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. Do not modify by changing the font size or deleting parts of the application. Letter of Recommendation: 1) &P : 1) Loo! at attachment ' for reference.
2)
s! the recommender to fill out attachment "#$ seal the en%elope and sign the bac! flap of en%elope.
(f you can)t con%ert your score by using attachment '$ you must follow the instruction on the website www.wes.org *+,-.: /ou may ha%e to pay a fee)
0aculty$ Department and cademic 1a2or: 1) Loo! at 3451# 6yungsung 7ni%ersity &uideline8 attachment 1a!e sure to sign at the bottom of attachment "1 9 ": 1a!e sure each attachment " is at the top of the page 1a!e sure to add ;<# photo after completing the application form
/ou must fill out$ scan and send the application form by 1arch 1=th to sarahcho>!s.ac.!r
Schedule: pplication Period : ?urrent date @ 1ar.1= th *Documents scannedAemailed to 6yungsung 7ni%ersity) pplication Re%iew: 1ar.1'th @ 1ar.1Bth *Cy 6yungsung 7ni%ersity)
Phone (nter%iew: 1ar.45th @ 1ar.41st *Cy 6yungsung 7ni%ersity) nnouncement of selected 45 ?andidates: 1ar.4#th *Cy 6yungsung 7ni%ersity) pril 'th *1ust be recei%ed by pril 'th from the successful candidates)
ttachment "1
(Only for Applicants who apply for this program via a Designated University)
Korean Government Scholarship rogram (KGS ) Application !orm for Graduate Study
EPlease tic! *F ) a boG that applies to you.
"# ($nstitute of %ecommendation) *6orean 7ni%ersity) "# (&ype of %ecommendation) *&eneral) '# (Degree (ourse of Application) *1aster)s) H *Doctoral) )# (Desired !ield of Study) H *Iumanities and Jocial Jciences) *+atural Jciences and -echnology) H !" * rts and Physical .ducation) *# #$% &' (&O $K *( +( )* ) + , (Only for &O $K ,evel * and ,evel + holders) -&O $K ,evel * and + holders must start their studying from Sep ". /0")) H Jep 1$ 451#
-. ( ersonal Data)
Please read the form carefully. All applicants must complete all sections only by typing. /0 12*&i%en name) : /*0amily name) : H 1ale *0ull +ame) Kulia Ienderson Kulia Ienderson 0emale E +ame should be spelled the same as in the passport and in .nglish. 345 *Date of Cirth) 7 *?ountry) 89 *Passport) 4*1BL5) (ndonesia *+umber) XXXXXXXX *Date of (ssue) March 05 2013 :; *?ontact (nformation) Eonly applicant)s own <=> *(nformation concerning applicant)s most recent education) 5*5:) *4') 61* ge: ;;
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*?itizenship)
(ndonesia
ddress: Iome ddressA ?urrent ddressA Malid ddress -el. * DL4 15-'=:#-14;#) .-mail: ?urrentA Malid .-mail ddress <=?@* )A *+ame of pre%iously attended 7ni%.) F * cademic Degree recently awarded) C? 7ni%ersity BC7ADE *?ountryA?ity) G * cademic 1a2or) ?omputer Jcience ?ountryA?ity
Cachelor
H 1aster
$"> *Language Proficiency) Published papers$ if a%ailable*one or two) wards$ if a%ailable *one or two) KL * pplying 7ni%ersity)
<=FH'I *-itle of graduation dissertation$ if a%ailable) J$/*.nglish Proficiency) Nrite + if not a%ailable Nrite + if not a%ailable 0 *+ame of 7ni%.) 6yungsung 7ni%ersity
Le%el: H1 H4 H; H# H: H= Jcore: +
M0 *0aculty)
0 *Department)
G * cademic 1a2or)
N *Period) 455'@4511
OLoo! at 451# 6J7 OLoo! at 451# 6J7 OLoo! at 451# 6J7 &uideline for &uideline for the listP &uideline for the listP the listP +atural Jcience ?omputer Jcience ?omputer Jcience A0 BC7 GOP )*F *+ame of 7ni%.) *?ountry) * cademic 1a2or) *Diploma or Degree) C? 7ni%ersity ?ountry ?omputer Jcience C.Jc.
1st year 4nd year ;rd year #th year :th year /- Jchool TU WXV% /ear *-ransc (converted TV *&P ) ripts) score) -erm 1 4 ; 1 4 ; 1 4 ; 1 4 ; 1 4 ; /100 E1% QR Cachel- ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A ;.:A#.5 B5A155 or #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 #.5 OLoo! at S attachment 'P *only A A A A A A A A A A A A A A terms 1aster A attende d) Y@ Z[ \]> N 0 Y ^ _C@` *,ccupation or *Period) *(nstitution or *Position) *,peration or Duty) Research ?areer) company) 455'455B C? 1iddle Jchool -eacher -eaching a #bcd a e fg !h i *Pre%ious Misits to 6orea) lm %n *Pre%ious Jcholarship wards Recei%ed from 6orean institutions) N *Period) + 0 *Jponsor) + mo* mount) *7JQAyear) * * 4*451#) pplicantRs +ame : Kulia Ienderson A ) A ) *5:) *signature Iand-written) %nN *Period) I*Purpose of Jtay)
j *?ity or Region)
5*54)
E &P *&rade Point %erage) must be con%erted on a maGimum scale of 155 points *con%erted points) E Jee ttachment ."' E 0ill out both the records of Cachelor)s 9 1aster)s in the case of those applying for Doctoral programs
ttachment "4 qr (Self $ntroduction) * Please type or print clearly within 1 page using blac in . (in !orean or in "nglish) (*10 points)
o /our course of life$ your %iew of life$ study bac!ground$ your hopes 9 wishes$ etc o /our education and wor! eGperience$ etc.$ in relation to the 6&JP program o /our moti%ations for applying for this program o Reason for study in 6orea
ttachment "; @u (Study * Please type or print clearly within 1 page using blac in . (*10 points) &oal of study 9 Jtudy Plan
lan)
&oal of study D study plan D future plan S no longer than one page
&oal of study D study plan D future plan S no longer than one page
ttachment "#
,etter of %ecommendation
&o the applicant: Please fill in your name and the other reTuired information below. (n turn$ deli%er or email this form to the person who will write this letter. 1O&2: ReTuest your recommender to seal his or her letter of recommendation in an official en%elope and sign across the bac! flap upon completion. Recommendation letters that are not sealed and signed will not be accepted. (onfidential +ame of pplicant: *gi%en name) +ationality: Desired Degree Program: H 1aster)s Desired 1a2or: H Doctoral *family name)
&o the recommender: -he person named abo%e has applied for the U6orean &o%ernment Jcholarship Program). Ne as! for your assistance$ and would appreciate your fran! and candid appraisal of the applicant. * Please type or print clearly using black ink. 1. Iow long ha%e you !nown the applicant and in what relationshipV
Please assess the applicantRs Tualities in the e%aluation table gi%en below. Rate the applicant compared to other classmates who areAwere in the same school year with himAher. -ruly .Gcellent Mery &ood &ood Celow %erage .Gceptional ?lassification +A -op 4W -op 15W -op 4:W 1iddle :5W Lower 4:W cademic chie%ement 0uture cademic Potential (ntegrity ResponsibilityA(ndependence ?reati%ityA,riginality ?ommunication J!ills (nterpersonal s!ills Leadership 4. Nhat do you consider to be the applicant)s strengthsV
#. Iow well do you thin! the applicant has thought out plans for graduate studyV
:. Please comment on the applicant)s performance record$ potential$ or personal Tualities which you belie%e would be helpful in considering the applicant)s application for the proposed degree program.
Date
lease return this form sealed in an official envelope and signed across the 3ac4 to the applicant# 5e greatly appreciate your timeliness regarding this letter for your recommendee#
ledge (cyc ) s an applicant for the 451# 36orean &o%ernment Jcholarship Program *6&JP) for &raduate Jtudy8$ ( pledge to abide by the following rules: *1) -o refrain from %iolation of uni%ersity regulations and to fulfill my obligations as a 6&JP scholar to the best of my ability. *4) -o beha%e in a manner appropriate to 6orean culture and society$ and not to participate in any form of political acti%ity *such as organizing a political party$ 2oining a political party$ attending political meetings$ publishing political articles and declarations$ organizing or participating in demonstrations of a political nature$ and so on). *;) -o accept responsibility for paying any debts incurred in 6orea *#) -o agree with +((.DRs decision concerning the graduate program and the 6orean language course *:) -o abide by all terms and regulations set by +((.D. *=) -o permit +((.D to use my personal information for the 6&JP. (f ( am pro%ed to ha%e %iolated any of the abo%e or to ha%e made a false statement in my application documents$ ( shall accept any resolution or penalty made by +((.D$ e%en when it mayAmight result in suspension$ re%ocation or withdrawal of my scholarship. ( was informed and fully understand that 6&JP scholars are not permitted to transfer schools for the entire duration of scholarship after confirming their host institution including 6orean language institution.
ttachment "=
pplicants are not reTuired to undergo an authorized medical eGam before passing the 4 nd Jelection with +((.DX howe%er$ all successful candidates must ta!e a comprehensi%e medical eGam when its) orientation *including an I(M and -CP. drug testEE$ etc) in accordance with the reTuirements of the 6orea (mmigration Jer%ice and the 6&JP. (f the results show that the applicant is unfit to study and li%e o%erseas more than ; years$ heAshe may be disTualified.
EE-he -CP. *tetrabromophenolphthalein ethyl ester) drug tests are for e%aluating past usage of stimulant drugs.
&ender: 1
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Nhen and for what reason did you last consult a physicianV *Please eGplain in the ad2acent space.) Y7.J-(,+
Ia%e you e%er had an infectious disease that posed a ris! to public health *such as$ but not limited to$ tuberculosis$ 9$: and other S&Ds)V 1. allergiesV 4. high blood pressureV ;. diabetesV #. any type of IepatitisV
Ia%e you e%er suffered from or been treated for depression$ anGiety$ or any other mental or mood disorderV *(f you ha%e recei%ed treatment$ please eGplain and attach an official medical report.) Ia%e you e%er been addicted to alcoholV Ia%e you e%er abused any narcotic$ stimulant$ hallucinogen or other substance *whether legal or prohibited)V (f necessary$ are you prepared to undergo physical tests to %erify the answers gi%en in response to Tuestions and abo%eV Ia%e you been hospitalized in the last two *4) yearsV Ia%e you had any serious in2ury$ ailment or sic!ness in the last fi%e *:) yearsV Do you ha%e any %isual or hearing impairmentsV Do you ha%e any physical disabilitiesV Do you ha%e any cogniti%eAmental disabilitiesV re you ta!ing any prescribed medicationV re you on a special dietV ,n a%erage$ how many standard ser%ings of alcohol do you consume each wee!V
( drin! occasionally with my friends on the wee!end ( ha%e been hospitalized in the last 4 years due to typhoid
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