee who studies at a preparatory educational institution prior to enroll in a university: The
scholarship period will last for five years from April 2021 to March 2026, including one-year preparatory
education in the Japanese language and other subjects due to be provided upon arrival in Japan. For
scholarship grantees majoring in medicine, dentistry, veterinary medicine or a six-year course in pharmacy, the
scholarship period will be seven years until March 2028.

(2) A grantee who enroll in a university through direct placement: The scholarship period will last for four
years (or for six years for those majoring in medicine, dentistry, veterinary medicine or in a six-year course
in pharmacy). The scholarship period will start from the time of enrollment in the university which the
university designates.
(Note 1) In (2) above, the period of enrollment may be April 2021, September 2021 or October 2021
depending on the university’s academic calendar.
(Note 2) If a grantee graduates earlier or withdraws from his/her undergraduate course for early entrance to
graduate school, the scholarship will be provided until his/her graduation or withdrawal.
(Note 3) The grantees majoring a six-year course in pharmacy must undergo the “Pharmaceutical Common
Achievement Tests” implemented prior to practical training. In cases when it is impossible for the
grantees to fulfill the fixed standards necessary for practical training, the scholarship may be
cancelled.

(3) Extension of period of scholarship

If a grantee graduates from an undergraduate course, is admitted for enrollment in a master's course at a
graduate school during the period of his/her scholarship and has outstanding academic achievement that meets
certain criteria, he/she may have the scholarship period extended upon a successful examination by MEXT.

7. SCHOLARSHIP BENEFITS
(1) Allowance: 117,000 yen per month. A supplemental regional allowance of 2,000 yen or 3,000 yen per month
will be added to the monthly scholarship amount for the grantees studying or conducting research in specially
designated regions. Due to the situation of the Japanese Government’s budget, the amount of payment may be
subject to change each fiscal year. If a grantee is absent from the university or the preparatory educational
institution for an extended period, the scholarship shall be suspended for that period.
(2) Education Fees: Fees for the entrance examination, matriculation, and tuition at universities will be paid by
MEXT.

(3) Traveling Expenses

① Transportation to Japan: MEXT will stipulate the travel schedule and route, and provide an airline ticket to
grantees who will arrive in Japan during the specified period stated in “5. (6) Arrival in Japan”. The airline
ticket will be an economy-class ticket for the flight from the international airport closest to the grantee’s
residence (in principle, the country of nationality) to an international airport in Japan used on the normal route
to the accepting university. The grantee shall bear at his/her own expense all costs related to domestic travel
from the grantee’s residence to the nearest international airport, airport taxes, airport usage fees, special taxes
necessary for travel, travel expenses within Japan (including airline transit costs), travel insurance expenses,
carry-on luggage or unaccompanied baggage expenses, etc. The grantee shall also bear at his/her own expense
travel and lodging costs incurred in a third country if the grantee must travel to a third country before coming

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 to Japan for visa purposes because there are no Japanese diplomatic missions in his/her country, or if there are
no direct flights from the grantee’s country of residence to Japan. MEXT will provide an economy-class airline
ticket from the grantee’s country of residence to the said third country, and from the third country to an
international airport in Japan used on the normal route to the accepting university. In principle, the address
given in the space for “Your address before departure for Japan” on the application form shall be recognized as
the “residence,” and the airline ticket will be arranged for a flight from the international airport nearest to that
address. Except for cases when the grantee must travel to a third country to obtain a visa, MEXT will not
provide an airline ticket for cases of travel to Japan from a country other than the grantee’s country of
residence due to the grantee’s personal circumstances. If a grantee will arrive in Japan before or after the
specified period stated in “5. (6) Arrival in Japan”, travel expenses will not be paid.
② Transportation from Japan: Based on the application by the grantee, MEXT will provide an airline ticket to
grantees who shall graduate the accepting university and return to the home country by the end of the final
month of the period of scholarship (See “6. PERIOD OF SCHOLARSHIP”) designated by MEXT. MEXT
shall provide an economy-class airline ticket from the international airport in Japan used for the normal route
to and from the accepting university to the international airport (in principle, in the country of nationality)
nearest to the returning recipient’s residence. The grantee shall bear at his/her own expense all costs related to
travel from the grantee’s residence in Japan to the nearest international airport, airport taxes, airport usage fees,
special taxes necessary for travel, travel expenses within the country of nationality (including airline transit
costs), travel insurance expenses, carry-on luggage or unaccompanied baggage expenses, etc. If a grantee
returns to the home country before the end of period of scholarship due to personal circumstances, or reasons
stated in “8. SUSPENSION OF PAYMENT OF SCHOLARSHIP”, MEXT will not pay for the returning travel
expenses.
If a grantee continues to stay in Japan after the scholarship period has ended in cases such as proceeding to
further education or being employed in Japan, travel expenses for a temporary return will also not be paid.

8. SUSPENSION OF PAYMENT OF SCHOLARSHIP

Payment of the scholarship will be cancelled for the reasons given below. Should any of the following reasons
apply, the grantee may be ordered to return a part of, or all of, the scholarship paid up to that time. Payment of the
scholarship may also be stopped during the period up to the decision on the disposition of the matter.
① A grantee is determined to have made a false statement on his/her application;
② A grantee violates any article of his/her pledge to the Minister of Education, Culture, Sports, Science and
Technology;
③ A grantee violates any Japanese laws and is sentenced and imprisoned for an indefinite period or for a period
of exceeding 1 year;
④ A grantee is suspended from his/her university or preparatory educational institution or receives other
punishment, or is removed from enrollment; as a disciplinary action in accordance with school regulations of
the accepting institution;
⑤ It has been determined that it will be impossible for a grantee to complete the course within the standard
period of study because of poor academic grades or suspension or absence from the university or preparatory
educational institution;
⑥ A grantee came to Japan without newly acquiring the “Student” residence status, or changed his/her
residence status to one other than “Student”;
⑦ A grantee has received another scholarship (excluding those specified for research expenditures);
⑧ A grantee proceeds to a more advanced level of education without receiving approval for an extension of the
period of the scholarship.

9. SELECTION
(1) The Japanese diplomatic missions will conduct the First Screening of applicants by means of examination of
submitted application documents, written academic examinations and interviews.
① Subjects of Written Academic Examinations (to be undertaken by all applicants)
Chosen Field of Study Subjects

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 Social Sciences and Humanities - A
Japanese, English, and Mathematics(A)
Social Sciences and Humanities - B
Natural Sciences - A Japanese, English, Mathematics(B), Chemistry, and Physics
Natural Sciences - B
Japanese, English, Mathematics(B), Chemistry, and Biology
Natural Sciences - C

② Calculators and other devices may not be used during the written examinations.

(2) The date and time of the notification of the results of the First Screening will be specified separately by the
Japanese diplomatic mission in the applicant’s country; the reasons for the results of the screening will not be
disclosed. Those who pass the First Screening will not necessarily be selected as the MEXT Scholarship
grantees.

(3) Applicants who have passed the First Screening will be recommended to MEXT. MEXT will then conduct the
Second Screening of the recommended applicants and decide the scholarship grantees. MEXT selects
candidates from each course.

(4) Applicants will be informed of the final selection results by the Japanese diplomatic mission in the applicant’s
country by the end of January 2021. The reasons for the results will not be disclosed. Any objections to the
decision on the university of placement will not be accepted.

10. APPLICATION DOCUMENTS

Applicants must submit the following documents to the Japanese diplomatic mission in the country of the
applicant’s nationality by the designated deadline. The submitted documents will not be returned.
1 original

1 copy

No. Documents Remarks

① Application Form ○ ○ Use the FY2021 Application Form. (See Note 4.)
Only for applicants desiring direct placement. Use
② Direct Placement Preference Form ●
the FY2021 Preference Form. (See Note 5.)
Academic transcript(s) for all A transcript issued either by the school/university
③ school years of school/university ○ ○ attended or by the applicant's national
attended government. (See Note 6.)
If the applicant has not yet graduated, submit a
Certificate(s) of graduation of
④ ○ ○ certificate of prospective graduation from the
school/university attended
school/university. (See Note 7.)
Recommendation letter from either a
Free format. A sample format is available. (See
⑤ class teacher or principal of last ○ ○
Note 8.)
school attended
⑥ Medical certificate ○ ○ Use the FY2021 certificate form.
⑦ Certificate of enrollment ● ● Only for those currently enrolled in a university.
Certificate of university enrollment Only for those who pass the university enrollment
⑧ ● ●
qualification examination qualification examination. (See Note 7 and 9.)
Only in case the applicant has documents attesting
● to competency in Japanese or English; submit 2
⑨ Certificate of language proficiency
(2 copies) copies. No original document necessary. (See Note
10.)
(Note 1) Documents indicated by the white circle (○) must be submitted by all the applicants. Documents
indicated by the black circle (●) should be submitted only if applicable.
(Note 2) These documents must be written in Japanese or English, or translation in either of these languages
should be attached.

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(Note 3) The applicants must submit two application packets: one is a complete set of original documents and the
other is a complete set of their copies. Write the document number, from ① to ⑨ (refer to the
numbers in the table above) in the upper right-hand corner of the first page for all the documents.
(Note 4) The applicant’s photograph to be attached to the Application Form should be of clear quality, taken
within six months of submission, and printed on paper specially for photographs. The photograph
should be 4.5 x 3.5 cm., upper-body, full-faced, no hats. Please write applicant’s name and nationality
on the back of the photograph. The photograph data can be pasted to the Application Form and printed
out.
(Note 5) A list of undergraduate courses permitting direct placement is provided by the Japanese diplomatic
mission in the applicant’s country. Applicants desiring direct placement should choose and fill in their
preferred university and department in the Preference Form out of the list. Prior to the submission of the
Form, applicants should inquire the Japanese diplomatic mission about and understand the
undergraduate courses accepting direct placement, the number of students accepted, any conditions for
acceptance including Japanese language proficiency, information on any entrance examinations
conducted by the university, the period when overseas students may enroll and start their studies, etc.
(Note 6) Applicants must submit the following documents according to his/her academic background:
(a) Applicants who are attending, or have graduated from, an upper secondary school: an academic
transcript from the upper secondary school;
(b) Applicants who are attending, or have already graduated from, a university: academic transcripts
from both the upper secondary school and the university.
The academic transcripts should show the grade scale applied and the grades earned by the applicant in
all the subjects studied for each year of study at the school or the university. Those who are currently
attending an upper secondary school or a university must also submit the academic transcript that covers
the period from the year of enrollment to the term for which grades have been determined at the time of
application for the scholarship. Those who are attending an upper secondary school or a university must
also submit a transcript when he/she graduates from that school or university by the time selection
results are finalized. In the case that the last school offers a single-structure education system consisting
of a lower and upper secondary level or a primary and secondary level, the necessary academic
transcripts to be submitted shall cover all school years of upper secondary education.
(Note 7) Applicants must submit the following documents according to his/her academic background:
(a) Applicants who are attending an upper secondary school: a certificate of prospective graduation
from the upper secondary school;
(b) Applicants who have already graduated from an upper secondary school: a certificate of
graduation from the upper secondary school;
(c) Applicants who are attending a university: a certificate of graduation from the upper secondary
school (in addition, they must submit a ⑦certificate of enrollment.);
(d) Applicants who have already graduated from a university: certificates of graduation from both the
upper secondary school and the university.
A copy of the graduation certificate and the certificate of university enrollment qualification
examination is acceptable if the copy is attested by an authorized official of the university or an
examination authority. Do not submit the originals as the submitted documents will not be returned.
Those who are attending an upper secondary school or a university must also submit a certificate of
graduation when he/she graduates from that school or university by the time selection results are
finalized.
(Note 8) A recommendation letter for those who are attending an upper secondary school or a university should
be issued by that school or university they are attending. A recommendation letter for those who
graduated from an upper secondary school or a university should be issued by that school or university.
(Note 9) For applicants with “⑧Certificate of university entrance qualification examination”, this document may
be submitted in place of documents No. ③, ④ and ⑤.
(Note 10) If printing out the certificates from the Internet, print out and submit a page showing the applicant’s
name and the details of the relevant qualification (level, score, etc.).

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11. NOTES
(1) The grantees are advised to learn, before departing for Japan, the Japanese language and to acquire information
about Japanese weather, climate, customs, university education, and conditions of the university to attend in
Japan, as well as about the difference between the Japanese legal system and that of his/her home country.

(2) As the first installment of the scholarship payment will be made from one month to one and a half months after
the grantee’s arrival in Japan, the grantee is recommended to bring at least approximately US$2,000 with
him/her to Japan to cover immediate living expenses and other necessary expenses.

(3) The scholarship payments will be transferred to the bank account of Japan Post Bank (JP Bank) opened by
each grantee after the arrival in Japan. MEXT will not transfer the scholarship payments to other account.

(4) Grantees must enroll in National Health Insurance (Kokumin Kenko Hoken) upon arrival in Japan.
(5) It is suggested that grantees acquire a “My Number Card” upon arrival in Japan.

(6) Accommodations:
① During the period of preparatory education, grantees can reside in the residential accommodations of Tokyo
University of Foreign Studies or Osaka University, depending on where they are enrolled. Expenses
relating to accommodations will be borne by the grantee.
② Residence halls for international students provided by universities: Some universities have residence halls
for international students. The grantees enrolled at such universities may reside at these residence halls
under certain conditions. However, due to the limited number of rooms, some of these facilities may be
unavailable. Expenses relating to accommodations will be borne by the grantee.
③ Private boarding houses or apartments: Those who are unable to find accommodation in the
aforementioned facilities may live in regular dormitories of the university or in private boarding
houses/apartments with his/her expenses. It is difficult for grantees with dependents (spouse and children)
to find appropriate housing in Japan. The grantee is requested to arrive in Japan alone first to secure
housing before having his/her dependent(s) come to Japan.

(7) Information regarding the MEXT Scholarship Students (name, gender, date of birth, nationality, accepting
university/graduate school/undergraduate school, field of specialty, period of enrolment, career path after
completion of scholarship, contact information [address, telephone number, e-mail address]) may be shared
with other relevant government organizations for the purpose of utilization for international students programs
implemented by the Japanese Government (support during period of study in Japan, follow-up survey,
improvement of the international student system).
Information regarding MEXT Scholarship Students (excluding date of birth and contact information) may be
included in publicity materials prepared by the Japanese Government for promoting the acceptance of
international students in Japan, particularly in order to introduce former MEXT Scholarship Students who are
playing active roles in countries around the world.
These matters are included in the Pledge stipulating rules and regulations which MEXT Scholarship Students
must comply with and submit when they have been granted the Scholarship.

(8) The English texts attached to the Application Guidelines and the Application Form are for complementary use
only. English expressions do not change the Japanese content.

(9) If there are any questions about the content of the written text in this Application Guidelines or any other
matters, applicants/grantees should inquire the Japanese diplomatic mission in the country of the applicant’s
nationality and follow their instructions.

(10) In addition to the regulations stipulated in this Application Guidelines, those that are necessary to implement
the Japanese Government Scholarship programs shall be determined by the Japanese Government.

-9-
(11) In some circumstances such as travel restrictions or curfew, there are possibilities that the selection process
will be cancelled or applicants will not be able to come to Japan even after being selected as scholarship
students.

- 10 -
 2021年度日本政府（文部科学省）奨学金留学生申請書 （学部留学生）
2021 APPLICATION FORM FOR JAPANESE GOVERNMENT (MEXT) SCHOLARSHIP
　(UNDERGRADUATE STUDENTS)
記入上の注意 INSTRUCTIONS
１．タイプ、又は手書きの場合はブロック体で明瞭に記入すること｡1. Type or write neatly by hand in block letters.
２．数字は算用数字を用いること｡ 2. Use Arabic numerals (0, 1, 2, 3, 4…).
３．年号はすべて西暦とすること｡ 3. Write years in western calendar.
４．固有名詞はすべて正式な名称とし、一切省略しないこと｡ 4. Write proper nouns in full without abbreviation.
※本申請書に記載された個人情報については、本奨学金の選考のため ※Personal data filled in this application form will only be used for scholarship
に使用するほかは、特にEmail アドレス等の連絡先については、採用後に selection purposes. Contact information such as email addresses of selected
おける関係者のネットワークを作ること及び必要に応じ日本政府より各種
情報を送信する以外には使用しない。 applications might be used by the Japanese Government in order to create academic
networks or to send out relevant information when necessary.

姓 Surname 名 Given name ﾐﾄﾞﾙﾈｰﾑ Middle name

1. 氏名（ｱﾙﾌｧﾍﾞｯﾄ）
Name (in alphabet)

※パスポートの表記と同一にすること　　Write your name exactly as it appears on your passport.

2. 性別 3. 婚姻状況 □独身　Single 写真 Photo
□　男　Male　　□　女　Female
Gender Marital Status □既婚　Married （4.5cm×3.5cm）
4. 国籍 6ヶ月以内に撮影した写真
又はデジタル画像を貼る
Nationality
こと。写真の裏面に名前と
5. 日本国籍 □無 □　有：離脱予定年月 年 月 国籍を書くこと。
2 0
Japanese Nationality NO 　　YES: expatriation date yy mm Paste your photo or digital
6. 生年月日 年齢 （2021/4/1現在） image taken within 6 months.
年 月 日 歳
yyyy mm dd Age　(As of April 1, 2021) yrs Write your name and
Date of Birth
nationality on the back of the
※申請者は1996年4月2日以降に出生した者であること。募集要項の学歴条件番号③を満たして申請 photo.
する者のみ、日本の大学入学時点で18歳以上であることが必要である。Applicants must have been born on
or after April 2, 1996. Only applicants who meet the condition No.③ of academic background in Section 5. (3) of the
Application Guidelines should be over 18 years of age or older at the time of admission to a Japanese university.

7.(1) 現住所 国名
Current Address Country

※現住所が日本の場合、現在の在留資格の種類
If you currently reside in Japan, what is your current resident status?
※既に我が国の在留資格「永住者」、「定住者」等を有している場合であっても、採用後に「留学」に変更する必要がある。な
お、国費外国人留学生の身分終了後に改めて「永住者」又は「定住者」の在留資格を申請しても当然には認定されない可能
性があることを理解した上で申請すること。 An applicant with "permanent resident" or "long-term resident" status must change his/her
status to "student" if selected. Be aware that application for the original status after "student" status is expired may not be necessarily approved.

□　同上　Same as above.
(2) 渡日前住所
Your address before □　下記住所に変更することが確定している　The above 'Current Address' will be changed as follows:
departure for Japan 国名
Country
※渡日前住所が現住所から変更になることが確定している場合は、「(2)渡日前住所」の「下記住所に変更することが確定して
いる」に✔を入れ、住所を記入すること。変更がない場合は「同上」に✔を入れること。If the current address will be changed at the time
of leaving from your country, please check the box of 'The above 'Current Address' will be changed as follows:' and specify the new address. If the current
address will not be changed, check the box of 'Same as above'.

※渡日前住所が国籍国と異なる場合は、渡日旅費が不支給となることを理解しているか。If your address □はい □いいえ

before departure for Japan is outside your home country, do you understand that an airline ticket to Japan will not be provided? YES NO
(3) 査証申請予定公館
Name of Japanese diplomatic office where you will apply for visa issuance
※下記外務省ウェブページを参照し、国籍国に所在する公館の中から公館名を１つ記載すること。不明な場合は在外公館に確認す
ること。Write a Japanese diplomatic office in the country of your nationality in reference to the following webpage of the Ministry of Foreign Affairs.
Please consult in advance with a Japanese diplomatic office if you are unsure about this item.
Embassies & Consulates: https://www.mofa.go.jp/about/emb_cons/over/index.html
(4) 電話番号
(5) Email
Phone number
※可能な限り、渡日前～日本留学中～帰国後にわたり使い続けることが予想されるEmailアドレスを記入すること。
You are suggested to write an email address that can be used continuously before, during and after your stay in Japan.

-1-
 □学生 在籍学校名
Student Name of school
8. 現在の身分 □就労者 勤務先名
Present status Employed Name of organization
□その他
Others

9.過去に在籍した高
校又は大学での専攻
分野
Specialized field of study
in high school or
university

10. 学歴　　Academic record

INSTRUCTIONS
１．初等教育から最新の教育課程まで正規生として修学した課程 1. Write your record from primary education (elementary school) to most recent educational level attended
のみ記入すること。幼稚園・保育所教育は記入不要。 only as a full-time student. Exclude kindergarten education and nursery school education.
２. 「卒業年月」は学校の公式な卒業年月を記入すること。（例： 学 2. Write the official graduation year and month in the space of "To: yyyy/mm". (ex. In case of October intake and
校の学事暦が10月入学9月卒業の場合、最後の8～9月が休暇の September graduation under the school's academic calendar, put "9 (September)" in the space of "mm" as an
場合も「卒業月」欄は「9月」となる。） official graduation month although the term from August to September is a summer break.)

３. 最終学歴が卒業見込の者は、「卒業年月」には卒業見込年月 3. For those whose status is "Expected to graduate", write expected year and month of graduation in the
を記入すること。 space of "To: yyyy/mm".

４. 「卒業状況」を「その他」と選択した場合は、具体の状況を「特 4. If the applicant chooses "Other status" in the Status, indicate the detail of status in the Remarks
記事項欄」に記入すること。（例：退学、休学中） column. (ex. Withdrawal, leave of absence)
５．「大学予備教育」は後期中等教育に含まれる｡ 5. Preparatory education for university admission is included in upper secondary education.
６． ｢大学入学資格試験｣に合格している場合には、その旨「特記
6. If the applicant has passed the university entrance qualification, indicate this in the Remarks column.
事項」欄に記入すること｡
７．「飛び級」をしている場合には、その旨を「特記事項」欄に記入 7. Any school years or levels skipped should be indicated in the Remarks column.
すること。（例：後期中等教育－3年次を飛び級により短期卒業） Example: Upper secondary education - Skipped senior year for the early graduation.
８．住居の移転や大学の再入学等を理由に、同教育課程で複数 8. If you attended multiple schools at the same level of education due to moving house or readmission to
の学校に在籍していた場合は、同じ欄に複数の学校の在籍を記
university, write all the schools in the same column.
載すること。
９. 下記に書ききれない場合は、別紙に記入することも可能。しか 9. You may use a separate piece of paper if the space below is insufficient. In such a case, please
しその場合は、別紙に記入する旨を明記すること。 indicate that the information is on a separate page.

教育段階 学校名 所在地 入学及び卒業（見込）年月 修学年数 卒業状況 特記事項

Year & month of enrollment & Period of schooling
Educational level School name Location Status Remarks
graduation (expected to graduate) attended
州・省 State/Province
入学 年 月
初等教育 From yyyy mm
（小学校） 年
Primary Education 市・町 City/Town yrs
(Elementary School) 卒業 年 月
To yyyy mm

州・省 State/Province
前期中等教育
入学 年 月
（中学校） From yyyy mm
Lower Secondary 年
Education(Middle 市・町 City/Town yrs
School/Junior High 卒業 年 月
To yyyy mm
School)
州・省 State/Province
後期中等教育
入学 年 月
（高校）
From yyyy mm
Upper Secondary 年
Education 市・町 City/Town yrs
((Senior) High 卒業 年 月
To yyyy mm
School)
州・省 State/Province
卒業
高等教育 入学 年 月 □ Graduated
（大学学部） From yyyy mm

Tertiary(Higher)
年 卒業見込
□ Expected
市・町 City/Town yrs to graduate
Education 卒業 年 月
(Undergraduate) その他
To yyyy mm □ Other status
2021年4月1日時点の通算の学校教育修学年数 年
Total years of schooling attended as of April 1, 2021 yrs
特記事項 Remarks
（上記の特記事項欄で書ききれない場合は適宜使用すること）
You may use the space if the space of the above Remarks
column is insufficient.

-2-
11. 過去に国費外国人留学生に採用されたことがあるか。なお、過去に国費外国人留学生として採用された者
□いいえ □はい
は応募対象外である。
NO YES
Have you been awarded a Japanese Government (MEXT) Scholarship in the past? If 'YES', you are NOT eligible to apply.

※過去に受給した奨学金が文部科学省奨学金に該当するか否か不明の場合は事前に在外公館に相談すること。If you are

unsure whether previously awarded financial aid corresponds to a MEXT Scholarship or not, please consult in advance with a Japanese diplomatic office.

12. 日本政府（文部科学省）奨学金制度による他のプログラム（2020年度奨学金支給開始プログラムのうち採
否結果が未決定のプログラム及び2021年度奨学金支給開始のプログラム）に併願しているか。それらの日本
政府（文部科学省）奨学金との併願は認められない。Are you applying for any other Japanese Government (MEXT) □いいえ □はい
Scholarships (including the programs for which scholarship payments will begin in FY2020, although their final selection results have not NO YES
been decided yet, and the programs for which scholarship payments will begin in FY2021)? It is not allowed to apply for other Japanese
Government (MEXT) Scholarships at the same time.
13.(1) 本制度による奨学金と重複し、日本政府（文部科学省）以外の機関（自国政府機関を含む）から奨学金等
を受給、又は受給予定であるか。 □いいえ □はい
Are you receiving or scheduled to be receiving any scholarship from any organization other than the Japanese Government NO YES
(MEXT) (including an organization of your home country government) together with the MEXT Scholarship?
※「はい」の場合、本奨学金と他の奨学金の併給は認められないため、本制度に採用後は他の奨学金の
受給を停止しなければならないことを理解しているか。 □はい □いいえ
If 'YES', do you understand you must cancel other scholarships after selected for MEXT Scholarship Student since it is YES NO
not allowed to receive other scholarships together with the MEXT Scholarship?

(2) 他の奨学金に応募又は他の奨学金を受給している場合は、その名称、期間、金額等を記すこと｡
If you are receiving or applying for other scholarships, please specify the name of the sponsor, scholarship period, scholarship amount, etc.
奨学金の名称・期間・金額
Name of sponsor, period and
amount of the scholarship
14. 日本での希望専攻分野　Preferred field of study and major in Japan

(1) 系列 文科系 理科系

□ Social Sciences and Humanities □ Natural Sciences
Field of study
※いずれかをチェックすること。　Check either box.
(2) 専攻分野　Major
系列 Course 番号 No. 専攻分野名
(A,B,C) (1-19) Name of major
第1希望
First choice
第2希望
Second choice
第3希望
Third choice
※必ず募集要項「２．募集分野」から選んで記入すること。例： 理科系、A、1、数学
Select from the field of study in the Application Guidelines "2. FIELDS OF STUDY". E.g. Natural Sciences, A, 1, Mathematics
15. 希望理由　Reasons for selection of field of study and major

※14.で記入した専攻分野について、希望する理由を具体的に記入すること。
Specify the reasons why you selected each "Field of study" and "Major" in section 14.

第1希望
First choice

第2希望
Second choice

第3希望
Third choice

-3-
16. 日本に関心をもったきっか
けは何か。
What was the trigger for having an
interest in Japan?

17. 日本留学の経験を通じて日
本と母国のためにどのような貢
献ができると考えているか。
What kinds of things do you think you can
contribute to Japan and your home country
through your experience of studying in
Japan?

18. 語学力
読む能力 Reading 書く能力 Writing 話す能力 Speaking 聴く能力 Listening
Language ability
日本語 Japanese

英語 English
その他
( )
Others
※３から０で自己評価すること
３＝優 Excellent ２＝良 Good １＝可 Fair ０＝不可 Poor
Self-rate on a scale of 3 to 0.
（例）日本留学試験(日本語) ○○○/450点
(Ex.) EJU Japanese Score: ○○○/450
19. 日本語能力（資格） 日本語能力試験 ﾚﾍﾞﾙ その他
Japanese language qualifications JLPT level Other

iBT
20. 英語能力（資格） その他
TOEFL IELTS
English language qualifications Other type Other
( )

21. 緊急の際の母国の連絡先　　Contact person in your home country in case of emergency.

氏名 続柄
Name Relationship
現住所 職業
Current address Occupation
電話番号／FAX番号
Email
Phone / Facsimile number

22. 日本への渡航及び滞在歴　　Past visits or stays in Japan List from your most recent visits.

期間　Period 渡航目的　Purpose

From 年 月 To 年 月
yyyy mm
～ yyyy mm

From 年 月 To 年 月
yyyy mm
～ yyyy mm

私は2021年度日本政府（文部科学省）奨学金留学生募集要項に記載されている事項をすべて了解
し、上記の通り申請資格を満たしていることを確認の上、申請します。
I understand and accept all the conditions stated in the Application Guidelines for Japanese Government (MEXT)
Scholarship for FY2021, and upon confirmation of my qualifications for application as stated above, I hereby apply
for this scholarship.

申請者署名 申請年月日 20 　年 　月 　日
/ /
Applicant's signature Date of application year month day

-4-
 2021年度日本政府（文部科学省）奨学金留学生 直接配置希望大学申請書
（学部留学生）
2021 DIRECT PLACEMENT PREFERENCE FORM FOR JAPANESE GOVERNMENT (MEXT)
SCHOLARSHIP (UNDERGRADUATE STUDENTS)
相当程度の日本語能力を有し予備教育が不要と認められる者又は日本語能力を求めない大学に入学を希望する者について大学進学前の予備
教育を省略し、直接大学への入学を認める場合を直接配置という。
Direct placement is the system whereby the requirement for preparatory education before entrance is waived and direct admission to a university is permitted if you have
sufficient knowledge of the Japanese language and there is no necessity for preparatory education, or if you wish to enter a university course that has no Japanese language
requirement.

※この用紙は大学への直接配置を希望する者のみが提出すること。
※Only those who prefer direct placement need to submit this form.
Surname (姓) Given name (名) Middle name (ﾐﾄﾞﾙﾈｰﾑ)
 1.氏名（ｱﾙﾌｧﾍﾞｯﾄ）
  Name in Alphabet
※パスポートの表記と同一にすること  Write your name exactly as it appears on your passport.
 2.性別  3.国籍
□ 男 Male   □ 女 Female
  Gender Nationality
 4.生年月日 年 月 日 年齢 (2021/4/1現在） 歳
Date of Birth yyyy mm dd Age (As of April 1, 2021) yrs
 5. 希望大学・学部 The university in Japan you wish to attend.

○在外公館が提供する直接配置可能大学リストの中から選ぶこと。
 Choose from the list of the universities that accept direct placement. The list is available at the Japanese diplomatic office.

○１つの希望専攻分野につき、希望大学を最大２つまで選び、希望順に記載すること。
 You can choose two universities at most in each of preferred fields of study. Fill in the university names in order of preference.

○希望専攻分野欄の系列及び専攻分野番号は、申請書の記載内容と必ず一致させること。
 The preferred "Course" and "Majors No." below and those on your Application Form should be the same.

希望専攻分野 番号 希望大学名 Preferred University, Faculty and Department

Preferred Field of 系列 Majors
Course
Study No. 大学名 学部名 学科名
(A,B,C)
(1-19) Name of University Name of Faculty Name of Department

第1希望
First Choice
第1希望
First Choice
第2希望
Second Choice

□
文科系
Social 第1希望
Sciences First Choice
and
Humanities
第2希望
Second Choice
□ 第2希望
理科系 Second Choice
Natural
Sciences

第1希望
First Choice
第3希望
Third Choice
第2希望
Second Choice
 JAPANESE GOVERNMENT (MEXT) SCHOＬARSHIP RECOMMENDATION FORM

Applicant's Name (Please print):

,
(Surname) (Given name) (Middle name)

To the Applicant : Please fill in your full name above. Give this form and an envelope marked “confidential" and addressed to yourself to the person you
have asked to recommend you. Ask this person to place the completed form in the envelope, seal the envelope, sign across the seal, and send it back to
you. Submit the unopened envelope with your application to the Japanese Embassy/Consulate General.

To the Recommender : Please respond to the following questions. Please type or print. After completing this form, place it in the envelope provided, seal
the envelope, sign across the seal, and return it to the applicant. This recommendation is a required part of the application process and to be used for
admissions purposes only; prompt return to the candidate is important. MEXT appreciates your assistance and would like to assure you that your comments
will be carefully considered.

Recommender's name :

Title and Institution :

Address (either work or home) :

Telephone: ／ Email :

１．During which period of time have you had the most frequent contact with the applicant? From to .

２．What was the nature of your relationship?

３．In what areas does the applicant need improvement or growth?

４．Please comment on the applicant's interpersonal skills. How well does he or she work within a team?

５．How would you describe the applicant's leadership skills?

６．Please comment on the applicant's degree of self-confidence.

７．Please comment on the applicant's personal character.

８．Please indicate your overall evaluation of the applicant for a Japanese Government (MEXT) Scholarship.
（ ）Strongly recommend （ ）Recommend （ ）Recommend with reservation

９．Please write whatever additional comments you would like to make about the applicant's potential for graduate study in Japan and potential for becoming
a responsible, effective person for your country. Additional pages may be attached, and the back page of this form can also be used.

Signature Date

Note: Any other formats of recommendation letter will be accepted.

 健康診断書（2021年度版） CERTIFICATE OF HEALTH (for 2021)
（医師に記入してもらうこと） (to be completed by the examining physician)
日本語又は英語により明瞭に記載すること。 Please fill out (PRINT/TYPE) in Japanese or English.

氏名
Name Surname 姓 Given name    名 Middle name  ミドルネーム
性別 □ 男 Male 生年月日     年     月     日
Gender □ 女 Female Date of Birth yyyy mm dd

１．身体検査
Physical examination
(1)身長 (2)体重
cm kg
Height Weight
(3)血圧 (4)血液型
mmHg∼       mmHg □A □B □AB □O □RH＋□RH−
 Blood pressure Blood type
(5)脈拍 □ 整 Regular (7)色覚異常の有無 □ 正常 Normal
 Pulse □ 不整 Irregular  Color blindness □ 異常 Impaired
裸眼        (右)        (左) (8)聴力 □ 正常 Normal
Without glasses   (R)        (L)  Hearing □ 異常 Impaired
(6) 視力 Eyesight
矯正         (右)    (左) (9)言語 □ 正常 Normal
With glasses or contact lenses (R) (L)  Speech □ 異常 Impaired
２．胸部聴診及びＸ線検査 （６ヶ月以内）
Physical and X-ray examinations of the chest (within six months)
胸部X線所見 撮影年月日     年     月     日
Describe the condition of lungs. Date of X-ray yyyy mm dd
フィルム番号
Film No.
(1)肺 □ 正常 Normal
 Lungs □ 異常 Impaired
(2)心臓 □ 正常 Normal
 Cardiomegaly □ 異常 Impaired
異常がある場合⇒心電図 □ 正常 Normal
If impaired⇒Electrocardiograph □ 異常 Impaired
３．現在治療中の病気
□ 無 No □ 有 Yes ： 病名 Disease
  Disease currently being treated
完治時期/治療中 完治時期/治療中
４．既往症
✔ 病名Name Date of recovery ✔ 病名Name Date of recovery
  Past illness/disorder /under treatment /under treatment
該当するものにチェックと完治時期 結核 マラリア
/治療中を記入、いずれも該当し Tuberculosis Malaria
ない場合は「無し」にチェックするこ その他感染症 てんかん
と。 Other communicable disease Epilepsy
Please check and fill in the date of 腎疾患 心疾患
recovery/under treatment. Kidney disease Heart disease
If NOT contracted any of them in the 糖尿病 薬剤アレルギー
past, please check “None”. Diabetes Drug allergy
無し 精神疾患 四肢機能障害
✔ Functional disorder in the
None Psychosis extremities
５．検 査
Laboratory tests
(1) 尿検査 糖 蛋白 潜血
  Urinalysis: glucose protein occult blood
(2) 貧血検査 赤沈 白血球数 血色素量 貧血
mm/Hr /cmm gm/dl
Anemia test ESR WBC count Hemoglobin Anemia
(3)肝機能検査 GPT GOT
（IU/ｌ） （IU/ｌ） γ-GTP （IU/ｌ）
  LFT （ALT) （AST)
６．医師の診断・意見
Physician's impression of the applicant’s health
 継続的治療・投薬の必要性があればその旨ご記入下さい。
Please fill in if the applicant needs regular medication or treatment.

７. In view of the applicant's history and the above findings, is 日付

it your observation that his/her health status is adequate to Date
pursue studies in Japan? 志願者の既往歴、診察・検査の結果から判断して、現 医師署名
在の健康の状況は充分に留学に耐えうるものと思われますか？ Physician's Signature

検査施設名
□ YES （はい） □ NO （いいえ） Office/Institution

※Please be sure to check either "YES" or "NO". If you do not 所在地

check "YES", the Embassy will NOT accept the application. Address
  必ず「はい」又は「いいえ」にチェックしてください。「はい」にチェックがない場合、 大使館
は申請を受理しません。
 APPLICATION GUIDELINES
JAPANESE GOVERNMENT (MEXT) SCHOLARSHIP FOR 2021
(COLLEGE OF TECHNOLOGY STUDENTS)

The Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan offers scholarships to
international students who wish to study at Japanese colleges of technology as College of Technology Students
under the Japanese Government (MEXT) Scholarship Program as follows.

1. DEFINITION OF “COLLEGE OF TECHNOLOGY STUDENTS”

Those who are enrolled in a course of study or in an advanced course at a college of technology, or who are
receiving preparatory education in the Japanese language and other subjects prior to placement at the college of
technology. Under the application guidelines, MEXT calls for applicants who will study in a one-year preparatory
course and then will be enrolled into the third year of the course at the college of technology and receive
specialized education for three years (in the case of maritime engineering, for three and a half years.)

2. FIELDS OF STUDY
Those who apply for a college of technology student must choose a field of study in accordance with the
following procedure and fill in “Preferred field of study and majors elements” on the application form.

(1) Choose preferred field(s) of study from among (A) to (H) below. Applicants may enter a first, second and third
choice.

(A) Mechanical Engineering (B) Electrical and Electronic Engineering

(C) Information, Communication and Network Engineering (D) Materials Engineering
(E) Architecture (F) Civil Engineering (G) Maritime Engineering (H) Other Fields

(2) Choose preferred majors element(s) from the “Name of Majors Elements” listed in the chosen field(s) of
study on the Annex “Majors and Related Key Terms for Fields of Study”.

(Note 1) Applicants can choose “(H) Other Fields” in combination with every other field of study. The subject
(Chemistry or Physics) for the academic written examination will be determined depending on the
combination of chosen fields of study. Please confirm your subject to be undertaken in “8.
SELECTION”.
(Note 2) Applicants who apply for “(D) Materials Engineering” may not choose it in combination with other
fields of study, excluding “(H) Other Fields”. Applicants wishing to choose more than one Majors
Elements, should select their first, second and third choice of the Elements from ones under “(D)
Materials Engineering” and/or “(H) Other Fields”.
(Note 3) An Applicant who applies for “(G) Maritime Engineering” must have vision of 0.5 or more in either eye
with or without glasses, and no color-blindness.
(Note 4) Applicants who choose “(H) Other Fields” (International Communication or Management Information
Engineering) may have difficulties in finding colleges of technology capable of accepting them.
Applicants who choose “(H) Other Fields” are recommended to choose another field(s) of study in
addition to “(H) Other Fields”.

3. PREPARATORY EDUCATION AND STUDY AT COLLEGE OF TECHNOLOGY

(1) Preparatory Education
① Each grantee will be enrolled at a preparatory educational institution designated by MEXT for the first year
of the scholarship period. The preparatory course is a one-year intensive course in the Japanese language,
Japanese affairs, mathematics, and other subjects necessary for preparation for proceeding to a college of
technology.

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 ② A grantee who has completed the preparatory course will go on to a college of technology designated by
MEXT. If a grantee is determined to be incapable of completing the preparatory course, his/her scholarship
will be cancelled and he/she will be required to return to his/her home country.
③ If a grantee cannot enter the college of technology even though he/she has completed the preparatory
education, his/her scholarship will be cancelled, and he/she will be required to return to his/her home
country.
(2) College of Technology
① The college of technology which the grantee who has completed the preparatory course enrolls will be
decided by MEXT upon consultation with the college concerned. No objection by the grantee against the
decision will be allowed.
② A college of technology operates under a five-year course requiring graduation from a junior high school
for entrance, but the grantees of this scholarship will be enrolled into the third year of the course at the
college of technology and receive specialized education for three years prior to graduation (or three and a
half years for those who major in maritime engineering). A grantee who graduates will be awarded a
diploma and an academic title of “Associate”.
③ All classes will be given in the Japanese language.
④ After a five-year course, a two-year advanced course is offered by the college of technology to provide a
further level of education. If a grantee wishes to continue study at the advanced course as MEXT
Scholarship student, the scholarship period should be extended upon successful examination by MEXT (See
“5. (2) Extension of period of scholarship”.) If a grantee completes the advanced course and passes the
examination by the National Institution for Academic Degrees and Quality Enhancement of Higher
Education (NIAD-QE), NIAD-QE awards a bachelor’s degree to him/her.

(3) Change of Field of Study and Transfer to Another Institution

① A grantee will not be permitted to change his/her field of study during the study at preparatory educational
institution and college of technology.
② A grantee will not be permitted to transfer to another educational institution during the period of the
preparatory education course or the course at the college of technology.

4. QUALIFICATIONS AND CONDITIONS

MEXT accepts applications from international students for study in Japan who satisfy the following qualifications
and conditions. Its aim is to foster human resources who will become bridges of friendship between the grantee’s
country and Japan through study in Japan and who will contribute to the development of both countries and the
wider world.

(1) Nationality: Applicants must have the nationality of a country that has diplomatic relations with Japan. An
applicant who has Japanese nationality at the time of application is not eligible. However, persons with dual
nationality who hold Japanese nationality and whose place of residence at the time of application is outside of
Japan are eligible to apply as long as they choose the nationality of the other country and renounce their
Japanese nationality by the date of their arrival in Japan. The First Screening must be conducted at the
Japanese Embassy or Consulate (hereinafter referred to “Japanese diplomatic mission”) in the country of
which the applicant chooses the nationality.

(2) Age: Applicants, in principle, must be born between on or after April 2, 1996.
Exceptions are limited to cases in which MEXT deems that the applicant could not apply within the eligible
age limit due to the situation or circumstances of the applicant’s country (military service obligation, loss of
educational opportunities due to disturbances of war, etc.) Personal circumstances (financial situation, family
circumstances, state of health, circumstances related to applicant’s university or place of employment, etc.)
will not be considered for exceptions.

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(3) Academic Background: Applicants must satisfy any one of the following conditions.
① Applicants who have completed 11 years of schooling in countries other than Japan. (Applicants who will
meet the above condition by March 2021 are eligible.)
② Other than the above ① condition, applicants who are eligible for transfer admission to a third-year course
at a college of technology at the time of application.

(4) Japanese Language: Applicants must be willing to learn Japanese. Applicants must be interested in Japan and
be willing to deepen their understanding of Japan before and after arriving in Japan. In addition, in principle,
applicants must be willing to receive college of technology education in Japanese.

(5) Health: Applicants must submit a health certificate in the prescribed format signed by a physician attesting
that the applicant has no physical or mental conditions hindering the applicant’s study in Japan.

(6) Arrival in Japan: In principle, applicants must be able to arrive in Japan between April 1, 2021, and April 7,
2021. Departure from the home residence should be on or after April 1, 2021.
Excluding cases in which MEXT deems as unavoidable circumstances, the applicant must withdraw from this
scholarship program if the applicant cannot arrive in Japan by the end of the specified period above which
decided by MEXT or the accepting preparatory educational institution.

(7) Visa Requirement: An applicant shall, in principle, newly obtain a “Student” visa at the Japanese diplomatic
mission located in the applicant’s country of nationality, and enter Japan with the residence status of “Student.”
Accordingly, even if the applicant already has other residence status (“Permanent resident,” “Long-term
resident,” etc.), the applicant must change it to the “Student” status and re-enter Japan. Moreover, the
applicant should be aware that after expiration of the status as a MEXT Scholarship student and even if the
student again applies for their original resident status of “Permanent resident” or “Long-term resident,” such
resident statuses might not be necessarily granted. The applicant should also be aware that the scholarship will
be cancelled if he/she arrived in Japan without a newly obtained “Student” visa.

(8) Non-Eligibility: Those who meets any one of the following conditions are ineligible. If identified ineligible
after being selected as a scholarship student, he /she must withdraw from the scholarship.
① Those who are military personnel or military civilian employees at the time of their arrival in Japan or
during the period of the payment of the scholarship;
② Those who cannot arrive in Japan by the last date of the period specified by MEXT or the accepting
institution;
③ Those who are previous grantees of Japanese Government (MEXT) Scholarship programs (including those
who withdraw from the scholarship program after the arrival in Japan). The Monbukagakusho Honors
Scholarship for Privately-Financed International Students is not included in the Japanese Government
(MEXT) Scholarship programs;
④ Those who are currently also applying to another program under the Japanese Government (MEXT)
scholarship system. This includes the programs for which scholarship payments will begin in FY2020,
although their final selection results have not been decided yet, and the programs for which scholarship
payments will begin in FY2021;
⑤ Those who are already enrolled in a Japanese university or other institution with a residence status of
“Student,” or who are going to be enrolled, or plan to enroll, in a Japanese university or other institution as
a privately-financed international student from the time of application to the MEXT scholarship program in
the applicant’s country until the commencement of the period for payment of the MEXT scholarship.
However, this stipulation does not apply to privately-financed international students who, even though they
are enrolled, or are planning to enroll, in a Japanese university or other institution, verifiably complete
their studies before the start of the scholarship payment period, return to their home country at the time of
the scholarship application, and newly acquire the “Student” residence status and come to Japan;

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 ⑥ Those who are planning to receive scholarship money from an organization other than MEXT (including a
government organization of the applicant’s country) on top of the scholarship money provided by MEXT
after the start of the scholarship payment period;
⑦ Those who are expected to graduate at the time of application and cannot satisfy the condition of academic
background by the deadline given;
⑧ Holders of dual nationality at the time of application who cannot verify that they will give up Japanese
nationality by the time of the arrival in Japan;
⑨ Those who change their residence status to that of other than “Student” after their arrival in Japan;
⑩ Those who plan to, from the time of application for the MEXT scholarship program, engage in long-term
research (such as fieldwork or internship) outside Japan or plan to take a long-term leave of absence from
the preparatory educational institution or the college of technology.

(9) Others: MEXT Scholarship will be granted those who are willing to contribute to mutual understanding
between Japan and their home country by participating in activities at schools and communities during their
study in Japan while contributing to the internationalization of Japan. They shall also make efforts to promote
relations between the home country and Japan by maintaining close relations with the university attended after
graduation, cooperating with the conducting of surveys and questionnaires, and cooperating with relevant
projects and events conducted by Japanese diplomatic missions after they return to their home countries.

5. PERIOD OF SCHOLARSHIP
(1) The scholarship period will last for four years from April 2021 to March 2025, including one-year preparatory
education in the Japanese language and other subjects due to be provided upon arrival in Japan. For
scholarship grantees majoring in maritime engineering, the scholarship period will be four and a half years,
lasting up to September 2025.

(2) Extension of period of scholarship: If a grantee graduates from a college of technology, is admitted for
enrollment in an advanced course at a college of technology or in a university as a third-year transfer student
and has outstanding academic achievement that meets certain criteria, he/she may have the period of his/her
scholarship extended upon successful examination by MEXT.

6. SCHOLARSHIP BENEFITS
(1) Allowance: 117,000 yen per month. A supplemental regional allowance of 2,000 yen or 3,000 yen per month
will be added to the monthly scholarship amount for the grantees studying or conducting research in specially
designated regions. Due to the situation of the Japanese Government’s budget, the amount of payment may be
subject to change each fiscal year. If a grantee is absent from the college of technology or preparatory
educational institution for an extended period, the scholarship shall be suspended for that period.

(2) Education Fees: Fees for the entrance examination, matriculation, and tuition at colleges of technology and
preparatory educational institutions will be paid by MEXT.

(3) Traveling Expenses

① Transportation to Japan: MEXT will stipulate the travel schedule and route, and provide an airline ticket to
grantees who will arrive in Japan during the specified period stated in “4. (6) Arrival in Japan”. The airline
ticket will be an economy-class ticket for the flight from the international airport closest to the grantee’s
residence (in principle, the country of nationality) to an international airport in Japan used on the normal route
to the accepting institution. The grantee shall bear at his/her own expense all costs related to domestic travel
from the grantee’s residence to the nearest international airport, airport taxes, airport usage fees, special taxes
necessary for travel, travel expenses within Japan (including airline transit costs), travel insurance expenses,
carry-on luggage or unaccompanied baggage expenses, etc. The grantee shall also bear at his/her own expense
travel and lodging costs incurred in a third country if the grantee must travel to a third country before coming

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 to Japan for visa purposes because there are no Japanese diplomatic missions in his/her country, or if there are
no direct flights from the grantee’s country of residence to Japan. MEXT will provide an economy-class airline
ticket from the grantee’s country of residence to the said third country, and from the third country to an
international airport in Japan used on the normal route to the accepting institution. In principle, the address
given in the space for “Your address before departure for Japan” on the application form shall be recognized as
the “residence,” and the airline ticket will be arranged for a flight from the international airport nearest to that
address. Except for cases when the grantee must travel to a third country to obtain a visa, MEXT will not
provide an airline ticket for cases of travel to Japan from a country other than the grantee’s country of
residence due to the grantee’s personal circumstances. If a grantee will arrive in Japan before or after the
specified period stated in “4. (6) Arrival in Japan”, travel expenses will not be paid.
② Transportation from Japan: Based on the application by the grantee, MEXT will provide an airline ticket to
grantees who shall graduate the college of technology and return to the home country by the end of the final
month of the period of scholarship (See “5. PERIOD OF SCHOLARSHIP”) designated by MEXT. MEXT
shall provide an economy-class airline ticket from the international airport in Japan used for the normal route
to and from the accepting institution to the international airport (in principle, in the country of nationality)
nearest to the returning recipient’s residence. The grantee shall bear at his/her own expense all costs related to
travel from the grantee’s residence in Japan to the nearest international airport, airport taxes, airport usage fees,
special taxes necessary for travel, travel expenses within the country of nationality (including airline transit
costs), travel insurance expenses, carry-on luggage or unaccompanied baggage expenses, etc. If a grantee
returns to the home country before the end of the period of scholarship due to personal circumstances, or
reasons stated in “7. SUSPENSION OF PAYMENT OF SCHOLARSHIP”, MEXT will not pay for the
returning travel expenses.
If a grantee continues to stay in Japan after the scholarship period has ended in cases such as proceeding to
further education or being employed in Japan, travel expenses for a temporary return will also not be paid.

7. SUSPENSION OF PAYMENT OF SCHOLARSHIP

Payment of the scholarship will be cancelled for the reasons given below. Should any of the following reasons
apply, the grantee may be ordered to return a part of, or all of, the scholarship paid up to that time. Payment of the
scholarship may also be stopped during the period up to the decision on the disposition of the matter.
① A grantee is determined to have made a false statement on his/her application;
② A grantee violates any article of his/her pledge to the Minister of Education, Culture, Sports, Science and
Technology;
③ A grantee violates any Japanese laws and is sentenced and imprisoned for an indefinite period or for a period
of exceeding 1 year;
④ A grantee is suspended from his/her college of technology or preparatory educational institution or receives
other punishment, or is removed from enrollment; as a disciplinary action in accordance with school
regulations of the accepting institution;
⑤ It has been determined that it will be impossible for a grantee to complete the course within the standard
period of study because of poor academic grades or suspension or absence from the college or preparatory
educational institution;
⑥ A grantee came to Japan without newly acquiring the “Student” residence status, or changed his/her
residence status to one other than “Student”;
⑦ A grantee has received another scholarship (excluding those specified for research expenditures);
⑧ A grantee proceeds to a more advanced level of education without receiving approval for an extension of the
period of the scholarship.

8. SELECTION
(1) The Japanese diplomatic missions will conduct the First Screening of applicants by means of examination of
submitted application documents, written academic examinations and interviews.

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 ① Subjects of Written Academic Examinations (to be undertaken by all applicants)
<Fields of Study>
(A) Mechanical Engineering (B) Electrical and Electronic Engineering
(C) Information, Communication and Network Engineering (D) Materials Engineering
(E) Architecture (F) Civil Engineering (G) Maritime Engineering (H) Other Fields

Chosen Field of Study Subjects

(D) Japanese, English, Mathematics, and Chemistry
(A), (B), (C), (E), (F), (G) Japanese, English, Mathematics, and Physics
(H) Japanese, English, Mathematics, and either Chemistry or Physics※
※ Applicants who combine (H) and (D) as his/her choice of fields of study must undertake Chemistry.
※ Applicants who combine (H) and the fields of study other than (D) as his/her choice of fields of study
must undertake Physics.
※ Applicants who choose (H) only can designate either Chemistry or Physics in his/her preference.
Please specify which subject you will undertake on your application form.

② Calculators and other devices may not be used during the written examinations.

(2) The date and time of the notification of the results of the First Screening will be specified separately by the
Japanese diplomatic mission in the applicant’s country; the reasons for the results of the screening will not be
disclosed. Those who pass the First Screening will not necessarily be selected as the MEXT Scholarship
Students.

(3) Applicants who have passed the First Screening will be recommended to MEXT. MEXT will then conduct the
Second Screening of the recommended applicants and decide the scholarship grantees. MEXT selects
candidates from each field of study.

(4) Applicants will be informed of the final selection results by the Japanese diplomatic mission in the applicant’s
country by the end of January 2021. The reasons for the results will not be disclosed. Any objections to the
decision on the university of placement will not be accepted.

9. APPLICATION DOCUMENTS
Applicants must submit the following documents to the Japanese diplomatic mission in the country of the
applicant’s nationality by the designated deadline. The submitted documents will not be returned.
1 original

1 copy

No. Documents Remarks

① Application Form ○ ○ Use the FY2021 Application Form. (See Note 4.)
Academic transcript(s) for all A transcript issued either by the school/university
② school years of last ○ ○ attended or by the applicant's national government.
school/university attended (See Note 5.)
If the applicant has not yet graduated, submit a
Certificate(s) of graduation of
③ ○ ○ certificate of prospective graduation from the
school/university attended
school/university. (See Note 6)
Recommendation letter from
Free format. A sample format is available. (See Note
④ either a class teacher or ○ ○
7.)
principal of last school attended
⑤ Medical certificate ○ ○ Use the FY2021 certificate form. (See Note 8.)
⑥ Certificate of enrollment ● ● Only for those currently enrolled in a university.
Only in case the applicant has documents attesting to
Certificate of language ●
⑦ competency in Japanese or English; submit 2 copies.
proficiency (2 copies)
No original document necessary. (See Note 9.)

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(Note 1) Documents indicated by the white circle (○) must be submitted by all the applicants. Documents
indicated by the black circle (●) should be submitted only if applicable.
(Note 2) These documents must be written in Japanese or English, or translation in either of these languages
should be attached.
(Note 3) The applicants must submit two application packets: one is a complete set of original documents and the
other is a complete set of their copies. Write the document number from ① to ⑦ (refer to the
numbers in the table above) in the upper right-hand corner of the first page for all the documents.
(Note 4) The applicant’s photograph to be attached to the Application Form should be of clear quality, taken
within six months of submission, and printed on paper specially for photographs. The photograph
should be 4.5 x 3.5 cm., upper-body, full-faced, no hats. Please write applicant’s name and nationality
on the back of the photograph. The photograph data can be pasted to the Application Form and printed
out.
(Note 5) Applicants must submit the following documents according to his/her academic background:
(a) Applicants who are attending, or have graduated from, an upper secondary school: an academic
transcript of the upper secondary school;
(b) Applicants who are attending, or have already graduated from, a university: academic
transcripts from both the upper secondary school and the university.
The academic transcripts should show the grade scale applied and the grades earned by the applicant
in all the subjects studied for each year of study at the school or the university. Those who are
currently attending an upper secondary school or a university must also submit the academic
transcript that covers the period from the year of enrollment to the term for which grades have been
determined at the time of application for the scholarship. Those who are attending an upper secondary
school or a university must also submit a transcript when he/she graduates from that school or
university by the time selection results are finalized. In the case that the last school offers a single-
structure education system consisting of a lower and upper secondary level or a primary and
secondary level, the necessary academic transcripts to be submitted shall cover all school years of
upper secondary education.
(Note 6) Applicants must submit the following documents according to his/her academic background:
(a) Applicants who are attending an upper secondary school: a certificate of prospective graduation
from the upper secondary school;
(b) Applicants who have already graduated from an upper secondary school: a certificate of
graduation from the upper secondary school;
(c) Applicants who are attending a university: a certificate of graduation from the upper secondary
school (in addition, they must submit a ⑥certificate of enrollment.);
(d) Applicants who have already graduated from a university: certificates of graduation from both
the upper secondary school and the university.
A copy of the graduation certificate is acceptable if the copy is attested by an authorized official of the
school. Do not submit the originals as the submitted documents will not be returned. Those who are
attending an upper secondary school or a university must also submit a certificate of graduation when
he/she graduates from that school or university by the time selection results are finalized.
(Note 7) A recommendation letter for those who are attending an upper secondary school or a university should
be issued by that school or university they are attending. A recommendation letter for those who
graduated from an upper secondary school or a university should be issued by that school or university.
(Note 8) An applicant who applies for “(G) Maritime Engineering” and has vision of less than 0.5 without glasses
must fill in vision of more than 0.5 with glasses on the certificate form.
(Note 9) If printing out the certificates from the Internet, print out and submit a page showing the applicant’s
name and the details of the relevant qualification (level, score, etc.).

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10. NOTES
(1) The grantees are advised to learn, before departing for Japan, the Japanese language and to acquire information
about Japanese weather, climate, customs, college education, and conditions of the college to attend in Japan,
as well as about the difference between the Japanese legal system and that of his/her home country.

(2) As the first installment of the scholarship payment will be made from one month to one and a half months after
the grantee’s arrival in Japan, the grantee is recommended to bring at least approximately US$2,000 with
him/her to Japan to cover immediate living expenses and other necessary expenses.

(3) The scholarship payments will be transferred to the bank account of Japan Post Bank (JP Bank) opened by
each grantee after the arrival in Japan. MEXT will not transfer the scholarship payments to other account.

(4) Grantees must enroll in National Health Insurance (Kokumin Kenko Hoken) upon arrival in Japan.

(5) It is suggested that grantees acquire a “My Number Card” upon arrival in Japan.

(6) Accommodations:
① In principle, each grantee will be able to live in a dormitory during the preparatory education. Expenses
relating to accommodations will be borne by the grantee.
② After entering a college of technology, a grantee will be able to live in a dormitory belonging to the college.
Expenses relating to accommodations will be borne by the grantee.

(7) Information regarding the MEXT Scholarship Students (name, gender, date of birth, nationality, accepting
college/university/graduate school/undergraduate school, field of specialty, period of enrolment, career path
after completion of scholarship, contact information [address, telephone number, e-mail address]) may be
shared with other relevant government organizations for the purpose of utilization for international students
programs implemented by the Japanese Government (support during period of study in Japan, follow-up
survey, improvement of the international student system).

Information regarding MEXT Scholarship Students (excluding date of birth and contact information) may be
included in publicity materials prepared by the Japanese Government for promoting the acceptance of
international students in Japan, particularly in order to introduce former MEXT Scholarship Students who are
playing active roles in countries around the world.

These matters are included in the Pledge stipulating rules and regulations which MEXT Scholarship Students
must comply with and submit when they have been granted the Scholarship.

(8) The English texts attached to the Application Guidelines and the Application Form are for complementary use
only. English expressions do not change the Japanese content.

(9) If there are any questions about the content of the written texts in this Application Guidelines or any other
matters, applicants/grantees should inquire the Japanese diplomatic mission in the country of the applicant’s
nationality and follow their instructions.

(10) In addition to the regulations stipulated in this Application Guidelines, those that are necessary to implement
the Japanese Government Scholarship programs shall be determined by the Japanese Government.

(11) In some circumstances such as travel restrictions or curfew, there are possibilities that the selection process
will be cancelled or applicants will not be able to come to Japan even after being selected as scholarship
students.

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 2021年度日本政府（文部科学省）奨学金留学生申請書 （高等専門学校留学生）
2021 APPLICATION FORM FOR JAPANESE GOVERNMENT (MEXT) SCHOLARSHIP
　(COLLEGE OF TECHNOLOGY STUDENTS)
記入上の注意 INSTRUCTIONS
１．タイプ、又は手書きの場合はブロック体で明瞭に記入すること｡1. Type or write neatly by hand in block letters.
２．数字は算用数字を用いること｡ 2. Use Arabic numerals (0, 1, 2, 3, 4…).
３．年号はすべて西暦とすること｡ 3. Write years in western calendar.
４．固有名詞はすべて正式な名称とし、一切省略しないこと｡ 4. Write proper nouns in full without abbreviation.
※本申請書に記載された個人情報については、本奨学金の選考のため ※Personal data filled in this application form will only be used for scholarship
に使用するほかは、特にEmail アドレス等の連絡先については、採用後に selection purposes. Contact information such as email addresses of selected
おける関係者のネットワークを作ること及び必要に応じ日本政府より各種
情報を送信する以外には使用しない。 applications might be used by the Japanese Government in order to create academic
networks or to send out relevant information when necessary.

姓 Surname 名 Given name ﾐﾄﾞﾙﾈｰﾑ Middle name

1. 氏名（ｱﾙﾌｧﾍﾞｯﾄ）
Name (in alphabet)

※パスポートの表記と同一にすること　　Write your name exactly as it appears on your passport.

2. 性別 3. 婚姻状況 □独身　Single 写真 Photo

□　男　Male　　□　女　Female
Gender Marital Status □既婚　Married （4.5cm×3.5cm）
6ヶ月以内に撮影した写真
4. 国籍
又はデジタル画像を貼る
Nationality こと。写真の裏面に名前と
5. 日本国籍 □無 □　有：離脱予定年月 年 月 国籍を書くこと。
2 0 Paste your photo or digital
Japanese Nationality NO 　　YES: expatriation date yy mm
image taken within 6 months.
6. 生年月日 年 月 日 年齢 （2021/4/1現在） 歳
Write your name and
Date of Birth yyyy mm dd Age　(As of April 1, 2021) yrs
nationality on the back of the
※応募者は1996年4月2日以降に出生した者であること。 photo.
　 Applicants must have been born on and after April 2, 1996.
7.(1) 現住所 国名
Current Address Country

※現住所が日本の場合、現在の在留資格の種類
If you currently reside in Japan, what is your current resident status?

※既に我が国の在留資格「永住者」、「定住者」等を有している場合であっても、採用後に「留学」に変更する必要がある。な
お、国費外国人留学生の身分終了後に改めて「永住者」又は「定住者」の在留資格を申請しても当然には認定されない可能
性があることを理解した上で申請すること。An applicant with "permanent resident" or "long-term resident" status must change his/her
status to "student" if selected. Be aware that application for the original status after "student" status is expired may not be necessarily approved.

□　同上　Same as above.
(2) 渡日前住所 □　下記住所に変更することが確定している　The above 'Current Address' will be changed as follows:
Your address before
departure for Japan 国名
Country

※渡日前住所が現住所から変更になることが確定している場合は、「(2)渡日前住所」の「下記住所に変更することが確定して
いる」に✔を入れ、住所を記入すること。変更がない場合は「同上」に✔を入れること。If the current address will be changed at the
time of leaving from your country, please check the box of 'The above 'Current Address ' will be changed as follows:' and specify the new
address. If the current address will not be changed, check the box of 'Same as above'.

※渡日前住所が国籍国と異なる場合は、渡日旅費が不支給となることを理解しているか。If your address □はい □いいえ

before departure for Japan is outside your home country, do you understand that an airline ticket to Japan will not be provided? YES NO
(3) 査証申請予定公館
Name of Japanese diplomatic office where you will apply for visa issuance
※下記外務省ウェブページを参照し、国籍国に所在する公館の中から公館名を１つ記載すること。不明な場合は在外公館に確認す
ること。Write a Japanese diplomatic office in the country of your nationality in reference to the following webpage of the Ministry of Foreign Affairs.
Please consult in advance with a Japanese diplomatic office if you are unsure about this item.
Embassies & Consulates: https://www.mofa.go.jp/about/emb_cons/over/index.html
(4) 電話番号
(5) Email
Phone number
※可能な限り、渡日前～日本留学中～帰国後にわたり使い続けることが予想されるEmailアドレスを記入すること。
You are suggested to write an email address that can be used continuously before, during and after your stay in Japan.

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 □学生 在籍学校名
Student Name of school
8. 現在の身分 □就労者 勤務先名
Present status Employed Name of organization
□その他
Others

9.過去に在籍した高
校又は大学での専攻
分野
Specialized field of study
in high school or
university

10.　学歴　　Academic record
INSTRUCTIONS
１．初等教育から最新の教育課程まで正規生として修学した課程 1. Write your record from primary education (elementary school) to most recent educational level attended
のみ記入すること。幼稚園・保育所教育は記入不要。 only as a full-time student. Exclude kindergarten education and nursery school education.
２. 「卒業年月」は学校の公式な卒業年月を記入すること。（例： 学 2. Write the official graduation year and month in the space of "To: yyyy/mm". (ex. In case of October intake and
校の学事暦が10月入学9月卒業の場合、最後の8～9月が休暇の September graduation under the school's academic calendar, put "9 (September)" in the space of "mm" as an
場合も「卒業月」欄は「9月」となる。） official graduation month although the term from August to September is a summer break.)

３. 最終学歴が卒業見込の者は、「卒業年月」には卒業見込年月 3. For those whose status is "Expected to graduate", write expected year and month of graduation in the
を記入すること。 space of "To: yyyy/mm".

４. 「卒業状況」を「その他」と選択した場合は、具体の状況を「特 4. If the applicant chooses "Other status" in the Status, indicate the detail of status in the Remarks
記事項欄」に記入すること。（例：退学、休学中） column. (ex. Withdrawal, leave of absence)
５．「大学予備教育」は後期中等教育に含まれる｡ 5. Preparatory education for university admission is included in upper secondary education.
６． ｢大学入学資格試験｣に合格している場合には、その旨「特記
6. If the applicant has passed the university entrance qualification, indicate this in the Remarks column.
事項」欄に記入すること｡
７．「飛び級」をしている場合には、その旨を「特記事項」欄に記入 7. Any school years or levels skipped should be indicated in the Remarks column.
すること。（例：後期中等教育－3年次を飛び級により短期卒業） Example: Upper secondary education - Skipped senior year for the early graduation.
８．住居の移転や大学の再入学等を理由に、同教育課程で複数 8. If you attended multiple schools at the same level of education due to moving house or readmission to
の学校に在籍していた場合は、同じ欄に複数の学校の在籍を記
university, write all the schools in the same column.
載すること。
９. 下記に書ききれない場合は、別紙に記入することも可能。しか 9. You may use a separate piece of paper if the space below is insufficient. In such a case, please
しその場合は、別紙に記入する旨を明記すること。 indicate that the information is on a separate page.

教育段階 学校名 所在地 入学及び卒業（見込）年月 修学年数 卒業状況 特記事項

Year & month of enrollment & Period of schooling
Educational level School name Location Status Remarks
graduation (expected to graduate) attended
州・省 State/Province
入学 年 月
初等教育 From yyyy mm
（小学校） 年
Primary Education 市・町 City/Town yrs
(Elementary School) 卒業 年 月
To yyyy mm

州・省 State/Province
前期中等教育
入学 年 月
（中学校） From yyyy mm
Lower Secondary 年
Education(Middle 市・町 City/Town yrs
School/Junior High 卒業 年 月
To yyyy mm
School)
後期中等教育 州・省 State/Province
入学 年 月
（高校） From yyyy mm
Upper Secondary 年
Education 市・町 City/Town yrs
((Senior) High 卒業 年 月
To yyyy mm
School)
州・省 State/Province
卒業
高等教育 入学 年 月 □ Graduated
（大学学部） From yyyy mm

Tertiary(Higher)
年 卒業見込
□ Expected
市・町 City/Town yrs to graduate
Education 卒業 年 月
(Undergraduate) その他
To yyyy mm □ Other status
2021年4月1日時点の通算の学校教育修学年数 年
Total years of schooling attended as of April 1, 2021 yrs
特記事項 Remarks
（上記の特記事項欄で書ききれない場合は適宜使用すること）
You may use the space if the space of the above Remarks
column is insufficient.

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11. 過去に国費外国人留学生に採用されたことがあるか。なお、過去に国費外国人留学生として採用された者
□いいえ □はい
は応募対象外である。
NO YES
Have you been awarded a Japanese Government (MEXT) Scholarship in the past? If 'YES', you are NOT eligible to apply.

※過去に受給した奨学金が文部科学省奨学金に該当するか否か不明の場合は事前に在外公館に相談すること。If you are

unsure whether previously awarded financial aid corresponds to a MEXT Scholarship or not, please consult in advance with a Japanese diplomatic office.

12. 日本政府（文部科学省）奨学金制度による他のプログラム（2020年度奨学金支給開始プログラムのうち採
否結果が未決定のプログラム及び2021年度奨学金支給開始のプログラム）に併願しているか。それらの日本
政府（文部科学省）奨学金との併願は認められない。Are you applying for any other Japanese Government (MEXT) □いいえ □はい
Scholarships (including the programs for which scholarship payments will begin in FY2020, although their final selection results have not NO YES
been decided yet, and the programs for which scholarship payments will begin in FY2021)? It is not allowed to apply for other Japanese
Government (MEXT) Scholarships at the same time.
13.(1) 本制度による奨学金と重複し、日本政府（文部科学省）以外の機関（自国政府機関を含む）から奨学金等
を受給、又は受給予定であるか。 □いいえ □はい
Are you receiving or scheduled to be receiving any scholarship from any organization other than the Japanese Government NO YES
(MEXT) (including an organization of your home country government) together with the MEXT Scholarship?
※「はい」の場合、本奨学金と他の奨学金の併給は認められないため、本制度に採用後は他の奨学金の
受給を停止しなければならないことを理解しているか。 □はい □いいえ
If 'YES', do you understand you must cancel other scholarships after selected for MEXT Scholarship Student since it is YES NO
not allowed to receive other scholarships together with the MEXT Scholarship?

(2) 他の奨学金に応募又は他の奨学金を受給している場合は、その名称、期間、金額等を記すこと｡
If you are receiving or applying for other scholarships, please specify the name of the sponsor, scholarship period, scholarship amount, etc.
奨学金の名称・期間・金額
Name of sponsor, period and
amount of the scholarship
14. 日本での希望専攻分野及び専門項目
Preferred field of study and majors elements
※必ず別紙「専攻分野に関連する主な専門項目等」から選んで記入すること。
Select from the Annex "Majors and Related Key Terms for Fields of Study".
記号 専攻分野名 番号 主な専門項目等名
Code Name of field of study No. Name of majors elements
第1希望
First choice

第2希望
Second choice

第3希望
Third choice

※上記に記入した希望専攻分野が「H.その他」のみの申請者は、「化学」又は「物理」のどちらの科目を
□化学 □物理
受験するか選択すること。Applicants who filled "H. Other Fields" only in the above first to third choices must
Chemistry Physics
choose a subject "Chemistry" or "Physics" for written academic examinations.

15. 希望理由　Reasons for selection of field of study and majors elements

※14.で記入した専門項目について、希望する理由を具体的に記入すること。
Specify the reasons why you selected each "field of study" and "majors elements" in section 14.

第1希望
First choice

第2希望
Second choice

第3希望
Third choice

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16. 日本に関心をもったきっか
けは何か。
What was the trigger for having an
interest in Japan?

17. 日本留学の経験を通じて日
本と母国のためにどのような貢
献ができると考えているか。
What kinds of things do you think you can
contribute to Japan and your home country
through your experience of studying in
Japan?

18. 語学力
読む能力 Reading 書く能力 Writing 話す能力 Speaking 聴く能力 Listening
Language ability
日本語　Japanese

英語　English
その他
( )
Others
※３から０で自己評価すること
３＝優 Excellent ２＝良 Good １＝可 Fair ０＝不可 Poor
Self-rate on a scale of 3 to 0.
（例）日本留学試験(日本語) ○○○/450点
(Ex.) EJU Japanese Score: ○○○/450
19. 日本語能力（資格） 日本語能力試験 ﾚﾍﾞﾙ その他
Japanese language qualifications JLPT level Other

iBT
20. 英語能力（資格） その他
TOEFL IELTS
English language qualifications Other type Other
( )

21. 緊急の際の母国の連絡先　　Contact person in your home country in case of emergency.

氏名 続柄
Name Relationship
現住所 職業
Current address Occupation
電話番号／FAX番号
Email
Phone / Facsimile number

22. 日本への渡航及び滞在歴　　Past visits or stays in Japan List from your most recent visits.

期間　Period 渡航目的　Purpose

From 年 月 To 年 月
yyyy mm
～ yyyy mm

From 年 月 ～ To 年 月
yyyy mm yyyy mm

私は2021年度日本政府（文部科学省）奨学金留学生募集要項に記載されている事項をすべて了解
し、上記の通り申請資格を満たしていることを確認の上、申請します。
I understand and accept all the conditions stated in the Application Guidelines for Japanese Government (MEXT)
Scholarship for FY2021, and upon confirmation of my qualifications for application as stated above, I hereby apply
for this scholarship.

申請者署名 申請年月日 20 　年 　月 　日
/ /
Applicant's signature Date of application year month day

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 ＜別紙／Annex＞
専攻分野に関連する主な専門項目等 (Majors and Related Key Terms for Fields of Study)
専攻分野(Fields of Study) 主な専門項目等(Majors Elements)
記号 専攻分野名 番号 主な専門項目等名 キーワード（Key Words）
(Code) (Name of Fields of Study) (No.) (Name of Majors Elements)

1 機械要素・材料加工(Machine Elements and Material Processing) 機械材料・材料力学(Engineering Materials and Strength of Materials)
生産工学・加工学(Production Engineering and Manufacturing Technology)
2 材料科学・力学(Materials Science and Mechanics)
設計工学・機械要素(Design Engineering and Mechanical Elements)
3 流体・熱工学(Fluid and Thermal Engineering) 流体工学(Fluid Engineering)
機械 熱工学(Thermal Engineering)
A (Mechanical Engineering) 4 機械システム設計・制御(Mechanical System Design and Control)
エネルギー工学(Energy Engineering)
5 ＣＡＤ/ＣＡＭ(Computer Aided Design/Computer Aided Manufacturing) 計測工学(Measurement Engineering)
制御工学(Control Engineering)
6 メカトロニクス(Mechatronics)
CAD/CAM/CAE(Computer Aided Design/Computer Aided Manufacturing/Computer Aided Engineering)
7 ロボット工学(Robotics) メカトロニクス・ロボット工学(Mechatronics and Robotics)

1 アナログ回路(Analog Circuits) アナログ回路(Analogy Circuit) 電子制御・計測(Electronic Control and Measurement)

2 電力システム(Electric Power System) 通信・ネットワーク(Communication and Networks) 電子デバイス(Electronic Device)
導電体材料(Conducting Material) 電子材料(Electronic Material)
3 パワーエレクトロニクス(Power Electronics) コンバータ・インバータシステム(Converter/Inverter System) エネルギー変換工学(Energy Conversion)
電気・電子 4 ディジタル回路(Digital Circuits) 絶縁体・誘電体材料(Dielectrics and Electrical Insulation) 高電圧(High Voltage)
B (Electrical and Electronic ディジタル回路(Digital Circuit) 集積回路(Integrated Circuit)
Engineering) 5 集積回路(Integrated Circuits) 電力エネルギーシステム(Electric Power and Energy System) 磁性体材料(Magnetic Material)
6 電気・電子材料(Electric/Electronic Materials) 電力用機器(Electric Power Apparatus) パワーエレクトロニクス(Power Electronics)
電気回路(Electrical Circuit) ロボティクス(Robotics)
7 電気・電子機器(Electric/Electronic Device) 電磁気学(Electromagnetic Theory) 回転機(Rotating Machinery)
8 電気・電子制御(Electric/Electronic Control) 電子回路(Electronic Circuit) 半導体(Semiconductor)

1 信号・画像処理(Signal/Image Processing)

2 有線通信 (Cable Communication)

3 無線通信(Wireless communication)
コンピュータプログラミング(Computer Programming)
4 情報通信(Communication Engineering) マルチメディア(Multimedia)
5 衛星通信(Satellite Communication) 情報セキュリティ(Information Security)
コンピュータシステム(Computer System)
情報・通信・ネットワーク 6 マイクロ波(Microwaves) データベース(Database)
C (Information, Communication
Webシステム(Web System)
and Network Engineering) 7 ソフトウエア工学(Computer Software)
携帯電話(Mobile Phone)
8 コンピュータグラフィクス(Computer Graphics) インターネット(Internet)
9 オペレーティングシステム(Operating System) 放送局(Broadcasting Station)

10 周辺機器とインターフェース技術(Peripherals and Interface Technology)

11 コンピューターネットワーク(Computer Network)

12 通信制御(Communication Control)

1 金属工学(Metallurgical Engineering)
化学的合成(Chemical Synthesis) 有機合成化学・有機材料(Synthetic Organic
2 無機材料工学(Inorganic Materials Engineering) 高分子(Polymer) Chemistry, Organic Materials)
3 有機材料工学(Organic Materials Engineering) 金属(Metal) 高分子合成・物性・機能性高分子(Polymer
生物化学(Biological Chemistry) Synthesis, Polymer Property, and Functional Polymers)
物質・材料 4 高分子化学(Polymer Chemistry) 生物工学(Biological Engineering) 単位操作とプロセスエンジニアリング(Unit
D (Materials Engineering) 化学分析(Chemical Analysis) Operations and Process Engineering)
5 化学工学(Chemical Engineering)
核酸・タンパク質・糖鎖・脂質(Nucleic Acids,
環境のための材料(Materials for Environment)
6 生物化学(Biological Chemistry) 金属材料(Metallic Materials) Proteins, Sugar, Lipid)
結晶・ガラス・セラミックス(Crystal, Glass, Ceramics) バイオテクノロジー(Biotechnology)
7 生物工学(Biological Engineering)
グリーン・環境化学(Green Sustainable Chemistry)
8 環境工学(Environmental Engineering in Materials Science and Engineering)

1 建築設計(Architectural Design and Drawing)

2 建築構造(Structural Engineering in Architecture/Building Structures) 建築設計製図(Architectural Design and Drawing) 光環境設計(Lighting Design)
3 建築材料・施工(Building Materials and Execution Works) 建築意匠(Architectural Design) 空気調和(Design for Heating and Cooling)
建築史(History of Architecture) 建築音響(Architectural Acoustic)
建築 4 建築史(Architectural History and Design) 住宅論(Housing) 建築設備(Building Equipment)
E (Architecture) 構造(Timber Structures)
5 建築計画(Architectural Planning) 各種建物・地域施設(Various Types of Buildings and Community
Centers) 鉄筋コンクリート構造(Reinforced Concrete
6 建築構造力学(Structural Mechanics in Architecture) インテリア(Interior) Structures)
室内環境(Indoor Environment Quality)
7 建築環境工学（Architectural Environmental Engineering）

8 都市計画(City Planning)

1 構造力学(Structural Engineering in Infrastructures)

2 地盤工学(Geotechnical Engineering)
構造力学(Structural Engineering in Infrastructures) 廃棄物管理(Municipal Waste Management)
3 土木材料(Materials in Civil Engineering and Infrastructure Constructions) 地下構造／トンネル(Underground Structure/Tunnel) 持続可能都市(Sustainable City)
4 水理学(Hydraulic Engineering) 土木材料(Materials for Infrastructure Construction) 都市・地域計画(City and Regional Planning)
土木
F (Civil Engineering)
鉄筋コンクリート橋(Reinforced Concrete Bridges) 交通工学(Traffic Engineering)
5 環境工学(Environmental Engineering/Reduction of Environmental Burden) 水理学／流体力学(Hydraulics/Fluid Mechanics) 防災工学(Disaster Prevention Engineering)
6 都市・交通計画(City Planning/Traffic Engineering) 水文学／河川工学(Hydrology/River Engineering) 土木施工法(Construction Management)
排水処理(Wastewater Treatment)
7 防災工学(Disaster Prevention Engineering)

8 土木施工法(Constructions Management)

1 航法(Navigation)

2 測位(Position Fixing)

3 操船学・運用学(Ship Maneuvering and Seamanship)

4 海洋・気象学(Oceanography and Meteorology)

商船
G (Maritime Engineering) 5 海法(Maritime Laws)

6 造船学(Naval Architecture)

7 ディーゼル機関(Marine Diesel Engine)

8 船舶補機(Marine Auxiliary Machinery)

9 船舶材料(Marine Material)

1 国際コミュニケーション(International Communication) 経営学(Business Administration)

その他
H (Other Fields)
経済学(Economics)
2 経営情報工学(Management Information Engineering) 情報分析(Information Analysis)
 JAPANESE GOVERNMENT (MEXT) SCHOＬARSHIP RECOMMENDATION FORM

Applicant's Name (Please print):

,
(Surname) (Given name) (Middle name)

To the Applicant : Please fill in your full name above. Give this form and an envelope marked “confidential" and addressed to yourself to the person you
have asked to recommend you. Ask this person to place the completed form in the envelope, seal the envelope, sign across the seal, and send it back to
you. Submit the unopened envelope with your application to the Japanese Embassy/Consulate General.

To the Recommender : Please respond to the following questions. Please type or print. After completing this form, place it in the envelope provided, seal
the envelope, sign across the seal, and return it to the applicant. This recommendation is a required part of the application process and to be used for
admissions purposes only; prompt return to the candidate is important. MEXT appreciates your assistance and would like to assure you that your comments
will be carefully considered.

Recommender's name :

Title and Institution :

Address (either work or home) :

Telephone: ／ Email :

１．During which period of time have you had the most frequent contact with the applicant? From to .

２．What was the nature of your relationship?

３．In what areas does the applicant need improvement or growth?

４．Please comment on the applicant's interpersonal skills. How well does he or she work within a team?

５．How would you describe the applicant's leadership skills?

６．Please comment on the applicant's degree of self-confidence.

７．Please comment on the applicant's personal character.

８．Please indicate your overall evaluation of the applicant for a Japanese Government (MEXT) Scholarship.
（ ）Strongly recommend （ ）Recommend （ ）Recommend with reservation

９．Please write whatever additional comments you would like to make about the applicant's potential for graduate study in Japan and potential for becoming
a responsible, effective person for your country. Additional pages may be attached, and the back page of this form can also be used.

Signature Date

Note: Any other formats of recommendation letter will be accepted.

 健康診断書（2021年度版） CERTIFICATE OF HEALTH (for 2021)
（医師に記入してもらうこと） (to be completed by the examining physician)
日本語又は英語により明瞭に記載すること。 Please fill out (PRINT/TYPE) in Japanese or English.

氏名
Name Surname 姓 Given name    名 Middle name  ミドルネーム
性別 □ 男 Male 生年月日     年     月     日
Gender □ 女 Female Date of Birth yyyy mm dd

１．身体検査
Physical examination
(1)身長 (2)体重
cm kg
Height Weight
(3)血圧 (4)血液型
mmHg∼       mmHg □A □B □AB □O □RH＋□RH−
 Blood pressure Blood type
(5)脈拍 □ 整 Regular (7)色覚異常の有無 □ 正常 Normal
 Pulse □ 不整 Irregular  Color blindness □ 異常 Impaired
裸眼        (右)        (左) (8)聴力 □ 正常 Normal
Without glasses   (R)        (L)  Hearing □ 異常 Impaired
(6) 視力 Eyesight
矯正         (右)    (左) (9)言語 □ 正常 Normal
With glasses or contact lenses (R) (L)  Speech □ 異常 Impaired
２．胸部聴診及びＸ線検査 （６ヶ月以内）
Physical and X-ray examinations of the chest (within six months)
胸部X線所見 撮影年月日     年     月     日
Describe the condition of lungs. Date of X-ray yyyy mm dd
フィルム番号
Film No.
(1)肺 □ 正常 Normal
 Lungs □ 異常 Impaired
(2)心臓 □ 正常 Normal
 Cardiomegaly □ 異常 Impaired
異常がある場合⇒心電図 □ 正常 Normal
If impaired⇒Electrocardiograph □ 異常 Impaired
３．現在治療中の病気
□ 無 No □ 有 Yes ： 病名 Disease
  Disease currently being treated
完治時期/治療中 完治時期/治療中
４．既往症
✔ 病名Name Date of recovery ✔ 病名Name Date of recovery
  Past illness/disorder /under treatment /under treatment
該当するものにチェックと完治時期 結核 マラリア
/治療中を記入、いずれも該当し Tuberculosis Malaria
ない場合は「無し」にチェックするこ その他感染症 てんかん
と。 Other communicable disease Epilepsy
Please check and fill in the date of 腎疾患 心疾患
recovery/under treatment. Kidney disease Heart disease
If NOT contracted any of them in the 糖尿病 薬剤アレルギー
past, please check “None”. Diabetes Drug allergy
無し 精神疾患 四肢機能障害
✔ Functional disorder in the
None Psychosis extremities
５．検 査
Laboratory tests
(1) 尿検査 糖 蛋白 潜血
  Urinalysis: glucose protein occult blood
(2) 貧血検査 赤沈 白血球数 血色素量 貧血
mm/Hr /cmm gm/dl
Anemia test ESR WBC count Hemoglobin Anemia
(3)肝機能検査 GPT GOT
（IU/ｌ） （IU/ｌ） γ-GTP （IU/ｌ）
  LFT （ALT) （AST)
６．医師の診断・意見
Physician's impression of the applicant’s health
 継続的治療・投薬の必要性があればその旨ご記入下さい。
Please fill in if the applicant needs regular medication or treatment.

７. In view of the applicant's history and the above findings, is 日付

it your observation that his/her health status is adequate to Date
pursue studies in Japan? 志願者の既往歴、診察・検査の結果から判断して、現 医師署名
在の健康の状況は充分に留学に耐えうるものと思われますか？ Physician's Signature

検査施設名
□ YES （はい） □ NO （いいえ） Office/Institution

※Please be sure to check either "YES" or "NO". If you do not 所在地

check "YES", the Embassy will NOT accept the application. Address
  必ず「はい」又は「いいえ」にチェックしてください。「はい」にチェックがない場合、 大使館
は申請を受理しません。
 APPLICATION GUIDELINES
JAPANESE GOVERNMENT (MEXT) SCHOLARSHIP FOR 2021
(SPECIALIZED TRAINING COLLEGE STUDENTS)

The Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan offers scholarships to
international students who wish to study at Japanese specialized training colleges as Specialized Training College
Students under the Japanese Government (MEXT) Scholarship Program as follows.

1. DEFINITION OF “SPECIALIZED TRAINING COLLEGE STUDENTS”

Those who are enrolled in a postsecondary course at a specialized training college, or who are receiving
preparatory education in the Japanese language and other subjects prior to placement at the specialized training
college.

2. FIELDS OF STUDY
Those who apply for a specialized training college student must choose a field of study in accordance with the
following procedure and fill in “Preferred field of study and subjects in Japan” on the application form.

(1) Choose a preferred field of study from among (A) to (F) below.

(A) Technology (B) Personal Care and Nutrition (C) Education and Welfare
(D) Business (E) Fashion and Home Economics (F) Culture and General Education

(2) Choose preferred subject(s) from the “Name of Subjects” listed in the chosen field of study on the Annex
“Majors and Related Subjects for Fields of Study”. Applicants may enter a first and second choice of subjects
from the same field of study.

(Note 1) Applicants who choose “Other Subjects” in the field of (A) to (F) are required to specify what kind of
subjects they want to study in “Preferred Field of Study and Subjects in Japan” and “Reasons for
Selection of Field of Study and Subjects” on the application form. If there are no accepting colleges for
the subjects which are not specified as “Name of Subjects” and “Main Learning Contents” in the Annex
“Majors and Related Subjects for Fields of Study”, his/her applications will be rejected and the
applicants must withdraw from the scholarship selection. (Examples of subjects: medicine, biology,
psychology, aircraft piloting, etc.)

3. PREPARATORY EDUCATION AND STUDY AT SPECIALIZED TRAINING COLLEGE

(1) Preparatory Education
① Each grantee will be enrolled at a preparatory educational institution designated by MEXT for the first year
of the scholarship period. The preparatory course is a one-year intensive course in the Japanese language,
Japanese affairs, and other subjects necessary for preparation for proceeding to a specialized training
college.
② A grantee who has completed the preparatory course will go on to a specialized training college designated
by MEXT. If a grantee is determined to be incapable of completing the preparatory course, his/her
scholarship will be cancelled and he/she will be required to return to his/her home country.

(2) Specialized Training College

① The specialized training college which the grantee who has completed the preparatory course enrolls will be
decided by MEXT upon consultation with the college concerned. No objection by the grantee against the
decision will be allowed.

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 ② A grantee of this scholarship will be enrolled into a postsecondary course of a specialized training college
requiring graduation from an upper secondary school for entrance and receive professional education for
two years prior to graduation. A grantee who graduates will be awarded a diploma.
③ All classes will be given in the Japanese language.

(3) Change of Field of Study and Transfer to Another Institution

① A grantee will not be permitted to change his/her field of study during the study at preparatory educational
institution and specialized training college.
② A grantee will not be permitted to transfer to another educational institution during the period of the
preparatory education course and the course at the specialized training college.

4. QUALIFICATIONS AND CONDITIONS

MEXT accepts applications from international students for study in Japan who satisfy the following qualifications
and conditions. Its aim is to foster human resources who will become bridges of friendship between the grantee’s
country and Japan through study in Japan and who will contribute to the development of both countries and the
wider world.

(1) Nationality: Applicants must have the nationality of a country that has diplomatic relations with Japan. An
applicant who has Japanese nationality at the time of application is not eligible. However, persons with dual
nationality who hold Japanese nationality and whose place of residence at the time of application is outside of
Japan are eligible to apply as long as they choose the nationality of the other country and renounce their
Japanese nationality by the date of their arrival in Japan. The First Screening must be conducted at the
Japanese Embassy or Consulate (hereinafter referred to “Japanese diplomatic mission”) in the country of
which the applicant chooses the nationality.

(2) Age: Applicants, in principle, must be born between on or after April 2, 1996. However, applicants who satisfy
the following ③ condition of Academic Background must be 18 years of age or older at the time of
admission to a university in Japan.
Exceptions are limited to cases in which MEXT deems that the applicant could not apply within the eligible
age limit due to the situation or circumstances of the applicant’s country (military service obligation, loss of
educational opportunities due to disturbances of war, etc.) Personal circumstances (financial situation, family
circumstances, state of health, circumstances related to applicant’s university or place of employment, etc.)
will not be considered for exceptions.

(3) Academic Background: Applicants must satisfy any one of the following conditions.
① Applicants who have completed 12 years of schooling in countries other than Japan. (Applicants who will
meet the above condition by March 2021 are eligible.)
② Applicants who have completed studies at a school equivalent to a Japanese upper secondary school in
countries other than Japan. (Applicants who will meet the above condition by March 2021 are eligible.)
③ Applicants who have successfully passed an academic qualification examination that is equivalent to the
completion of 12 years of schooling in countries other than Japan. (Applicants who will meet the above
condition by March 2021 are eligible.)
④ Other than the above ① , ② and ③ conditions, applicants who are eligible for enrollment in a
postsecondary course at a specialized training college at the time of application.

(4) Japanese Language: Applicants must be willing to learn Japanese. Applicants must be interested in Japan and
be willing to deepen their understanding of Japan before and after arriving in Japan. In addition, in principle,
applicants must be willing to receive specialized training college education in Japanese.

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(5) Health: Applicants must submit a health certificate in the prescribed format signed by a physician attesting
that the applicant has no physical or mental conditions hindering the applicant’s study in Japan.

(6) Arrival in Japan: In principle, applicants must be able to arrive in Japan between April 1, 2021, and April 7,
2021. Departure from the home residence should be on or after April 1, 2021.
Excluding cases in which MEXT deems as unavoidable circumstances, the applicant must withdraw from this
scholarship program if the applicant cannot arrive in Japan by the end of the specified period above which
decided by MEXT or the accepting preparatory educational institution.

(7) Visa Requirement: An applicant shall, in principle, newly obtain a “Student” visa at the Japanese diplomatic
mission located in the applicant’s country of nationality, and enter Japan with the residence status of “Student.”
Accordingly, even if the applicant already has other residence status (“Permanent resident,” “Long-term
resident,” etc.), the applicant must change it to the “Student” status and re-enter Japan. Moreover, the
applicant should be aware that after expiration of the status as a MEXT Scholarship student and even if the
student again applies for their original resident status of “Permanent resident” or “Long-term resident,” such
resident statuses might not be necessarily granted. The applicant should also be aware that the scholarship will
be cancelled if he/she arrived in Japan without a newly obtained “Student” visa.

(8) Non-Eligibility: Those who meets any one of the following conditions are ineligible. If identified ineligible
after being selected as a scholarship student, he /she must withdraw from the scholarship.
① Those who are military personnel or military civilian employees at the time of their arrival in Japan or
during the period of the payment of the scholarship;
② Those who cannot arrive in Japan by the last date of the period specified by MEXT or the accepting
institution;
③ Those who are previous grantees of Japanese Government (MEXT) Scholarship programs (including those
who withdraw from the scholarship program after the arrival in Japan). The Monbukagakusho Honors
Scholarship for Privately-Financed International Students is not included in the Japanese Government
(MEXT) Scholarship programs;
④ Those who are currently also applying to another program under the Japanese Government (MEXT)
Scholarship system. This includes the programs for which scholarship payments will begin in FY2020,
although their final selection results have not been decided yet, and the programs for which scholarship
payments will begin in FY2021;
⑤ Those who are already enrolled in a Japanese university or other institution with a residence status of
“Student,” or who are going to be enrolled, or plan to enroll, in a Japanese university or other institution
as a privately-financed international student from the time of application to the MEXT scholarship
program in the applicant’s country until the commencement of the period for payment of the MEXT
scholarship. However, this stipulation does not apply to privately-financed international students who,
even though they are enrolled, or are planning to enroll, in a Japanese university or other institution,
verifiably complete their studies before the start of the scholarship payment period, return to their home
country at the time of the scholarship application, and newly acquire the “Student” residence status and
come to Japan;
⑥ Those who are planning to receive scholarship money from an organization other than MEXT (including a
government organization of the applicant’s country) on top of the scholarship money provided by MEXT
after the start of the scholarship payment period;
⑦ Those who are expected to graduate at the time of application and cannot satisfy the condition of academic
background by the deadline given;
⑧ Holders of dual nationality at the time of application who cannot verify that they will give up Japanese

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 nationality by the time of the arrival in Japan;
⑨ Those who change their residence status to that of other than “Student” after their arrival in Japan;
⑩ Those who plan to, from the time of application for the MEXT scholarship program, engage in long-term
research (such as fieldwork or internship) outside Japan or plan to take a long-term leave of absence from
the preparatory educational institution or the specialize training college.

(9) Others: MEXT Scholarship will be granted those who are willing to contribute to mutual understanding
between Japan and their home country by participating in activities at schools and communities during their
study in Japan while contributing to the internationalization of Japan. They shall also make efforts to promote
relations between the home country and Japan by maintaining close relations with the university attended after
graduation, cooperating with the conducting of surveys and questionnaires and cooperating with relevant
projects and events conducted by the Japanese diplomatic mission after they return to their home countries.

5. PERIOD OF SCHOLARSHIP
(1) The scholarship period will last for three years from April 2021 to March 2024, including one-year
preparatory education in the Japanese language and other subjects due to be provided upon arrival in Japan.

(2) Extension of period of scholarship: If grantee graduates from a specialized training college, is admitted for
enrollment in a Japanese university as a third-year transfer student and has outstanding academic achievement
that meets certain criteria, he/she may have the period of his/her scholarship extended upon successful
examination by MEXT.

6. SCHOLARSHIP BENEFITS
(1) Allowance: 117,000 yen per month. A supplemental regional allowance of 2,000 yen or 3,000 yen per month
will be added to the monthly scholarship amount for the grantees studying or conducting research in specially
designated regions. Due to the situation of the Japanese Government’s budget, the amount of payment may be
subject to change each fiscal year. If a grantee is absent from the specialized training college or preparatory
educational institution for an extended period, the scholarship shall be suspended for that period.

(2) Education Fees: Fees for the entrance examination, matriculation, and tuition at specialized training colleges
and preparatory educational institutions will be paid by MEXT.

(3) Traveling Expenses:

① Transportation to Japan: MEXT will stipulate the travel schedule and route, and provides an airline ticket to
grantees who will arrive in Japan during the specified period stated in “4. (6) Arrival in Japan”. The airline
ticket will be an economy-class ticket for the flight from the international airport closest to the grantee’s
residence (in principle, the country of nationality) to an international airport in Japan used on the normal route
to the accepting institution. The grantee shall bear at his/her own expense all costs related to domestic travel
from the grantee’s residence to the nearest international airport, airport taxes, airport usage fees, special taxes
necessary for travel, travel expenses within Japan (including airline transit costs), travel insurance expenses,
carry-on luggage or unaccompanied baggage expenses, etc. The grantee shall also bear at his/her own expense
travel and lodging costs incurred in a third country if the grantee must travel to a third country before coming
to Japan for visa purposes because there are no Japanese diplomatic missions in his/her country, or if there are
no direct flights from the grantee’s country of residence to Japan. MEXT will provide an economy-class airline
ticket from the grantee’s country of residence to the said third country, and from the third country to an
international airport in Japan used on the normal route to the accepting institution. In principle, the address
given in the space for “Your address before departure for Japan” on the application form shall be recognized as
the “residence,” and the airline ticket will be arranged for a flight from the international airport nearest to that
address. Except for cases when the grantee must travel to a third country to obtain a visa, MEXT will not

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 provide an airline ticket for cases of travel to Japan from a country other than the grantee’s country of
residence due to the grantee’s personal circumstances. If a grantee will arrive in Japan before or after the
specified period stated in “4. (6) Arrival in Japan”, travel expenses will not be paid.
② Transportation from Japan: Based on the application by the grantee, MEXT will provide an airline ticket to
grantees who shall graduate the specialized training college and return to the home country by the end of the
final month of the period of scholarship (See “5. PERIOD OF SCHOLARSHIP”). MEXT shall provide an
economy-class airline ticket from the international airport in Japan used for the normal route to and from the
accepting institution to the international airport (in principle, in the country of nationality) nearest to the
returning recipient’s residence. The grantee shall bear at his/her own expense all costs related to travel from
the grantee’s residence in Japan to the nearest international airport, airport taxes, airport usage fees, special
taxes necessary for travel, travel expenses within the country of nationality (including airline transit costs),
travel insurance expenses, carry-on luggage or unaccompanied baggage expenses, etc. If a grantee returns to
the home country before the end of scholarship payment period due to personal circumstances, or reasons
stated in “7. SUSPENSION OF PAYMENT OF SCHOLARSHIP” below, MEXT will not pay for the returning
travel expenses.
If a grantee continues to stay in Japan after the scholarship period has ended in cases such as proceeding to
further education or being employed in Japan, travel expenses for a temporary return will also not be paid.

7. SUSPENSION OF PAYMENT OF SCHOLARSHIP

Payment of the scholarship will be cancelled for the reasons given below. Should any of the following reasons
apply, the grantee may be ordered to return a part of, or all of, the scholarship paid made up to that time. Payment
of the scholarship may also be stopped during the period up to the decision on the disposition of the matter.
① A grantee is determined to have made a false statement on his/her application;
② A grantee violates any article of his/her pledge to the Minister of Education, Culture, Sports, Science and
Technology;
③ A grantee violates any Japanese laws and is sentenced and imprisoned for an indefinite period or for a period
of exceeding 1 year;
④ A grantee is suspended from his/her specialized training college or preparatory educational institution or
receives other punishment, or is removed from enrollment; as a disciplinary action in accordance with school
regulations of the accepting institution;
⑤ It has been determined that it will be impossible for a grantee to complete the course within the standard
period of study because of poor academic grades or suspension or absence from the specialized training
college or preparatory educational institution;
⑥ A grantee came to Japan without newly acquiring the “Student” residence status, or changed his/her
residence status has changed to one other than “Student”;
⑦ A grantee has received another scholarship (excluding those specified for research expenditures);
⑧ A grantee proceeds to a more advanced level of education without receiving approval for an extension of the
period of the scholarship.

8. SELECTION
(1) The Japanese diplomatic missions will conduct the First Screening of applicants by means of examination of
submitted application documents, written academic examinations and interviews.
① Subjects of Written Academic Examinations (to be undertaken by all applicants): Japanese, English, and
Mathematics.
② Calculators and other devices may not be used during the written examinations.

(2) The date and time of the notification of the results of the First Screening will be specified separately by the
Japanese diplomatic mission in the applicant’s country; the reasons for the results of the screening will not be

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 disclosed. Those who pass the First Screening will not necessarily be selected as the MEXT Scholarship
Students.

(3) Applicants who have passed the First Screening will be recommended to MEXT. MEXT will then conduct the
Second Screening of the recommended applicants and decide the scholarship grantees. MEXT selects
candidates from each field of study.

(4) Applicants will be informed of the final selection results by the Japanese diplomatic mission in the applicant’s
country by the end of January 2021. The reasons for the results will not be disclosed. Any objections to the
decision on the university of placement will not be accepted.

9. APPLICATION DOCUMENTS
Applicants must submit the following documents to the Japanese diplomatic mission in the country of the
applicant’s nationality by the designated deadline. The submitted documents will not be returned.
1 Original

1 Copy
No. Documents Remarks

① Application Form ○ ○ Use the FY2021 Application Form. (See Note 4.)
Academic transcript(s) for all A transcript issued either by the school/university
② school years of last ○ ○ attended or by the applicant's national
school/university attended government. (See Note 5.)
If the applicant has not yet graduated, submit a
Certificate(s) of graduation of
③ ○ ○ certificate of prospective graduation from the
school/university attended
school/university. (See Note 6.)
Recommendation letter from either
④ a class teacher or principal of last ○ ○ Free format. A sample is available. (See Note 7.)
school attended
⑤ Medical certificate ○ ○ Use the FY2021 certificate form.
⑥ Certificate of enrollment ● ● Only for those currently enrolled in a university.
Certificate of university enrollment Only for those who pass the university enrollment
⑦ ● ●
qualification examination qualification examination. (See Note 6 and 8.)
Only in case applicant has documents attesting to
● competency in Japanese or English; submit 2
⑧ Certificate of language proficiency
(2 copies) copies. No original document necessary. (See Note
9.)

(Note 1) Documents indicated by the white circle (○) must be submitted by all the applicants. Documents
indicated by the black circle (●) should be submitted only if applicable.
(Note 2) These documents must be written in Japanese or English, or translation in either of these languages
should be attached.
(Note 3) The applicants must submit two application packets: one is a complete set of original documents and the
other is a complete set of their copies. Write the document number from ① to ⑧ (refer to the
numbers in the table above) in the upper right-hand corner of the first page for all the documents.
(Note 4) The applicant’s photograph to be attached to the Application Form should be of clear quality, taken
within six months of submission, and printed on paper specially for photographs. The photograph
should be 4.5 x 3.5 cm., upper-body, full-faced, no hats. Please write applicant’s name and nationality
on the back of the photograph. The photograph data can be pasted to the Application Form and printed
out.
(Note 5) Applicants must submit the following documents according to his/her academic background:
(a) Applicants who are attending, or have graduated from, an upper secondary school: an academic

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 transcript of the upper secondary school
(b) Applicants who are attending, or have already graduated from, a university: academic
transcripts of both the upper secondary school and the university.
The academic transcripts should show the grade scale applied and the grades earned by the applicant
in all the subjects studied for each year of study at the school or the university. Those who are
currently attending an upper secondary school or a university must also submit the academic
transcript that covers the period from the year of enrollment to the term for which grades have been
determined at the time of application for the scholarship. Those who are attending an upper secondary
school or a university must also submit a transcript when he/she graduates from that school or
university by the time selection results are finalized. In the case that the last school offers a single-
structure education system consisting of a lower and upper secondary level or a primary and
secondary level, the necessary academic transcripts to be submitted shall cover all school years of
upper secondary education.
(Note 6) Applicants must submit the following documents according to his/her academic background:
(a) Applicants who are attending an upper secondary school: a certificate of prospective graduation
from the upper secondary school;
(b) Applicants who have already graduated from an upper secondary school: a certificate of
graduation from the upper secondary school;
(c) Applicants who are attending a university: a certificate of graduation from the upper secondary
school (in addition, they must submit a ⑥certificate of enrollment.);
(d) Applicants who have already graduated from a university: certificates of graduation from both the
upper secondary school and the university.
A copy of the graduation certificate and the certificate of university enrollment qualification
examination is acceptable if the copy is attested by an authorized official of the university or an
examination authority. Do not submit the originals as the submitted documents will not be returned.
Those who are attending an upper secondary school or a university must also submit a certificate of
graduation when he/she graduates from that school or university by the time selection results are
finalized.
(Note 7) A recommendation letter for those who are attending an upper secondary school or a university should
be issued by that school or university they are attending. A recommendation letter for those who
graduated from an upper secondary school or a university should be issued by that school or university.
(Note 8) For applicants with “⑦Certificate of university enrollment qualification examination”, this document
may be submitted in place of documents No. ②, ③ and ④.
(Note 9) If printing out the certificates from the Internet, print out and submit a page showing the applicant’s
name and the details of the relevant qualification (level, score, etc.).

10. NOTES
(1) The grantees are advised to learn, before departing for Japan, the Japanese language and to acquire information
about Japanese weather, climate, customs, college education, and conditions of the university to attend in
Japan, as well as about the difference between the Japanese legal system and that of his/her home country.

(2) As the first installment of the scholarship payment will be made from one month to one and a half months after
the grantee’s arrival in Japan, the grantee is recommended to bring at least approximately US$2,000 with
him/her to Japan to cover immediate living expenses and other necessary expenses.

(3) The scholarship payments will be transferred to the bank account of Japan Post Bank (JP Bank) opened by
each grantee after the arrival in Japan. MEXT will not transfer the scholarship payments to other account.

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(4) Grantees must enroll in National Health Insurance (Kokumin Kenko Hoken) upon arrival in Japan.

(5) It is suggested that grantees acquire a “My Number Card” upon arrival in Japan.

(6) Accommodations:
① In principle, each grantee will be able to live in a dormitory during the preparatory education. Expenses
relating to accommodations will be borne by the grantee.
② After entering a specialized training college, a grantee will be able to continue to live in the
aforementioned dormitory or other residential accommodations introduced by the college. Expenses
relating to accommodations will be borne by the grantee.

(7) Information regarding the MEXT Scholarship Students (name, gender, date of birth, nationality, accepting
college/university/graduate school/undergraduate school, field of specialty, period of enrolment, career path
after completion of scholarship, contact information [address, telephone number, e-mail address]) may be
shared with other relevant government organizations for the purpose of utilization for overseas students
programs implemented by the Japanese Government (support during period of study in Japan, follow-up
survey, improvement of the overseas student system).

Information regarding MEXT Scholarship Students (excluding date of birth and contact information) may be
included in publicity materials prepared by the Japanese Government for promoting the acceptance of
overseas students in Japan, particularly in order to introduce former MEXT Scholarship Students who are
playing active roles in countries around the world.

These matters are included in the Pledge stipulating rules and regulations which MEXT Scholarship
Students must comply with and submit when they have been granted the Scholarship.

(8) The English texts attached to the Application Guidelines and the Application Form are for complementary use
only. English expressions do not change the Japanese content.

(9) If there are any questions about the content of the written texts in this Application Guidelines or any other
matters, applicants/grantees should inquire the Japanese diplomatic mission in the country of the applicant’s
nationality and follow their instructions.

(10) In addition to the regulations stipulated in this Application Guidelines, those that are necessary to implement
the Japanese Government Scholarship programs shall be determined by the Japanese Government.

(11) In some circumstances such as travel restrictions or curfew, there are possibilities that the selection process
will be cancelled or applicants will not be able to come to Japan even after being selected as scholarship
students.

-8-
 2021年度日本政府（文部科学省）奨学金留学生申請書 （専修学校留学生）
2021 APPLICATION FORM FOR JAPANESE GOVERNMENT (MEXT) SCHOLARSHIP
　(SPECIALIZED TRAINING COLLEGE STUDENTS)
記入上の注意 INSTRUCTIONS
１．タイプ、又は手書きの場合はブロック体で明瞭に記入すること｡ 1. Type or write neatly by hand in block letters.
２．数字は算用数字を用いること｡ 2. Use Arabic numerals (0, 1, 2, 3, 4…).
３．年号はすべて西暦とすること｡ 3. Write years in western calendar.
４．固有名詞はすべて正式な名称とし、一切省略しないこと｡ 4. Write proper nouns in full without abbreviation.
※本申請書に記載された個人情報については、本奨学金の選考のため ※Personal data filled in this application form will only be used for scholarship
に使用するほかは、特にEmail アドレス等の連絡先については、採用後 selection purposes. Contact information such as email addresses of selected
における関係者のネットワークを作ること及び必要に応じ日本政府より
applications might be used by the Japanese Government in order to create academic
各種情報を送信する以外には使用しない。
networks or to send out relevant information when necessary.

姓 Surname 名 Given name ﾐﾄﾞﾙﾈｰﾑ Middle name

1. 氏名（ｱﾙﾌｧﾍﾞｯﾄ）
Name (in alphabet)

※パスポートの表記と同一にすること　　Write your name exactly as it appears on your passport.

2. 性別 3. 婚姻状況 □独身　Single
□　男　Male　　□　女　Female 写真 Photo
Gender Marital Status □既婚　Married
（4.5cm×3.5cm）
4. 国籍 6ヶ月以内に撮影した写真
Nationality 又はデジタル画像を貼るこ
と。写真の裏面に名前と国
5. 日本国籍 □無 □　有：離脱予定年月 年 月 籍を書くこと。
2 0
Japanese Nationality NO 　　YES: expatriation date yy mm Paste your photo or digital
image taken within 6 months.
6.生年月日 年 月 日 年齢 （2021/4/1現在） 歳
Write your name and
Date of Birth yyyy mm dd Age　(As of April 1, 2021) yrs
nationality on the back of the
※申請者は1996年4月2日以降に出生した者であること。募集要項の学歴条件番号③を満たして申請 photo.
する者のみ、日本の大学入学時点で18歳以上であることが必要である。Applicants must have been born on
or after April 2, 1996. Only applicants who meet the condition No.③ of academic background in Section 4. (3) of the
Application Guidelines should be over 18 years of age or older at the time of admission to a Japanese university.

7.(1)現住所 国名
Current Address Country

※現住所が日本の場合、現在の在留資格の種類
If you currently reside in Japan, what is your current resident status?
※既に我が国の在留資格「永住者」、「定住者」等を有している場合であっても、採用後に「留学」に変更する必要がある。な
お、国費外国人留学生の身分終了後に改めて「永住者」又は「定住者」の在留資格を申請しても当然には認定されない可能
性があることを理解した上で申請すること。An applicant with "permanent resident" or "long-term resident" status must change his/her
status to "student" if selected. Be aware that application for the original status after "student" status is expired may not be necessarily approved.

□　同上　Same as above.
(2) 渡日前住所
Your address before □　下記住所に変更することが確定している　The above 'Current Address' will be changed as follows:
departure for Japan 国名
Country
※渡日前住所が現住所から変更になることが確定している場合は、「(2)渡日前住所」の「下記住所に変更することが確定して
いる」に✔を入れ、住所を記入すること。変更がない場合は「同上」に✔を入れること。If the current address will be changed at the time
of leaving from your country, please check the box of 'The above 'Current Address ' will be changed as follows:' and specify the new address. If the
current address will not be changed, check the box of 'Same as above'.

※渡日前住所が国籍国と異なる場合は、渡日旅費が不支給となることを理解しているか。If your address □はい □いいえ

before departure for Japan is outside your home country, do you understand that an airline ticket to Japan will not be provided? YES NO
(3) 査証申請予定公館
Name of Japanese diplomatic office where you will apply for visa issuance
※下記外務省ウェブページを参照し、国籍国に所在する公館の中から公館名を１つ記載すること。不明な場合は在外公館に確認す
ること。Write a Japanese diplomatic office in the country of your nationality in reference to the following webpage of the Ministry of Foreign Affairs.
Please consult in advance with a Japanese diplomatic office if you are unsure about this item.
Embassies & Consulates: https://www.mofa.go.jp/about/emb_cons/over/index.html
(4) 電話番号
(5) Email
Phone number
※可能な限り、渡日前～日本留学中～帰国後にわたり使い続けることが予想されるEmailアドレスを記入すること。
You are suggested to write an email address that can be used continuously before, during and after your stay in Japan.
-1-
 □学生 在籍学校名
Student Name of school
8. 現在の身分 □就労者 勤務先名
Present status Employed Name of organization
□その他
Others

9.過去に在籍した高
校又は大学での専
攻分野
Specialized field of
study in high school or
university
10.　学歴　　Academic record
INSTRUCTIONS
１．初等教育から最新の教育課程まで正規生として修学した課 1. Write your record from primary education (elementary school) to most recent educational level attended
程のみ記入すること。幼稚園・保育所教育は記入不要。 only as a full-time student. Exclude kindergarten education and nursery school education.
２. 「卒業年月」は学校の公式な卒業年月を記入すること。（例： 2. Write the official graduation year and month in the space of "To: yyyy/mm". (ex. In case of October intake and
学校の学事暦が10月入学9月卒業の場合、最後の8～9月が休暇 September graduation under the school's academic calendar, put "9 (September)" in the space of "mm" as an
の場合も「卒業月」欄は「9月」となる。） official graduation month although the term from August to September is a summer break.)

３. 最終学歴が卒業見込の者は、「卒業年月」には卒業見込年月 3. For those whose status is "Expected to graduate", write expected year and month of graduation in the
を記入すること。 space of "To: yyyy/mm".

４. 「卒業状況」を「その他」と選択した場合は、具体の状況を「特 4. If the applicant chooses "Other status" in the Status, indicate the detail of status in the Remarks
記事項欄」に記入すること。（例：退学、休学中） column. (ex. Withdrawal, leave of absence)
５．「大学予備教育」は後期中等教育に含まれる｡ 5. Preparatory education for university admission is included in upper secondary education.
６． ｢大学入学資格試験｣に合格している場合には、その旨「特記
6. If the applicant has passed the university entrance qualification, indicate this in the Remarks column.
事項」欄に記入すること｡
７．「飛び級」をしている場合には、その旨を「特記事項」欄に記入する 7. Any school years or levels skipped should be indicated in the Remarks column.
こと。（例：後期中等教育－3年次を飛び級により短期卒業） Example: Upper secondary education - Skipped senior year for the early graduation.
８．住居の移転や大学の再入学等を理由に、同教育課程で複数 8. If you attended multiple schools at the same level of education due to moving house or readmission to
の学校に在籍していた場合は、同じ欄に複数の学校の在籍を記
university, write all the schools in the same column.
載すること。
９. 下記に書ききれない場合は、別紙に記入することも可能。しか 9. You may use a separate piece of paper if the space below is insufficient. In such a case, please
しその場合は、別紙に記入する旨を明記すること。 indicate that the information is on a separate page.

教育段階 学校名 所在地 入学及び卒業（見込）年月 修学年数 卒業状況 特記事項

Year & month of enrollment & Period of schooling
Educational level School name Location Status Remarks
graduation (expected to graduate) attended
州・省 State/Province
入学 年 月
初等教育 From yyyy mm
（小学校） 年
Primary Education 市・町 City/Town yrs
(Elementary School) 卒業 年 月
To yyyy mm

州・省 State/Province
前期中等教育 入学 年 月
（中学校） From yyyy mm
Lower Secondary 年
Education(Middle 市・町 City/Town yrs
School/Junior 卒業 年 月
High School) To yyyy mm

州・省 State/Province
後期中等教育 入学 年 月
（高校） From yyyy mm
Upper Secondary 年
Education 市・町 City/Town yrs
((Senior) High 卒業 年 月
School) To yyyy mm

州・省 State/Province
卒業
高等教育 入学 年 月 □ Graduated
（大学学部） From yyyy mm
年 卒業見込
Tertiary(Higher) □ Expected
市・町 City/Town yrs to graduate
Education 卒業 年 月
(Undergraduate) その他
To yyyy mm □ Other status
2021年4月1日時点の通算の学校教育修学年数 年
Total years of schooling attended as of April 1, 2021 yrs
特記事項 Remarks
（上記の特記事項欄で書ききれない場合は適宜使用すること）
You may use the space if the space of the above Remarks
column is insufficient.

-2-
11. 過去に国費外国人留学生に採用されたことがあるか。なお、過去に国費外国人留学生として採用された者
□いいえ □はい
は応募対象外である。
NO YES
Have you been awarded a Japanese Government (MEXT) Scholarship in the past? If 'YES', you are NOT eligible to apply.
※過去に受給した奨学金が文部科学省奨学金に該当するか否か不明の場合は事前に在外公館に相談すること。If you are
unsure whether previously awarded financial aid corresponds to a MEXT Scholarship or not, please consult in advance with a Japanese diplomatic office.

12. 日本政府（文部科学省）奨学金制度による他のプログラム（2020年度奨学金支給開始プログラムのうち採
否結果が未決定のプログラム及び2021年度奨学金支給開始のプログラム）に併願しているか。それらの日本
政府（文部科学省）奨学金との併願は認められない。Are you applying for any other Japanese Government (MEXT) □いいえ □はい
Scholarships (including the programs for which scholarship payments will begin in FY2020, although their final selection results have not NO YES
been decided yet, and the programs for which scholarship payments will begin in FY2021)? It is not allowed to apply for other Japanese
Government (MEXT) Scholarships at the same time.

13.(1) 本制度による奨学金と重複し、日本政府（文部科学省）以外の機関（自国政府機関を含む）から奨学金
等を受給、又は受給予定であるか。 □いいえ □はい
Are you receiving or scheduled to be receiving any scholarship from any organization other than the Japanese Government NO YES
(MEXT) (including an organization of your home country government) together with the MEXT Scholarship?
※「はい」の場合、本奨学金と他の奨学金の併給は認められないため、本制度に採用後は他の奨学金の
受給を停止しなければならないことを理解しているか。 □はい □いいえ
If 'YES', do you understand you must cancel other scholarships after selected for MEXT Scholarship Student since it is YES NO
not allowed to receive other scholarships together with the MEXT Scholarship?
(2) 他の奨学金に応募又は他の奨学金を受給している場合は、その名称、期間、金額等を記すこと｡
If you are receiving or applying for other scholarships, please specify the name of the sponsor, scholarship period, scholarship amount, etc.
奨学金の名称・期間・金額
Name of sponsor, period and
amount of the scholarship
14. 日本での希望専攻分野及び学科等
Preferred field of study and subjects in Japan
※必ず別紙「専攻分野に関連する主な学科等」から選んで記入すること。第2希望まで記入する場合、必ず第1希望と同一の専攻
分野から選択すること。Select from the Annex "Majors and Related Subjects for Fields of Study". If you enter a second choice, ensure that it is
from the same field of study as your first choice.
記号 希望専攻分野名 番号 希望学科名
Code Name of field of study No. Name of subjects

第1希望
First choice

第2希望
Second choice

15. 希望理由　Reasons for selection of field of study and subjects

※14.で記入した学科等を希望する理由を具体的に記入すること。
Specify the reasons why you selected each "field of study" and "subject" in section 14.

第1希望
First choice

第2希望
Second choice

16. 日本に関心をもったきっか
けは何か。
What was the trigger for having an
interest in Japan?

-3-
17. 日本留学の経験を通じて
日本と母国のためにどのよう
な貢献ができると考えている
か。What kinds of things do you think you
can contribute to Japan and your home
country through your experience of
studying in Japan?

18. 語学力
読む能力 Reading 書く能力 Writing 話す能力 Speaking 聴く能力 Listening
Language ability

日本語　Japanese

英語　English
その他
( )
Others
※３から０で自己評価すること
３＝優 Excellent ２＝良 Good １＝可 Fair ０＝不可 Poor
Self-rate on a scale of 3 to 0.
（例）日本留学試験(日本語) ○○○/450点
(Ex.) EJU Japanese Score: ○○○/450
19. 日本語能力（資格） 日本語能力試験 ﾚﾍﾞﾙ その他
Japanese language qualifications JLPT level Other

iBT
20. 英語能力（資格） その他
TOEFL IELTS
English language qualifications Other type Other
( )

21. 緊急の際の母国の連絡先　　Contact person in your home country in case of emergency.

氏名 続柄
Name Relationship
現住所 職業
Current address Occupation
電話番号／FAX番号
Email
Phone / Facsimile number

22. 日本への渡航及び滞在歴　　Past visits or stays in Japan List from your most recent visits.

期間　Period 渡航目的　Purpose

From 年 月 To 年 月
yyyy mm
～ yyyy mm

From 年 月 To 年 月
yyyy mm
～ yyyy mm

　私は2021年度日本政府（文部科学省）奨学金留学生募集要項に記載されている事項をすべて了解
し、上記の通り申請資格を満たしていることを確認の上、申請します。
　I understand and accept all the conditions stated in the Application Guidelines for Japanese Government (MEXT)
Scholarship for FY2021, and upon confirmation of my qualifications for application as stated above, I hereby apply
for this scholarship.

申請者署名 申請年月日 20　　　年 　　　月 　　　　日

/ /
Applicant's signature Date of application year month day

-4-
 ＜別紙／Annex＞
専攻分野に関連する主な学科等 (Majors and Related Subjects for Fields of Study)
専攻分野(Fields of Study) 学科等(Subjects)
主な学習内容
記号 専攻分野名 番号 学科等名 (Main Learning Contents)
(Code) (Name of Fields of Study) (No.) (Name of Subjects)
土木・建築 土木工学、建築設計等
1 (Civil Engineering and Architecture) (Civil Engineering, Architectural Design etc.)
電気・電子 電気工学、電子工学等
2 (Electrical and Electronic Engineering) (Electrical Engineering, Electronic Engineering etc.)
機械 機械工学、機械設計等
3 (Mechanical Engineering) (Mechanical Engineering, Mechanical Design etc.)
工業関係 無線・通信 電気通信、放送、テレビ等
A (Technology) 4 (Wireless Communication) (Telecommunications, Broadcast, Television etc.)
電子計算機 コンピュータ、プログラミング等
5 (Computer) (Computer, Programming etc.)
情報処理 情報処理、情報工学等
6 (Information Processing) (Information Processing, Information Engineering etc.)
その他（     ）
7 (Other Subjects)
栄養 栄養等
1 (Nutrition) (Nutrition etc.)
調理・製菓製パン 調理、製菓等
衛生関係 2 (Cooking and Confectionery, Bakery) (Cooking, Confectionery etc.)
B (Personal Care and Nutrition) 美容・理容 美容、理容等
3 (Cosmetology and Barber) (Cosmetology, Barber etc.)
その他（     ）
4 (Other Subjects)
保育等
1 保育士養成(Nursery Teacher Training)
(Nursery Teacher Training)
教育・社会福祉関係 介護福祉
C (Education and Welfare) 2 介護福祉(Nursing Welfare)
(Nursing Welfare)
その他（     ）
3 (Other Subjects)
経営 経営学、経営実学等
1 (Management) (Business Administration, Business Practice etc.)
経理・簿記 経理、簿記、財務等
2 (Accounting and Bookkeeping) (Accounting, Bookkeeping, Finance etc.)
ビジネス 実学ビジネス
商業実務関係 3 (Business) (Practical Business)
D (Business) 商業 商業、商業実務等
4 (Commercial) (Commercial, Commercial Practice etc.)
旅行 観光、ホテル等
5 (Travel) (Tourism, Hotel Management etc.)
その他（     ）
6 (Other Subjects)
和洋裁 服飾、ファッションデザイン等
服飾・家政関係 1 (Japanese/Western Dressmaking) (Clothing, Fashion Design etc.)
E (Fashion and Home Economics) その他（     ）
2 (Other Subjects)
音楽 音楽、音響等
1 (Music) (Music, Acoustic etc.)
映画・映像 映画、映像等
2 (Film and Video) (Film, Video etc.)
アニメーション アニメーション
3 (Animation) (Animation)
マンガ・イラストレーション マンガ、イラスト等
4 (Manga and Illustration) (Manga, Illustration etc.)
文化・教養関係 美術 美術、絵画等
F (Culture and General Education) 5 (Art) (Art, Painting etc.)
デザイン グラフィックデザイン、インテリアデザイン等
6 (Design) (Graphic Design, Interior Design etc.)
写真 写真
7 (Photography) (Photography)
通訳・翻訳 通訳、ガイド、翻訳等
8 (Interpretation and Translation) (Interpretation, Guide, Translation etc.)
その他（     ）
9 (Other Subjects)

※その他を選択する場合は、申請書に選択理由を詳細かつ具体的に記入すること。
NOTE: If you select "Other Subjects", please specify in detail your chosen subjects in your application form.
 JAPANESE GOVERNMENT (MEXT) SCHOＬARSHIP RECOMMENDATION FORM

Applicant's Name (Please print):

,
(Surname) (Given name) (Middle name)

To the Applicant : Please fill in your full name above. Give this form and an envelope marked “confidential" and addressed to yourself to the person you
have asked to recommend you. Ask this person to place the completed form in the envelope, seal the envelope, sign across the seal, and send it back to
you. Submit the unopened envelope with your application to the Japanese Embassy/Consulate General.

To the Recommender : Please respond to the following questions. Please type or print. After completing this form, place it in the envelope provided, seal
the envelope, sign across the seal, and return it to the applicant. This recommendation is a required part of the application process and to be used for
admissions purposes only; prompt return to the candidate is important. MEXT appreciates your assistance and would like to assure you that your comments
will be carefully considered.

Recommender's name :

Title and Institution :

Address (either work or home) :

Telephone: ／ Email :

１．During which period of time have you had the most frequent contact with the applicant? From to .

２．What was the nature of your relationship?

３．In what areas does the applicant need improvement or growth?

４．Please comment on the applicant's interpersonal skills. How well does he or she work within a team?

５．How would you describe the applicant's leadership skills?

６．Please comment on the applicant's degree of self-confidence.

７．Please comment on the applicant's personal character.

８．Please indicate your overall evaluation of the applicant for a Japanese Government (MEXT) Scholarship.
（ ）Strongly recommend （ ）Recommend （ ）Recommend with reservation

９．Please write whatever additional comments you would like to make about the applicant's potential for graduate study in Japan and potential for becoming
a responsible, effective person for your country. Additional pages may be attached, and the back page of this form can also be used.

Signature Date

Note: Any other formats of recommendation letter will be accepted.

 健康診断書（2021年度版） CERTIFICATE OF HEALTH (for 2021)
（医師に記入してもらうこと） (to be completed by the examining physician)
日本語又は英語により明瞭に記載すること。 Please fill out (PRINT/TYPE) in Japanese or English.

氏名
Name Surname 姓 Given name    名 Middle name  ミドルネーム
性別 □ 男 Male 生年月日     年     月     日
Gender □ 女 Female Date of Birth yyyy mm dd

１．身体検査
Physical examination
(1)身長 (2)体重
cm kg
Height Weight
(3)血圧 (4)血液型
mmHg∼       mmHg □A □B □AB □O □RH＋□RH−
 Blood pressure Blood type
(5)脈拍 □ 整 Regular (7)色覚異常の有無 □ 正常 Normal
 Pulse □ 不整 Irregular  Color blindness □ 異常 Impaired
裸眼        (右)        (左) (8)聴力 □ 正常 Normal
Without glasses   (R)        (L)  Hearing □ 異常 Impaired
(6) 視力 Eyesight
矯正         (右)    (左) (9)言語 □ 正常 Normal
With glasses or contact lenses (R) (L)  Speech □ 異常 Impaired
２．胸部聴診及びＸ線検査 （６ヶ月以内）
Physical and X-ray examinations of the chest (within six months)
胸部X線所見 撮影年月日     年     月     日
Describe the condition of lungs. Date of X-ray yyyy mm dd
フィルム番号
Film No.
(1)肺 □ 正常 Normal
 Lungs □ 異常 Impaired
(2)心臓 □ 正常 Normal
 Cardiomegaly □ 異常 Impaired
異常がある場合⇒心電図 □ 正常 Normal
If impaired⇒Electrocardiograph □ 異常 Impaired
３．現在治療中の病気
□ 無 No □ 有 Yes ： 病名 Disease
  Disease currently being treated
完治時期/治療中 完治時期/治療中
４．既往症
✔ 病名Name Date of recovery ✔ 病名Name Date of recovery
  Past illness/disorder /under treatment /under treatment
該当するものにチェックと完治時期 結核 マラリア
/治療中を記入、いずれも該当し Tuberculosis Malaria
ない場合は「無し」にチェックするこ その他感染症 てんかん
と。 Other communicable disease Epilepsy
Please check and fill in the date of 腎疾患 心疾患
recovery/under treatment. Kidney disease Heart disease
If NOT contracted any of them in the 糖尿病 薬剤アレルギー
past, please check “None”. Diabetes Drug allergy
無し 精神疾患 四肢機能障害
✔ Functional disorder in the
None Psychosis extremities
５．検 査
Laboratory tests
(1) 尿検査 糖 蛋白 潜血
  Urinalysis: glucose protein occult blood
(2) 貧血検査 赤沈 白血球数 血色素量 貧血
mm/Hr /cmm gm/dl
Anemia test ESR WBC count Hemoglobin Anemia
(3)肝機能検査 GPT GOT
（IU/ｌ） （IU/ｌ） γ-GTP （IU/ｌ）
  LFT （ALT) （AST)
６．医師の診断・意見
Physician's impression of the applicant’s health
 継続的治療・投薬の必要性があればその旨ご記入下さい。
Please fill in if the applicant needs regular medication or treatment.

７. In view of the applicant's history and the above findings, is 日付

it your observation that his/her health status is adequate to Date
pursue studies in Japan? 志願者の既往歴、診察・検査の結果から判断して、現 医師署名
在の健康の状況は充分に留学に耐えうるものと思われますか？ Physician's Signature

検査施設名
□ YES （はい） □ NO （いいえ） Office/Institution

※Please be sure to check either "YES" or "NO". If you do not 所在地

check "YES", the Embassy will NOT accept the application. Address
  必ず「はい」又は「いいえ」にチェックしてください。「はい」にチェックがない場合、 大使館
は申請を受理しません。