BQ orAa Dl)C v A BAa TAOD.~I HQC THAI NGUYEN

s6:33 t-IBHTN-HTQTvIv thong baa hoc bong cua Chinh phu

HanQu6c

CQNG HOA xA HQI CHiT NGHiA VI'¢T NAMDQc l~p - T\f do - H~nh phiic

Thai Nguyen, ngay 03 thdng 3 ndm 2015

Kinh giri: - Cac co sa giao due thanh vien- Cac don vi tnrc thuoc

Tren co sa hop tac gitra Dai hQCThai Nguyen va Dai hoc Keimyung, Han Quoc,

tnrong Dai hoc Keimyung thong bao v~ chuang trinh hoc bong cua Chinh phu Han Quocnam hoc 2015 hoc tai Dai hoc Keimyung danh cho can be>,giang vien, sinh vien cua Daihoc Thai Nguyen theo cac nganh hoc sau:

- Khoa hoc xa he>iva nhan van (Luat, Du lich, Quan li giao due, Tam li hoc,Thu vien, K~ toan ... );

- Khoa hoc tir nhien (Sinh hoc, Sire khoe cong d6ng, Moi tnrong, Dinh dirong,Y Duoc ... );

- K1 sir (Ki~n true, May tinh ... );- Van h6a nghe thuat (Am nhac, Thi~t k~... ).

Giam d6c Dai hoc Thai Nguyen d~ nghi cac don vi trien khai rong rai toi toan th€can be>,giang vien quan tam va chuan bi h6 sa theo huang d~n (tai lieu dinh kern); d6ngthai cac img vien lien h~ voi Ban Hop tac quoc t~ d€ c6 thu gioi thieu cua Giam d6c Daihoc Thai Nguyen.

MQi thong tin chi ti~t xin lien h~ Chuyen vien T? Nguyet Trang, email:banqhqt.dhtn@moet.edu.vn, di~n thoai 0280 3851690.

Tran trong earn an.!.

No'i 1l!t~Il:

Nhu tren;Website;

- LUll VT, HTQT.

~~~~~GIAM DOCBANHTQT

/

(Check List for Application Documents)

REGISTRATION NUMBER.. "'.

.°0,

~ *]1~ (Institute of Application):

~~;q(Confirmer) :

*Do not write in this area.

~ (Signature)

1) Name of Applicant: ;uCg•.•.iv-'-'e"'n1'-!fi.,...lr""stc-'-n,."a"'-m"'eL) ----'-Cf:"'a""m.....,ilcz.y/"'las""-'-t....,na"'m.."e><.l.) _

2) Country : _

3) Desired Degree Program : 00 Master's Do Doctoral o Research

(*Please tick (-1) in the appropriate box.)

Application Documents Submission(Y IN)

Check List Yes No1. Personal data (Attachment #1)

2. Self Introduction (Attachment #2)

3.Study Plan (Attachment #3)

Research Proposal(Attachment #3)

4. Letter of Recommendation(1) (Attachment #4)

~. Pledge (Attachment #5)

6. Personal Medical Assessment (Attachment #6)

7. Diploma or certificate of graduation from undergraduate institution

8. Official Transcript from undergraduate institution

9. Diploma or certificate of graduation from graduate institution

10. Official transcript of previously attended graduate institution(s)

11. Certificate of Employment

12. Certificate of TOPIK score (original copy), if applicable

13. Certificate of TOEFL or IELTS score (original copy), if applicable

14. Published papers, if applicable

15. Awards, if applicable

16. Copy of passport (possible to submit after selection)

Certificate of citizenship of applicant ex) the applicant's and his/her Parents' Birth

17. certificate, Passport copy or Certificate of nationality expatriation, etc.

Certificate of Loss of Korean citizenship (only for former Korean Citizenship holders)

18. Adoption Documents (only for overseas Korean adoptees)

1/

ITJ.\'1.~

Attachment # 1

Gj'" ~t.J1.!flett1l"Q:}«~T.i!};AJ 3':~) 2}-~ Al~At%(Only for Applicants (including research scholars) who apply for this program via a Designated University)

Korean Government Scholarship Program (KGSP) Application Form for Graduate Study

*Please tick eJ ) a box that applies to you.

1. ~~]I;gf (Institute of Recommendation)o ;?; LH CH 2,f (Korean University)

1. ~~.g.~ (Type of Recommendation)o gJ \:!.!"~~(General)

3. AI~ J1t~ (Degree Course of Application)o 6:l J.J J1t~ (Master's) 0 !;:!{N J1t~ (Doctoral) 0 ~F?·llf~ (Research)

4. £:l gt JlI ~ (Desired Field of Study)o e.!~ N:2.I JlI ~ (Humanities and Social Sciences)

o Afe!~ 2,fJlI ~ (Natural Sciences and Technology)

o 011xii ~ JlI ~ (Arts and Physical Education)

5. e!;?;0le!* e!~IAf (TOPIK5.g. 6.g. ~:;Af) E2,f ~e.!(Only for TOPIK LevelS and Level 6 holders)*TOPIK LevelS and 6 holders must start their studying from Sep 1,2015)

o DSep 1,2015

~~Ng (Personal Data)Please read theform carefully. All applicants must complete all sections only bv tvpine.

~'6! 01 ~(Given name) : I~(Family name) : o Male o Single(Full Name) (Photo 3*4)

* Name should be spelled the same as in the passport and in English. o Female o Married

~Id~~ Id(yyyy) ~(mm) ~(dd) LfOI(Age: )(Date of Birth)

~Jf I::;:lA~

I-. -.(Country) (Citizenship)

()j~ (Number)(Passport)

(Date ofIssue) (Date of expiry)

e!~x-l Address:(Contact Information)*only applicant's own Tel. ( ) E-mail:

i1~of2:l i1 §~ gj (Oll~)2{ jj} 6Hg~Jf/.s:.AI=--, -.(Information (Name of previously (Country/City)

concerning applicant's attended Univ.)most recent education) 2{~ ~~

(Academic Degree recently 0 Bachelor o Master (Academic Major)awarded)

i1§~~{:::~Ail~(Title of graduation

dissertation, if available)

1

OJ o,!::~ ~Oj~<S1 OTOEFL Korean Language Level: 01 02 03 04 05 06-,=-,(Language (English Proficiency) OIELTS Proficiency Score:

Proficiency) Score: (onlv TOPIK)Published papers, if

available(one or two)

Awards, ifavailable(one or two)

AI@~~CH~ CH0' D'1 ';I-d~ ~:ilf~ ~~-,= -,-r=(Applying University) (Name ofUniv.) (Faculty) (Department) (Academic Major)

"" 2;l JIll- 2,'".:w.~ oH@~Jf Ci~fEO~ ~~2{Sf1-, -,(Academic (Period) (Name ofUniv.) (Country) (Academic Major) (Diploma

Career) or Degree)-0

A; A; School 1styear 2nd year 3'd year 4thyear 5th year ~l! ~t!~*=-,(Transc Year ]J;j A; (converted=0ripts) Term 1. 2 3 1 2 3 1 2 3 1 2 3 1 2 3 (GPA) score)*01* 1100~Jle! Bachel- / / / / / / / / / / / / / / /

JI All or(only Master / / / / / / / / / / / / / / /terms

attended)~~ ~g e1=?~~ JI ll- JI ~ D'1 ~ ~ C,Cf01 Cl= OOt::::l-r

(Occupation or (Period) (Institution or (Position) (Operation or Duty)Research Career) company)

0

:ilfJi e1:~ OilAl ~ JI ll- Ji A CC!::.52 A; AI Q1 "T" ...L.'-

(Period)-, -, xjl¥f~~JmJi A CC!:: (Purpose of Stay) (City or-r ...L.,-

xjl¥f Af@1 Region) (OrganizationConcerned)

(Previous Visits toKorea)

~~~ *011 AI~JI~~ AI~ ~ Q!l (Amount) * 011JIl!-(Previous Scholarship (Sponsor) (US$/year) (Period)Awards Received from

Korean institutions) ( / ) 0

( / ) 0

ta(yyyy) ~(mm) ~(dd)

Applicant's Name: (signature)

* GPA(Grade POint Average) must be converted on a maximum scale of 100 points (converted POints) * See Attachment .#7* Fill out both the records of Bachelor's & Master's in the case of those applying for Doctoral programs

2

~

AI•I

HNl----*.~

Attachment #2

~ JI :1:JH (SelfIntroduction)* Please tvoe or print clearlv within J oaee usine black ink. (in Korean or in Enelish) (*10points)

I

o Your course of life, your view of life, study background, your hopes & wishes, etco Your education and work experience, etc., in relation to the KGSP programo Your motivations for applying for this programo Reason for study in Korea

3

Attachment #32,'-gj)jl~ (Study Plan)

* Please type or print clearly within 1 page using black ink. (*10points)

Goal of study & I 0 Goal of study, title or subject of research, and detailed study planStudy Plan/"

Future Plan I 0 Future plan in Korea or another country after study in Koreaafter Study

4

Attachment #3.>;

e!::r:il} AU (Research Pro posal)

* Please type or print clearly within 1 page using black ink. (*10 points)

l!cq Ij!!OI ¥~~ ~~ ~AIOjI ~11OltJAI.2. Please submit additional sheets ifmore space is needed.

[!] <2!-=?-~Ail Research Topic

[!] <2!-=?-~~ Research Objectives

00 <2!-=?-LH% Detailed Research Plan

[!] <2!-=?-'2ftgJ Research Methodology

[!] <2!-=?-QI 71 [H B..J!~ Expected Results ofthe Research

[!] <2!-=?-~ ~ Research Timetable

5

Attachment #4

Letter of RecommendationTo the applicant: Please fill in your name and the other required information below. In turn, deliver or email this form to the person

who will write this letter. NOTE: Request your recommender to seal his or her letter of recommendation in an official envelope and

sign across the back flap upon completion. Recommendation letters that are not sealed and signed will not be accepted.

Confidential

Name of Applicant: l./Cg"'i.!.v""en"-"n"'am......."e:.L) -.lC-"fa"'m"'I"'·lyJ....!'n""a"'m"'eCL) _

Nationality: _

Desired Degree Program: D 0 Master's Do Doctoral

Desired Major:

To the recommender: The person named above has applied for the 'Korean Government Scholarship Program'. We ask for your

assistance, and would appreciate your frank and candid appraisal of the applicant.

* Please type or print clearly using black ink.

1. How long have you known the applicant and in what relationship?

.-,Please assess the applicant's qualities in the evaluation table given below. Rate the applicant compared to other classmates who

e/ . h hool vear wi h him/har were in t e same sc 00 year Wit I er.Truly

Excellent Very Good Good Below AverageClassification Exceptional N/A

Top 2% Top 10% Top 25% Middle 50% Lower 25%Academic Achievement

Future Academic Potential

Integrity

ResponsibilitylIndependence

Creativity/Originality

Communication Skills

Interpersonal skills

Leadership

I. What do you consider to be the applicant's strengths?

6

2. What do you consider to be the applicant's weaknesses?

/~ How well do you think the applicant has thought out plans for graduate study?

5. Please comment on the applicant's performance record, potential, or personal qualities which you believe would be helpful in

considering the applicant's application for the proposed degree program.

Recommender's Name ---; ,Date _

Recommender's Signature -r-t- _

Position or Title: _

University (Institution): _

Address: _

(zip-code:Tel: _ Fax: _

Please return this form sealed in an official envelope and signed across the back to the applicant. We greatly appreciate your

timeliness regarding this letter for your recommendee.

7

Attachment #5

"Korean Government Scholarship Program for Graduate Study"

Pledge (A1 Q.j= A1)

As an applicant for the 2015 "Korean Government Scholarship Program (KGSP) forGraduate Study", I pledge to abide by the following rules:

(1) To refrain from violation of university regulations and to fulfill my obligations as aKGSP scholar to the best of my ability.

(2) To behave in a manner appropriate to Korean culture and society, and not to participate inany form of political activity (such as organizing a political party, joining a politicalparty, attending political meetings, publishing political articles and declarations,organizing or participating in demonstrations of a political nature, and so on).

(3) To accept responsibility for paying any debts incurred in Korea(4) To agree with NIIED's decision concerning the graduate program and the Korean

language course(5) To abide by all terms and regulations set by NIIED.(6) To permit NIIED to use my personal information for the KGSP.

If I am proved to have violated any of the above or to have made a false statement in my

application documents, I shall accept any resolution or penalty made by NIIED, even when it

may/might result in suspension, revocation or withdrawal of my scholarship.

I was informed and fully understand that KGSP scholars are not permitted to transfer schools

for the entire duration of scholarship after confirming their host institution including Korean

language institution.

(yyyy). (mm). (dd).

Applicant's Name: (signature)

8

Attachment #6

PERSONAL MEDICAL ASSESSMENTApplicants are not required to undergo an authorized medical exam before passing the 2nd Selection with NIIED; however, allsuccessful candidates must take a comprehensive medical exam when its' orientation (including an HIV and TBPE drug test**, etc)in accordance with the requirements of the Korea Immigration Service and the KGSP. If the results show that the applicant is unfit tostudy and live overseas more than 3 years, he/she may be disqualified.**The TBPE (tetrabromophenolphthalein ethyl ester) drug tests are for evaluating past usage of stimulant drugs.

Gender: I I HEIGHT I cm WEIGHT I kg

When and for what reason did you last consult a physician?(Please explain in the adjacent space.)

QUESTION YES NO IF YES, PLEASE EXPLAIN

o Have you ever had an infectious disease that posed a risk topublic health (such as, but not limited to, tuberculosis, HIVand other STDs)?

0 1. allergies?2. high blood pressure?3. diabetes?4. any type of Hepatitis?

o Have you ever suffered from or been treated for depression,anxiety, or any other mental or mood disorder? (If you havereceived treatment, please explain and attach an officialmedical report.)

o Have you ever been addicted to alcohol?

o Have you ever abused any narcotic, stimulant, hallucinogen orother substance (whether legal or prohibited)?

o Ifnecessary, are you prepared to undergo physical tests to verifythe answers given in response to questions 0 and 0 above?

o Have you been hospitalized in the last two (2) years?

o Have you had any serious injury, ailment or sickness in the lastfive (5) years?

o Do you have any visual or hearing impairments?

o Do you have any physical disabilities?

o Do you have any cognitive/mental disabilities?

o Are you taking any prescribed medication?

o Are you on a special diet?

o On average, how many standard servings of alcohol do you consume each week?

.

9

Attachment #7

GPA Conversion Table

96

4.0 Scale I 4.3 Scale ,I 4.5 8<aI. I 5.0 8<aI. --1 ....~.~~.~?~?u..s.~!~....3.97 - 4.0 I 4.26 - 4.3 ._ 4.46 - 4.5 I 4.95 - 5.00 I 100

::: ~:~~---rl.!- -~-. ::::~::: I ::: ~~:-F.-----:-:----------'3.84-3.87 4.12-4.16 4.31-4.35 I 4.79-4.83 I 97

3.80 - 3.83

3.62 - 3.66

3.58 - 3.61

3.49 - 3.57

3.41 - 3.48

3.32 - 3.40

3.24 - 3.31

3.15 - 3.23

3.07 - 3.14

2.98 - 3.06

2.90 - 2.97

2.81 - 2.89

2.72 -2.80

2.64 - 2.71

I I II 4.08 - 4.11 4.26 - 4.30 I 4.73 - 4.78 II . I I

3.75 - 3.79 I 4.03 - 4.07 ,. 4.21 - 4.25 I 4.68 - 4.72 1f-- 9_5 1

3.71 - 3.74 I 3.98 - 4.02 I 4.16 - 4.20 I 4.62 - 4.67 -I 94---------------, ------------- r----------~- J,--------- ----

3.67-3.70 I 3.93-3.97 4.11-4.15 I 4.57-4.61 II ----~I-------'I 3.89-3_92 4.06-4.10 I 4.51-4.56 I 92

93

I 3.84 - 3.88 4.01 - 4.05 I 4.45 - 4.50 I 91

I II II 3.75 - 3.83 3.91 - 4.00 4.34 - 4.44 j,-------+--------r-------+-------~--------

I 3.65 - 3.74 3.81 - 3.90 I 4.23 - 4.33 I'------_·_-+----------+---------+-----------+1-----------

I3.56 - 3.64 3.71-3.80 4.12 - 4.22

90

89

88

3.46 - 3.55 3.61 - 3.70 4.01 - 4.11 87

I 3.37-3.45 3.51-3.60 I 3.90 - 4.00 86

I 3.27 - 3.36 3.41 - 3.50 II---------r-------------~----·-----r------~--------f

L3.18-3.26 3.31-3.40 II-------~· ---~-----------~------------r-----------iI 3.09 - 3.17-·-f-------+-------~----------II 2.99 -3.08

3.79 - 3.89

3.68 - 3.78

3.21 - 3.30

3.45 - 356

85

84

83

82

3.57 - 3.67

3.11 - 3.20

I 2.90 - 2_98 3.01-3.10 3.34 - 3.44 81

2.80 - 2.89 2.91 - 3.00 3.23 - 3.33

10

80