JAPANESE GRANT AID FOR
                           APPLICATION FORM for MASTER LEVEL in Bangladesh.
        (This application form should be written clearly and completed in English. Typewriting is preferable.

 1. Desired Component
See the Application Guidelines for the details and tick your desired component (Development Issue) to study. The
applicant should be from its target cadre/personnel. If you tick no place or more than one place, your application will
become invalid.
           【Component】                        Target Cadre / Personnel                              Universities            Please tick
                                                                                                                            one you
        (Development Issue)                     Please tick one you belong to.                      (Duration)              apply for.

                                                                                        Yamaguchi University (2 Years)

 Public Administration                 □   BCS Cadre                                    Meiji University (2 Years)

                                                                                        Kyushu University (2 Years)

                                       □   BCS Cadre                                    Ritsumeikan University (2 Years)
                                       □   Class-1 officers of Bangladesh Bank          Hiroshima University (2 Years)
                                       □   BCS Cadre
 Environmental Policy                                                                   University of Tsukuba (2Years)
                                       □   Class-1 officers of Bangladesh Bank
                                                                                        International University of Japan
 International Relations               □   BCS Cadre
                                                                                        (2 Years)

 2. Personal Information

                              (1) Given Name:                                    Middle Name (if any) :
    Attach your recent
     photograph here              Family Name:
    (Should be taken
   within three months)          (as of written in passport or driver’s licence, if applicable)
    Please write your
   name on the back of        (2) Date of Birth: (day)            / (month)            / (year)
        the photo

                              (3) Age:           (as of 1st April 2010)

(4) Sex: [ ] M / [ ] F         (5) Marital Status: [ ] Single / [ ] Married

(6) Current Residence Address:

(7) Current Postal Address:

(8) Residence Phone:                                                 (9) Work Phone:

(10) Mobile Phone (if any):

*If you do not have phone at home:

Contact Person (Family or Relative):                                             Phone Number:

(11)   E-MAIL Address (if any):

                                                                                                       (NO BLOCK LETTER)
3.   Educational Background
(1) Educational Background (as of application)
                                                                   Period of
                            Name of School                                         From /To
       Level                                      Location       schooling you                            Degree
                             Department                                           (Month/Year)
                                                                 have attended
                          University of Dhaka                                                        Bachelor of
     (Example)                                     Dhaka            4 Years            -
                          Faculty of Economics                                                       Economics


(SSC                 or
(HSC                 or
(Bachelor            or

(                )

(                )

Total Duration of Academic Education Year:

__________ year (s) ________ month(s) (Please calculate very carefully)

*Diploma is excluded from calculation of school year.

(2) Have you ever been awarded any scholarship studying abroad?

     [ ] Yes Name of Scholarship:

               Country you studied:                     Duration (month/year)            – (month/year)

     [ ] No

(3) Are you currently applying for another scholarship?

     [ ] Yes Name of Scholarship:

     [ ] No

                                                                                              (NO BLOCK LETTER)
(4) Have you ever applied for JDS before?
    [ ]   Yes Study field, university, year you applied* :    Law       , Kobe           , 2006
          (* List all, if more than once.)                               ,                ,
                                                                         ,                ,
                                                                         ,                ,
    [ ]    No

                                                                                  (NO BLOCK LETTER)
4.        Work Experience
(1) Work Experience (as of application)
          Fill out from the most recent one and attach another sheet if necessary / Full-time job ONLY. Do NOT include
          part-time job or full-time job before graduation from university.
            Organization /
                                      Department             Position Title     Period of         From /To      **Type
             Company                                                            Working          (Month/Year)

                                 Economic      Relations   Senior Assistant                     XX/XXXX
(Ex.) Ministry of Finance                                                             3 years      -              A
                                 Division                  Chief

**For the type of organization above, choose the applicable alphabet below:
     A. Ministry/Governmental Agent      B. National Research Institution / Center.
     C. State Corp. /State Co.    D. University (State)    E. University (Private)
     F.    Other (please specify): ______________________________________________

Total Work Year: __________year(s) __________month(s) (Side Job, part-time Job are not included)

(2) Your Current Occupation (including title):
    do not abbreviate the name of the organization nor of the department

(3) Name of Current Department:

(4) Name of Current Work Place :

(5) Belonging Cadre (if any):

(6) Work Address:

(7) Work Phone:                                              Fax:

(8) Are you a permanent staff in your organization and eligible to get study leave/deputation for full period of study
    before your departure to Japan? (please tick     [ ]Yes [ ] No
                                                                                                (NO BLOCK LETTER)
5. What are (were) your responsibilities of your work? Your answer must be typed in 150 words
or less. Use separate sheet of A4 sized paper and attach it to this page as a cover. [Maximum 1 (one)
page]) *Do no forget your signature on each page of the attachments

(Current Work)

 (Last Work)

                                                                             (NO BLOCK LETTER)
6. Considering the sub-program/component of JDS which you apply for, how will you utilize
your knowledge, skills and experiences that you obtain in Japan on your return home for the
contribution to the development of Bangladesh? (Your answer must be typed in 400-500 words
[Maximum 2 (two) pages] Use separate sheet of A4 sized paper and attach them to this page as a
cover.) *Do no forget your signature on each page of the attachments

                                                                        (NO BLOCK LETTER)
7. Research Plan

On separate sheets of A4 sized paper, write a brief proposal of your Master’s thesis or research paper. Describe
how your study can contribute to find the solution to the problems of your country. It is strongly recommended
to show the connection between the sub-program/component (as target priority area and development issues of
JDS program) and the research plan. Other details about writing your proposal are giving in the attached “A
guideline for writing a research plan for JDS applicants.” The research proposal must be typed, and should be
no more than 700 words [Maximum 3 (three) pages.] Writing more than the limit is strictly prohibited. (You
may add a very short, less than 300 words, alternative research proposal if you are not quite sure what kind of
research you may undertake for your Master’s thesis.) Attach this page as a cover.
*Do not forget your signature on each page of the attachments

Tick one of the research areas listed below under the component of your choice:

Public Administration:
□ Advancing effective administrative systems
□ Decentralization and improvement of regional development
□ Social development and climate change
□ Strengthening of analysis, evaluation and planning in public policy

□ Ensuring balanced and stable fiscal management
□ Promotion of attractive market and active industries
□ Economic growth and climate change
□ Advancement of administrative capacity to improve trade and investment

Environmental Policy:
□ Building institutional capacity for environmental management
□ Development adopting Clean Development Mechanism
□ Environmental policy and climate change
□ Socio-environmental considerations for development projects

International Relations:
□ Strengthening of multilateral diplomatic relations focusing on development, trade, investment and finance
□ Building-up closer relationship with Asian countries

⇒Title of your Master’s thesis or research paper:

                                                                                           (NO BLOCK LETTER)
8. Declaration

     I, (print your full name) ______________________________________________ ,
     declare that I apply for JDS Program with full understanding of “Application
     Guidelines for JDS Program”, especially the articles stipulated below:

     1.   All the information answered and provided in this Application Form by me is
          true and accurate to the best of my knowledge and ability. My Application will
          be cancelled if any information mentioned above recognized to be false.

     2.   Application Form which is incomplete or missing the necessary documents is
          regarded ineligible.

     3.   All the selection procedure and its result are entirely entrusted to the secretariat
          of JDS and any inquiry and objection by applicants regarding the result of
          selection are not accepted.

     4.   If any act of dishonesty is found other than those above in the application and
          selection, I am to lodge no complaint about cancellation of the application.

     5.   The objective of the JDS is to provide Bangladesh citizens to study in Japan at
          master’s level in order to support national efforts to achieve social and
          economic development in Bangladesh. Thus, the returned fellow is mandated to
          contribute to the development of Bangladesh and to stay in Bangladesh at least
          for two years after completing Master’s degree in Japan.

     6.   I agree that my personal information in the Application Form, provided to
          Japan International Cooperation Center (JICE), will be used only for the
          purpose of the operation of JDS program.

                              Signature: ______________________________

                              (*Please sign at the bottom of all the pages)

                              Date: (day)_____/(month)_____/(year)_______

                                                                                 (NO BLOCK LETTER)

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