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The objective of the Korean Government Scholarship Program for an Undergraduate Course is to provide
international students with the opportunity to conduct advanced studies at higher educational institutions in Korea
in order to promote international exchanges in education and mutual friendship between the countries.

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   Ę ( ) *           
Guota of Scholarships
Country
in each country

5 Vietnam

4 Indonesia , Malaysia, Mongolia

3 Cambodia, Kazakhstan, Laos, Myanmar, Philippines, Thailand

Azerbaijan , Bangladesh, Colombia, Egypt, Ethiopia, Ghana, Guatemala, Kyrgyzstan,


2 Nepal, Russia, Pakistan, Peru, Singapore, Sri Lanka,
Uzbekistan, Turkey
Afghanistan, Angola, Bolivia, Brazil, Brunei, Bulgaria, Congo(DRC), Dominican
Republic, East Timor, El Salvador, Gabon, Guinea Bissau, , Hungary, Iran, Japan, Kenya,,
1
Lebanon, Mauritania, Mexico, Nigeria, Panama, Paraguay, Poland, Romania, Senegal,
Sweden, Tajikistan, Tanzania, Togo, Turkmenistan, Uganda, Ukraine, Yemen

+&  
Undergraduate degree courses for four years after successfully completing a one-year Korean Language Training.
Ę University transferring is not allowed (e.g. Beginning from the 3rd year is not allowed.)

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4-year undergraduate courses provided by the universities designated by NIIED
Ę Not applicable: fields the study period of which exceeds 4 years (e.g. medicine, dentistry, architecture)

"-  
Prospective applicant must meet the following qualification criteria:
(1) Must be a citizen of the country to which scholarships are offered, which is also applied to his/her parents.
Ę Applicant must not be a holder of Korean citizenship.
(2) Should be under 25 years of age as of March 1, 2011.
(3) Have an adequate health, both physically and mentally.
Ę Persons who are pregnant or having severe illness may not apply.
(4) Have finished or be scheduled to finish formal education of elementary, middle, high school as of March 1, 2011.
Ę Exceptional acceptance for a person who will have finished high school as of September 1, 2011 and who
will be able to have level 3 in TOPIK until then.
(5) Possess above 80% (out of 100%) in a grade point average (G.P.A.) of the whole school years of the high school
attended or within top 10% among graduates in the same year.
(6) Not at any time have received a Korean government scholarship for his/her undergraduate study before.
(7) Not have enrolled in an undergraduate course in Korea before.
(8) Preferential selection for applicants who are good at Korean or English.

.  %/0   
(1) Place of Submission: Korean Embassy (or Consulate) or Korean universities <Refer to Attachment &
CONTACT POINTS>
(2) Deadline of Submission: The date set by the above institution
(3) Documents to be submitted
Ê One Completed Application Form (on a prescribed form: RD-1)
Ê One NIIED Pledge (on a prescribed form: RD-2)
Ê One Self-introduction Essay (on a prescribed form: RD-3)
Ê One Study Plan (on a prescribed form:RD-4)
Ê Two Recommendation Letters (from two different referees stated below, on a prescribed form: RD-5)
ĘÊ Applicant's teacher or principal of the school, academic advisor or CEO of an organization, etc.
Σ One original Personal Medical Assessment (on a prescribed form: RD-6)
Τ One original Certificate of Health authorized by a doctor (on a prescribed form: RD-7)
ĘÊ Only applicable for candidates who have successfully passed through the selection procedure set
by the institution in charge of recommendation of candidates
' One original Copy of High School Diploma
Φ One original Copy of High School Grade Transcripts
Χ One original Copy of the Applicant¶s Passport
ĘÊ Application for issuance of a passport can be replaceable instead.
ƒ The Certificates of Citizenship of the Applicant and his/her Parents
ĘÊ A birth certificate or a copy of passport, etc.
š One original Copy of a Certificate of Korean or English Proficiency (if applicable)
ĘÊ It should be issued within 2 years from as of March 1, 2011

(4) Notes

Ê Applicants can apply for the program through more than one institution in charge of
recommendation of qualified candidates, but s/he SHOULD BE RECOMMENDED by ONLY
ONE INSTITUTION.

ĘÊ In case that s/he will be recommended by more than one institution, his/her application is to be
rejected; if informed by more than one institution that s/he is selected as one of their candidates, s/he
should make a decision as to which recommendation will be effective and let them know it.
ßÊ English Name Spelling in the application form MUST be exactly the same as in the passport.
ĘÊ One copy of application for issuance of a passport is replaceable for a copy of passport.
öÊ þpplication form and other program materials are to be filled out either in Korean or in English. And all
of the materials should be A4 sized; if smaller, attach th e material to an additional A4 sized paper; if bigger,
fold it up to be an A4 sized one.
Ê Regarding a high school grade transcript, it should prove that your academic achievement satisfies 5-(5)
above; otherwise, you should submit a certificate issued by the high school, which should include either an
official seal of the school or a school principal¶s signature.
$Ê The documents such as certificates or credentials issued in languages other than Korean or English must
include official notarized translation, which is to be put before the original.
Σ Other documents except the ones written on a for m prescribed by NIIED should contain
their numbers and names on the top right. (ex.' High School Diploma)
ΤÊ ;hen you submitting the documents to the institution in charge of selection of candidates, the documents
should be arranged in the order of the list of the required documents stated above. Each document can be
stapled, but all of the documents should be put together using (a) clip(s): do not staple them altogether, or
do not put them into a transparent file one by one.
' Submitted documents will not be returned to the applicant.
Φ Incomplete or incorrect documents are subject to rejection by NIIED.

o (  
(1) Scholarship Period: March 1, 2011 ~ February 28, 2016
(2) Scholarship Benefits
i Airplane ticket or airfare: The grantees will receive an airplane ticket or be paid an economy class airfare of
the shortest route between their country and Korea when they come to Korea, and, thereafter, when they
leave Korea after completion of their study.
ßÊ Monthly Allowance: 800,000 won per month

öÊ Tuitions: The full tuition is exempted by NIIED and the entrance fee for the first semester by the host

university.

Ê Settlement Allowance: 200,000 won upon arrival

$Ê Repatriation Allowance: 100,000 won upon completion of studies

ΣÊ Korean Language Training Expenses

ĘÊ The full costs up to 1 year (NIIED pays directly to the language training institution)
ΤÊ Medical Insurance: The grantees will be provided with health insurance for major accidents and illnesses
during their scholarship period.
(3) Notes
—Ê NIIED does not compensate fees for the domestic travel both in the grantee¶s country and Korea.

ßÊ Airfare for entry into Korea will not be provided to a grantee that has been staying in Korea for between
the confirmation date of selection of scholarship students and the designated entry due (February 28, 2011).
öÊ NIIED does not compensate fees for insurance of traveling to and from Korea.
Ê The medical fee is to be reimbursed through the insurance company to the grantee after s/he pays first
$Ê Any grantee who gives up his/her study during the scholarship period will not receive airfare and
allowance for repatriation except for the cases approved by NIIED such as severance of diplomatic
relations, war or other natural disasters.
ΣÊ Any grantee who quits the program in 3 months after one¶s entrance into Korea, should refund all
scholarship fees (The airfare of arriving Korea, settlement allowance, monthly allowance, Korean
language training expenses, etc.).

*  1& 2 


Application Procedures
Selection Procedures Period
(® Contact)
Check the invitation plan
NIIED will announce the 2011 invitation plan - List of the countries where scholarships
are available, requirements, application
October 20, 2010
forms, etc.
® www.niied.go.kr (HOT NE;S)
® www.gks.go.kr
Institutions in charge of recommendation of Check IRC¶s plan
qualified candidates ( 3%) will -Application deadline, selection procedures
Late October
announce their selection plan, which may be set by the relevant IRC, etc.
different depending on the institutions. ® IRC.
Submit the application documents and then
IRC will select candidates
November follow the set directions
® IRC
IRC will recommend the qualified
December 20
candidates to NIIED
Check the list of successful candidates
NIIED will announce the successful
Apply for a visa for the entry into Korea
candidates January 5, 2011
® www.niied.go.kr (NOTICE) or IRC
® www.gks.go.kr (SEE BELO;)
Check the entry itinerary and prepare for
IRC will notify NIIED of the grantee¶ entry
February 7~14 the entry into Korea
itinerary
® IRC
Grantees will enter Korea February 21 ~ 28 Enter Korea
Grantees will begin to take a Korean language
March 2 Begin to take a Korean language course
course
® Successful candidates can download their invitation letter and other important notes from the following site.
Ê www.gks.go.kr - KGSP APPLICATION - SUCCESSFUL CANDIDATES
Ê Access key: Candidateis family name followed by his/her birth-date (yymmdd2
Ex) when your famil y name i s AABBCC and your birth-date is March, 1, 1992 ĺ
AABBCC920301


# (
(1) Available Universities for 2011 KGSP grantees

Ajou Univ. Cheongju Univ. Chonnam National Univ. Chosun Univ. Chungbuk National Univ.
Chungnam National Univ. Daegu Univ. Daejeon Univ. Dong A Univ. Dongguk Univ. Dongseo Univ.
Ewha ;omans Univ. Gyeongsang National Univ. Hanllym Univ. Hankuk Univ. of Foreign Studies
Hannam Univ. Hanyang Univ. Hongik Univ. Inha Univ. Jeju National Univ. Jeonju Univ. KAIST
Kangwon National Univ. Keimyung Univ. Kongju National Univ. Konkuk Univ. Konyang Univ.
Kookmin Univ. Korea Univ. Kyonggi Univ. Kyunghee Univ. Mokpo National Univ. Myongji Univ.
Pai Chai Univ. Pukyong National Univ. Pusan National Univ. Seoul National Univ. Sogang Univ.
Sookmyung ;omen¶s Univ. Soon Chun Yang Univ. Sung Kyun Kwan Univ. Sunmoon Univ. Ulsan
Univ. ;oosuk Univ. ;oosong Univ. Yeungnam Univ. Yonsei Univ.

(2) Korean Language Course


Ê Institution: At an institution designated by NIIED
Ê Notes
Ê The grantee who has more than level 5 in TOPIK can be exempt from the preliminary Korean
language training and can start his/her bacheloris degree course.
Ê The grantee should reach level 3 in TOPIK after the completion of a Korean language course and
before starting a bachelor¶s degree course.
Ê In principle, the grantee is not supposed to leave Korea during Korean language training.
Ê The grantee must not bring his/her family to Korea during the Korean language training period. And
in case that s/he wishes to be accompanied by his/her family after completion of the language course,
the whole expenses for it should be borne by him/her.
- The grantee should have level 3 in TOPIK after completion of Korean language training and before
beginning a bachelor¶s degree course.
(3) Undergraduate Degree Program
iÊ Institution
Ê The grantee selected through the recommendation of a university: At the university which has
recommended him/her
Ê The grantee selected through the recommendation of a Korean embassy: At the university to which
s/he is admitted. (S/he may apply for admission to a university s/he would like to enter)
Ê Notes
Ê The grantee should make a preparation of the required documents for application for an admission to
a university.
Ê The grantee recommended by a Korean embassy will take a procedure for application for a university
admission while taking a Korean language course; as for information on application for admission,
please visit the university websites.
Ê If the grantee is needed to write a final thesis, it must be written in Korean in principle; i f the final
thesis must be written in another foreign language, s/he should submit its summary in Korean.
      
(1) Entry
iÊ Grantees must arrive in Korea by February 28, 2011. In case a grantee does not enter Korea by the

designated date without any special reason, his/her scholarship award will be canceled.

Grantees who will have finished high school as of September 1, 2011 and who will be able to have level 3
in TOPIK until then should arrive in Korea by August 30, 2011.
ßÊ Prior to arrival, grantees should acquire some knowledge about Korea and Korean culture, etc.

 Korean Language Study http://www.kosnet.go.kr


 Korean Universities http://www.studyinkorea.go.kr
 Korean Culture http://korea.net/
 The Korean Embassy abroad http://www.mofat.go.kr
 Entry & Residence http://immigration.go.kr.
öÊ Grantees are required to get a visa before arriving in Korea.
Ę Visa status: D-4 (Korean language course) or D-2 (Degree course)
Ę Visit the Consular section of the Korean embassy or consulate in your country of residence with an
invitation letter issued by NIIED upon the announcement of successful candidates.
The payment of the monthly allowance for the first month after arrival in Korea may be delayed. Therefore,
every grantee is advised to bring extra money to cover the living expenses for the period.
(2) Housing
i Grantees would reside in a university dormitory.
ß The dormitory fee will be deducted out of the monthly allowance by the university.
(3) Cancellation or temporary suspension of Scholarship
i If a grantee is found engaged in any of the following activities during his/her stay in Korea, his/her
scholarship will be suspended and then will be disqualified from a grantee position.
Ê ;hen any documents of the scholarship application has been found false
Ê ;hen the grantee is punished by the university or involved in any form of political activity
Ê ;hen the grantee has violated the written pledge which s/he has given to NIIED
Ê ;hen the grantee has violated the guidelines and regulations set by NIIED
Ê ;hen the grantee has been cautioned more than 2 times due to an unexcused absence or a prolonged
absence from the Korean language training or the temporary departure without permission or
notification
Ê ;hen the grantee has not earned at least 2/3 of the registered credit courses of the semester
Ê ;hen the grantee has not submitted a request for re-enrollment to the university and not notified
NIIED of re-enrollment without any proper reasons within one month after the period of µtemporary
absence from school¶ has ended
Ê ;hen the grantee has given up one¶s studies
Ê ;hen they refuse to study at the assigned university after s/he finished his/her Korean language
course
Ê ;hen an award holder returns to his/her country of origin or to another country for the purpose of
joining an exchange program similarly, operated by agreement on credit exchanges between the
Korean and foreign universities
Ê ;hen an award holder gets more than three warnings
Ê ;hen an award holder's TOPIK level is 0 after the completion of the Korean language course
Ê ;hen an award holder does not reach level 2 in TOPIK after the completion of the additional 6
month Korean language course
Ê ;hen an award holder does not reach level 3 in TOPIK after the completion of the additional 12
month Korean language course
ß Temporary suspension of scholarship
Ê ;hile taking a Korean language course, in special cases(e.g. funeral of his/her parents, his/her
wedding, treatment of illness, etc.), the grantee may leave Korea for a maximum of 2 weeks after s/he
gets the permission from NIIED; the scholarship for the period is not to be paid
Ê After the grantee begins his/her study at undergraduate course, s/he should obtain a proper approval
from the university where s/he studies in order to exit Korea for more than 30 days. His/her monthly
allowance is to be cut for the period of absence exceeding 30 days per semester

  
D  For application & submission of required documents <Refer to Attachment & CONTACT POINTS>
 The Korean Embassy or Consulate in the country of origin OR Korean universities
D For others except the above
 NIIED ;ebsite: http://www.niied.go.kr
[English version: Korean Government Scholarship Students ± G&A]







  Global Korea Scholarship [GKS]


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 ᏒK
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‫ږ‬ԩ ԭ Ῑ⽡⋆⋭ ೭Ꮡ⺁؉₹ ⺑

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5 ᗉ⯡৑

4 ዹᄱ₝ᰅṭ, Ꮶؑ, ₡೭੍ᰅṭ

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ẂؑႥ, ἁ᧝ᔽ೭ኝ, ἱ጑, Ῑԭ఍, Ῑ⦕Ⴅ₝ু, ₝Ⴉ, ₥ᘡ, ⠩৹, ⢒؉D
, ⧩⋩⧍ᯍ⧭,

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3 Ꮡ⋺‫إ‬ℾ:  ₝ঢ় ⺅‫ږ‬ờ Ἑᭁ ⿭ 4ⅅ ⺂᧕ ‫إ‬ℾ


Ę ఩⺂ ⳡ₮ ᚱԩ

4 Ꮡ⋺ᚭấ: ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Ό₝ ⋩ℾ⺅ ఩⺂ঢ় Յᩍ൅ 4ⅅ ⺂‫إ‬


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5 ⋩Ό₹‫ג‬
D  ⚽◅఩᧪‫ږ ږ‬K ᪵⁉₹ Dᘡ₡ ᔸ ᚩᏑ

Ę ⺅‫ږ ږ‬K ᪵⁉⺁⋩ ṳ⁩ ₹

D   3´ ₥ ⼭⃕, ድ 5ᩡ ᔡድ₡ ₹


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D4   3´ ₥ ⼭⃕ ☱, ∺, ؉บ⺂‫ ٹ‬ℭ ‫إ⁊ٹ‬ℾ ₝ᭁDἱℾ⺅ ₹

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D  ⺅‫ږ‬ỹᩅ ം₥ ‫إ‬ℾ₁ ⃎⺂ܱ ᕄ⁩ ᧕ᰍ₝ ữ஽ ₹

D  ⺅‫ږ‬ỹᩅ ⺂᧕ ‫إ‬ℾỹ บᆆ⺅ ᧕ᰍ₝ ữ஽ ₹


D8 ⺅‫ږ‬ờ ༹஽ Ἢờ ௎ᅎ Ῑᭁ₹ Ῑ఩

 ⋩Όᩅ ⅅ⛅
D  ⅅ ⛅ ◁: ⺅‫༹ ة ږ‬஽ ఩⺂ <þachmen &
ONTþ
T POINTS ╡↙>

D ⅅ⛅‫⺅ݙ‬: ᧪‫ةݙ ݙ‬₝ ℾ⺁஽ ‫ݙ‬₥‫⋩ݵ‬

D3 ⅅ⛅ᩅኁ
i ⋩Όᩅ ᚩ D᪵ℾẺᰆ:  

ß ᩅẦᩅ D᪵ℾẺᰆ: 

ö ₹‫ ݙ‬᪵Յᩅ D᪵ℾẺᰆ: 3


ᭁ⺂‫⾶׭‬ᩅ D᪵ℾẺᰆ: 4

$ ⚽◅ᩅ ᚩ D᪵ℾẺᰆ: ⚽◅₹ ⁥ᆅᚩ⩙ Ԫ ᚩ, 5

Ę ⋩೭‫᧕ٹ‬, ⛅ᰉ⺂‫⃎ٹ‬, ⋩೭‫ٹ‬ᭁ,


O บ
Σ ₹‫֝ ݙ‬Ծ ⋭఑ᩅ D᪵ℾẺᰆ:  

Τ ₁᧕ԩ ᕅܲ⺅ Ἢᑡ ֝Ծ ⋆ᩅ D᪵ℾẺᰆ:  

Ę ⚽◅‫ةݙ‬ỹᩅ ⃎⺂ᨆ ⿭ᘝᆅ ℾ⺅ ₹ỹ ⺅⺑


' ؉บ⺂‫↡ ٹ‬Ữ⋆ᩅ ᚩ
Φ ؉บ⺂‫ ٹ‬ᩚK⋆ᩅ ᚩ
Χ ᘡ₡ ἕÿ ᧕ᘡ
ĘÊ ἕÿ ⅅ⛅₝ ờ  ÿῙ, ἕÿ ᕅܲ ᰉ◖ᩅ บ ⅅ⛅⺁ἕấ ⺑
ƒ ᘡ₡ ᔸ ᚩᏑ₁ ᾡ‫ږ ږ‬K ₡⺉ ᭁ ₱஽ ⋆ᩅ ᧕ᘡ
ĘÊ ⛅ᨆ⋆ᩅ ༹஽ ἕÿ ᧕ᘡ บ
š ⺅‫ږ‬ờ ༹஽ Ἢờ ₡ ᩚK ⋆ᩅ ᧕ᘡ D᪵⋩₹ỹ ⺅⺑,  3´ ₥ ‫ݙ‬ÿ  ₝ঢ়
D4 ⁉₁᧕
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ᕄṭấ ⺑
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₝እ ‫ةݙ‬ỹ ÿᘝ⺁ἕấ ⺑
ß ⋩Όᩅ₁ Ἢờ ᩚ₁ ₹஽ ÿฅᰅ ἕÿ₁ ÿ‫إ‬ ṭấ ⺑
ö ᰉ◖ᩅእ ᝭ÿ⺅ Ꮡฉ ᩅኁ஽ ⺅‫ږ‬ờ ༹஽ Ἢờᆅ ÿᩚấ ⺁ÿ, þ4 ‫ג܅‬₝ờấ ⺑
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þ4 ‫ג܅‬ᘝ఍ ÿῙ, þ4 ‫ג܅‬ỹ ÿ೭ᆆ ờᩅ ⅅ⛅⺁ἕấ ⺑
ᩚK⋆ᩅ ‫ة‬ÿ, 5D5  ⋆⺁஽ ᩅኁእ ⅅ⛅⺁ἕấ ⺑
Ę ⺂‫ٹ‬ỹᩅ ᕅܲ⺁஽ ⋆ᩅᆅ ം ᧕  ₡⺉ ᭁ ữ஽ ÿῙ, ⺂‫⃎ٹ‬₁ ÿ೭
₡ᩅD⺂‫ٹ‬ ₡ ༹஽ ⺂‫᧕ ⃎ٹ‬₡ ⴕ⺑ ⹭እ ⅅ⛅⺁ἕấ ⺑
$ Ԫ↮ ⋆ᩅԩ ⺅‫ږ‬ờ ༹஽ Ἢờᆅ ÿᩚ൅ ÿ₝ ṭÿ ÿῙ ÿฅᰅ ⋆ ᘡ ÿᚩấ ⺑
Ę ⋆ᘡ₝ ₱ ÿῙ, ⋆ᘡ Όᘡ ỹ ℾÿ⺑
Σ ᘡΌ ᪵ℾẺᰆ ₝ᾡ₁ ᩅኁ஽ ᧪఑ Ῑ ỹ ᩅኁ ÿᩚ⺁ἕấ ⺑
Dἱ  ' iÿh School iploma
Τ ⋩Όᩅ ⅅ⛅ᰅ Ꮡ⋺᾽Ծ ⋩Όᩅኁ Ꮢᆆ ⁥ᆅ ℾÿ⺁೭ᆆ ⺁؉, ዦ⁥ᆅ ⺁೭ᆆ ⺑
Ę Յ ᩅኁእ ᯍ⩵₝ÿᆅ ⺉ ᭁ஽ ₱⁥ু, ⋩Ό ᩅኁ ℭ◝እ ᯍ⩵₝ÿᆅ ⺁ ু ⭕
ⰵ₥ỹ ⺁ুÿ  ⅅ⛅⺁⋩ ṳ೭ᆆ ⺑
' ⅅ⛅⺅ ᩅኁ஽ ₥◝ ÿ⺁⋩ ṳ⁵
Φ ⅅ⛅ ᩅኁ₁ ‫ ⃕ݙ‬ঢ় ₝ ᚩℾ ⺁ ু ᔡ᝭ ᩅኁԩ ₱஽ ÿῙỹ஽ ᕅ ఩᧪ỹᩅ ⅅᾡ⺑

 ⃎⺂ܱ ⋩ܲ
D  ⋩ܲ‫ݙ‬ԭ:  3 ÿ  8
D ⋩ܲঢ়
i ÿ ༹஽ ᇵ: ⚅☱ ₮‫ ږ‬ᰅ ᔸ ⚅↮ ‫ ږ‬ᰅ ᩅÿ‫إ‬ ‫⚅ ږ‬఑ ዕ ‫ږ‬ⅅ ԭ
ᘝÿ ÿ ༹஽ ᇵ ⋩ܲ
ß ᨆÿ᝭: ´ 8,Ό
ö ⺂᝭: ℭ ⺂‫ ݙ‬บᆆܱ⁩ ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Όỹᩅ, ₮⺂ܱ⁩ ఩⺂ỹᩅ ⋩Ό
ℾÿ⋩Όܱ: ⚅☱ ₮‫ ږ‬ᰅ ,Ό
$ ‫ږ‬ÿ᝭ܱ: ⚅↮ ‫ ږ‬ᰅ ,Ό
Σ ờ⺂Ἑᭁ᝭: ᘡΌ₝ ⋩ℾ⺅ ‫ةݙ⁊ٹ‬ỹ ⋩ܲ
Τ ₁ᇵᘝÿ: ⃎⺂‫ݙ‬ԭ ∺ ⋱ᗺ, ᧪, ᧕؉ บỹ ఩⺅ ᘝÿᇵ
D3 ⁉₁᧕
i ⃎⺂ᨆ₁ ₹‫ ږ‬ঢ় ₝ം ᔸ ⺅‫ ږ‬ঢ় ₝ം ᇵ஽ ⋩Ό⺁⋩ ṳ⁵
ß ⃎⺂ᨆ ℾ ᕅ ÿᘝ₥ᆅᚩ⩙ ₮‫⺅ݙ ږ‬D 8‫ږ⺅ ⋩ݵ‬ỹ ◝ኁ ∺₡ ₹஽
₮‫ږ‬ ᇵእ ⋩ܲ⺁⋩ ṳ⁵
ö ₮‫ ږ‬ᔸ ‫ږ‬ἕ ỹ ÿ ᘝÿᇵ஽ ⋩Ό⺁⋩ ṳ⁵
₁ᇵ᝭஽ ⃎⺂ᨆ₝ ᗺΌ ༹஽ Ầ‫ږ‬ỹ  ⿭ ᘝÿ᧕እ ÿ ᚱ
$ ⃎⺂‫ݙ‬ԭ ঢ় ∺೭ ⴕ‫₹ݙ‬ỹֵ஽ ᾡ‫ٹ‬ ‫׭ة‬₁ ఑ÿ, ℭ , ‫⧩ݙ‬ ◅⃕⋩ÿ บ
‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Ό₝ ₡ℾ⺁஽ ÿῙእ ⅅᾡ⺁؉ ‫ ږ‬ᇵ ‫ږ‬ÿ᝭ܱ ⋩Ό⺁⋩ ṳ⁵
Σ ⺅‫ ږ‬₮‫ ⿭ ږ‬3Յ´ ₝ঢ় ∺೭ ⴕ‫ ⺅ݙ‬ÿῙ, ⃎⺂ܱ ℭÿD₮‫ږ‬ ᇵ, ℾÿ⋩Όܱ, ᨆÿ᝭,
⺅‫ږ‬ờ Ἑᭁ᝭ บ ÿ⺁ἕấ ⺑
8 ᕅD⋩Ό ÿ
ᕅ ÿ ₥ℾ ⋩Ό ÿ D® ᑡ₁◁
⃎⺂ᨆ Ꮡ⋺ ‫ ⾶׭‬₡
[‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬ΌDNII]
 ☱◖ ఩᧪‫ ږ‬ᔸ ‫ږ‬ԩÿ ₡Ό, ⋩Ό
⃎⺂ᨆ Ꮡ⋺ ‫ ⾶׭‬ᕅ
   Dᭁ ₹‫ג‬, ÿ᝭ ᩅኁ บ
® niieÿÿor DOT NS
® ÿsÿor
[⃎⺂ᨆ ⿭ᘝ ⚽◅‫ةݙ‬D₝⺁ ⚽◅‫]ةݙ‬ ⚽◅‫⺂⃎ ةݙ‬ᨆ ᕅ ‫ ⾶׭‬₡
⃎⺂ᨆ ᕅ ‫ ⾶׭‬ᕅ  ⃎⺂ᨆ ⋩Όᩅኁ ⅅ⛅‫ ⺅ݙ‬ᔸ ᕅ
  ´ ⺁
Ę ₥ℾ ᔸ ᕅ ఩᧪ บ ᩡᚩ ঢ় ⁩ ℭ ᕒÿ บ
‫ةݙ‬ỹ ÿႥ ఍እ ᭁ ₱⁵ ® ⚽◅ ‫ةݙ‬
⋩Όᩅ ⅅ⛅ ᔸ ᕅ ℭ ᰅ
[⚽◅ ‫⺂⃎ ]ةݙ‬ᨆ ⿭ᘝ ᕅ   ´
® ⚽◅ ‫ةݙ‬
[⚽◅ ‫⺂⃎ ]ةݙ‬ᨆ ⿭ᘝ ⚽◅    D´
ÿ‫ ג‬ἕᚩ ₡ ᔸ ᝭₹ᰉ◖
[NII] ⚅↮ ÿ‫ ₹ג‬ᕅ    5Dᭁ ® niieÿÿor DNOTI

® ÿsÿor
[⚽◅ ‫⺂⃎ ]ةݙ‬ᨆ ₮‫ ږ‬₥ℾ ÿᘝ ₮‫ ږ‬₥ℾ ₡ ᔸ ₮‫ ږ‬ÿ᝭
 D´ÿ  4D´
D NII ®⚽◅ ‫ةݙ‬ ⺅‫ږ‬ờἙᭁ‫ةݙ‬, NII

⃎⺂ᨆ ⺅‫ ږ‬₮‫ږ‬  D´ÿ8D´ ⃎⺂ᨆ ⺅‫ ږ‬₮‫ږ‬

⃎⺂ᨆ ⺅‫ږ‬ờ Ἑᭁ ᰅÿ 3 Dᭁ ⃎⺂ᨆ ⺅‫ږ‬ờἙᭁ ᰅÿ

® ÿ‫₹ג‬஽ ṭჁ ᧕₝⯡ỹᩅ ☱◖⃎i ᔸ ÿ‫⁉ ₹ג‬₁᧕ i ᧕₝⯡ỹᩅ ఍ᆅฅ ᕄṭ



 ÿsÿor  KGSP þPP I
þTION  Sÿ

SS ÿ
þNIþTS
  ₡⋆⧍: ⃎⺂ᨆ₁ ᩚD amilÿ name ᨆ´₥Dÿÿmmii
ἱ ᩚ₝ þþ

₝ ؉ , ᨆ  ´ ₥ ₝ 99  3 ´ ₥₥ ÿῙ þþ

93

9 ⃎⺂ᨆ ᭁ⺂
D    ⃎⺂ᨆ ᭁ⺂ ԩ௎ ఩⺂

ԾΌ఩ , ֝‫ږ‬఩ , ֝Ẻ఩ , ÿ‫ݙ‬఩ , ÿ᧪఩ , ÿ఩ , ‫׭‬఩ , ؉ ఩ , ఩ , ‫ږ‬ᔥ఩ ,


఩ÿ఩ , ఩ℭ఩ , ം‫ږ‬఩ , ംᩅ఩ , ംṭ఩ , ⋩఩ , Ꮢⴕ఩ , ᕙ⃕఩ , ᚩÿ఩ , ᚩÿ఩ ,
ᩅԾ఩ , ᩅÿ఩ , ᑡ఩ , ᩚ‫ة܉‬఩ , ἕ఩ , ◅ÿ఩ , ṭ఩ , Ἑᩡ఩ , Ἢ৑఩ ,
Ῑ఩, Ῑ ఩, ÿÿ఩, ₝ÿἕ఩, ₡⺁఩, ℭ৑఩, ℭ఩, ⅅ఩, ↙ ఩,
◖఩, ৑఩,  ఩ , KþIST, ⺅ ‫ ږ‬ᾡ ఩ , ⺅ ৑ ఩ , ⺅ ÿ ఩ , ⺅Ẻ఩ , ఩

D ⺅‫ږ‬ờ Ἑᭁ
iÊ Ἑᭁ‫ةݙ‬: ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Ό₝ ⋩ℾ⺅ ⺅‫ږ‬ờ Ἑᭁ ‫ةݙ‬
ßÊ ⁉₁᧕
 TOPIK 5ܲ ₝᧪ ᪵⋩⺅ ₹஽ ⺅‫ږ‬ờ Ἑᭁ ữ₝ ⺂‭‫إ‬ℾỹ ⋭⺂⺉ ᭁ ₱⁵
 ⺅‫ږ‬ờ Ἑᭁ ↮ᇵ ⿭, ⺂‭‫إ‬ℾ ⋭⺂ ℭ‫ ⋩ݵ‬TOPIK 3ܲ ✑ฆ⺁ἕấ ⺑
 ⺅‫ږ‬ờ Ἑᭁ‫ݙ‬ԭ ംÿ  ⃎⺂ᨆ⁩ ⺅‫ږ‬ỹ ◝ኁ⺁஽ ÿ Ό ⁥ᆅ ⺑
 ⺅‫ږ‬ờ Ἑᭁ‫ݙ‬ԭ ∺ỹ஽ ԩÿംÿ ⺉ ᭁ ữ⁵ ₝⿭ ⃎⺂ᨆ₝ ԩÿ ംÿ⺉ ÿῙ,
₝ỹ ᪵᾽ÿ஽ ÿ᝭ ₥◝஽ ⃎⺂ᨆ ᘡ₡₝ ᚩ ⺁ἕấ ⺑
D3 ⺂᧕‫إ‬ℾ ᭁ⺂
iÊ ᭁ⺂‫ةݙ‬

Ê ఩⺂ ⚽◅ ᕄṭ ᕅ൅ ⃎⺂ᨆ: ⚽◅ ఩⺂
Ê ⃕ᾡ‫ ◅⚽ ة‬ᕄṭ ᕅ൅ ⃎⺂ᨆ: ᘡ₡₁ ỹ ÿႥ ₮⺂ÿԩእ ᕄ⁩ ఩⺂
ßÊ ⁉₁᧕
 ఩⺂ ₮⺂ỹ ⹭᾽⺅ ᩅኁ஽ ᘡ₡₝ ÿ᝭⺁ἕấ ⺑
 ⃕ᾡ‫ ◅⚽ ة‬ᕄṭ ᕅ൅ ⃎⺂ᨆ⁩ ⺅‫ږ‬ờἙᭁ ∺ỹ ఩⺂ ₮⺂ ⋩Ό ⺁ֵ
₮⺂ ‫ة‬ÿ ℾᘝ஽ ఩⺂₁ ᧕₝⯡እ ╡؉⺁‫ ݙ‬ᔽÿ
 ↡Ữથᑡ ÿᩚấ ⺁஽ ÿῙ, ⺅‫ږ‬ờᆅ ÿᩚ⺑ Ό ⁥ᆅ ⺑
Ę ᾡ‫ږ‬ờᆅ ÿᩚ⺉ ⹭᾽ԩ ₱஽ ÿῙ, ⺅‫ږ‬ờ ᾽Ầᘡ ⅅ⛅ấ ⺑

 ⃎⺂ᨆ ⁉₁᧕
D  ₮‫ږ‬
i ᕅ൅ ⃎⺂ᨆ⁩ ⋩ℾ₥‫ ⋩ݵ‬D 8‫ ⋩ݵ‬₮‫⺁ږ‬ἕấ ⺑ ⋩ℾ൅ ‫ݙ‬₥ ঢ়ỹ ₮‫⋩⺁ږ‬
ṳ ÿῙ ⃎⺂ᨆ ₹‫ג‬₝ ✑᪵ ᭁ ₱⁵
Ę  9 ⼭⃕ ؉บ⺂‫↡ ٹ‬Ữἱℾ₹ᆅ TOPIK 3ܲ ₝᧪ ✑ฆ₹஽  8´ዹ‫⋩ݵ‬
₮‫⺁ږ‬ἕấ ⺑
ß ⃎⺂ᨆ⁩ ₮‫ ږ‬ℭỹ ⺅‫ ږ‬ᔸ ⺅‫ ږ‬ᑡÿ บ₁ ᧕ℭ Ἑÿԩ ⹭᾽⺑
 ⺅‫ږ‬ờ⺂ÿ hp: osneÿor
 ⺅‫ږ‬ঢ় ఩⺂ hp: sÿÿinoreaÿor
 ⺅‫ږ‬ᑡÿ₝ hp: oreane
 ⃕ᾡ⺅‫ةږ‬ hp: moÿaÿor
 ₮‫ ږ‬ᔸ ◝ኁ hp: immiÿraionÿor
ö ₮‫ ږ‬᝭₹஽ ⺅‫ ږ‬₮‫ ږ‬ℭỹ ⃎⺂ᨆ ᘡ₡₝ ᕅܲᕄṭấ ⺑
Ę ⃎⺂ᨆ ℾÿᘝእ ᕄ⁩ ⿭ ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Όỹᩅ ᕅܲ⺅ ☱◖⃎ ⋩╡⺁؉ ⛅ᰉ‫ږ‬
⺅‫ ةږ‬Ἢ᧕‫إ‬ỹ ᰉ◖
₮‫☱⚅ ⿭ ږ‬ Յ´ᚭ ⃎⺂ܱ⁩ ⺂‫ ݙ‬ᰅÿ⁥ᆅ ₡⺁ἕ ֵ ⋩ܲ ᭁ ₱⁥ÿᆅ ₮‫ ږ‬ᰅ
⚅᪵⺅ Յ´ ᚭ₁ ᨆÿ᝭እ ⋩╡⺁஽ ÿ₝ ᔽÿ ⺑
D ᪵
i ⃎⺂ᨆ⁩ ⺅‫ږ‬ờ Ἑᭁ ᔸ ⺂᧕‫إ‬ℾ ᭁ⺂ ఩⺂₁ ‫᧕ ݙ‬ỹᩅ ᨆÿ⺁ֵ
ß ‫᧕ ݙ‬᝭஽ ᘡΌỹᩅ ⋩Ό⺁஽ ᨆÿ᝭ỹᩅ ⅅ⺑
D3 ⃎⺂ܱ ⋩ܲ∺఑ ᔸ ₥ᰅ ℾ⋩

i ఍⁵₁ ÿῙỹ஽ ⃎⺂ᨆ ₹‫᧪ ג‬ᰍ⺁؉ ⃎⺂ܱ ⋩ܲ ∺఑⺑

 ⃎⺂ᨆ⋩Ό‫׭ة‬ᩅኁ ᔸ ‫ ⧩ݙ‬ⅅ⛅ᩅኁԩ ÿ‭ᆅ ÿᩚÿ⁵₝ ฅᄕ  ÿ


 ᪵‫⁥ةݙ⁊ٹ‬ᆅᚩ⩙ ‫◁׭‬ᚭ ᕄÿ ু ℾ➁ÿം ⺅ ÿ
 ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Όỹ ⅅ⛅⺅ ⃎⺂ᨆ ᩅẦᩅ₁ ঢ়  ‭ÿ ÿ
 ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Ό₝ ℾ⺅ ℾᚩ☱◖ᾡ‫ږ‬₡⃎⺂ᨆ ⺂᧕⋩ ỹ ÿኝ⋩ ṭ௱⺅ ÿ
 ÿ఑ ₥ᰅ ⛅‫༹ ږ‬஽ ⺅‫ږ‬ờἙᭁ‫ةݙ‬₁ ⃕⺂ ∺ ÿ఑  ᔸ ⃎‫⁥ ݙ‬ᆅ ₡⺁ἕ

ÿ؉◁ᚭ  ₝᧪ ᕄ ÿ

 ⃕⺂ ∺  ⺂‫ݙ‬ỹ ᭁԾ ᰉ◖⺅ ‫إ‬Ꮢ ⺂ ₁  3 ₝᧪ ✑ฆ⺁⋩ ÿ⺅ ÿ


 ⺂‫ݙ‬ԭ ↮ᇵ ⿭ ℾ ⺅ ᧕⁉ ữ₝ Յ´ ₝ঢ়ỹ ⺂Όᩅእ ⅅ⛅⺁⋩ ṳ ÿ

 ∺೭ⴕ‫  ݙ‬ÿ

 ⺅‫ږ‬ờ Ἑᭁ ↮ᇵ ⿭, ₮⺂⺁‫ݙ‬ᆅ ⺅ ఩⺂ỹ ⋭⺂⺁⋩ ṳ ÿ


 ᾡ‫ږ‬఩⺂‫إ‬₁ ⺂ ‫ٹ‬ኁ บ₁ ᏒKD‫⺂ٹ‬ᨆ บ⁥ᆅ ⛅ᰉ‫༹ ږ‬஽ ⅅ3‫ږ‬ỹ ⛅‫ ⺅ږ‬ÿῙ

 ÿ؉ 3⾵ ₝᧪ ᕄ⁩ ÿ

 ⺅‫ږ‬ờἙᭁ ⿭ TOPIK ÿܲ₡ ÿ


 Յ´ ⺅‫ږ‬ờ ⚽ԩ Ἑᭁ ⿭ TOPIK ܲỹ ᔡ೭ÿ⺅ ÿ

 Յ´ ⺅‫ږ‬ờ ⚽ԩ Ἑᭁ ⿭ TOPIK 3ܲỹ ᔡ೭ÿ⺅ ÿ

ß ఍⁵₁ ÿῙỹ஽ ⃎⺂ܱ ⋩ܲ ₥ᰅ ℾ⋩⺑


 ⺅‫ږ‬ờἙᭁ ‫ݙ‬ԭ ∺ ⛅‫⺁ږ‬஽ ÿῙ ᪵ ⺅‫ږ‬ờἙᭁ‫⃎ةݙ‬₁ ÿԩእ ᕄṭấ ⺁ÿ, 

‫ݙ‬ԭᚭ ᨆÿ᝭஽ ⋩ܲ⺁⋩ ṭ௱⺑

 ⺂‭‫إ‬ℾ ⋭⺂ ⿭ ⺂‫ݙ‬ ⾵ 3₥ ☱‫⺁إ‬ἕ ₥ᰅ ⛅‫⺁ږ‬஽ ÿῙ ᪵ ఩⺂₁ ₡


ᕄṭấ ⺁ÿ, 3₥ ₝᧪₁ ☱‫ݙ إ‬ԭᚭ ᨆÿ᝭஽ ⋩ܲ⺁⋩ ṭ௱⺑

 ᑡ₁◁
D  ⋩Ό ᔸ ⋩Όᩅ ⅅ⛅ ‫ة‬ÿ ᧕
  ‫ږ⺅ ⃕ ږ‬఩᧕‫༹ ة‬஽ ఩⺂ <þachmen &
ONTþ
T POINTS ╡↙>
(2)Ê D  ₝ᾡ₁ ᧕
 ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Ό ᧕₝⯡: niieÿÿor
[nÿlish ÿersion  Korean Goÿernmen Scholarship Sÿens  &þ]

& &4567 !-  %8

* You should apply for the program ONLY THROUGH the KOREAN UNIVERSITIES
8 if
you come from the following countries;
- Brazil, East Timor, Hungary, Japan, Kenya, Nigeria, Pakistan, Poland, Romania, Tanzania,
Uganda
* You should apply for the program ONLY THROUGH the KOREAN EMBASSIES (or
CONSULATE) OF YOUR ORIGIN
68 if you come from the following countries;
- Afghanistan, Angola, Bolivia, Brunei, Bulgaria, Congo (DRC), Dominican Republic,
El Salvador, Gabon, Guinea Bissau, Iran, Lebanon, Mexico, Mauritania, Panama,
Paraguay, Russia, Senegal, Sweden, Tajikistan, Togo, Turkmenistan, Ukraine, Yemen
* If you come from the other countries except above mentioned countries, you may apply for the
program either through the KUs or through the KE.


NO
OÿNT  I
NO
OÿNT  I

K Kÿ K Kÿ
þ GþNISTþN 3 ÿI
O
 þNGO þ 3 ÿONGO Iþ  
3 þ þI þN 33 ÿþÿ ITþNIþ
4 þNG þS 34 ÿþNÿþ 
5 O IÿIþ 35 NPþ
 þI 3 NIG Iþ
 ÿNI 3 PþKISTþN 
8 ÿ Gþ Iþ 38 PþNþÿþ
9
þÿOIþ  39 Pþ þGÿþ

OÿO Iþ 4 P ÿ

ONGOD
 4 PI IPPINS 
 OÿINI
þN Pÿ I
4 PO þN
3 þST TIÿO 43 OÿþNIþ
ÿSSIþ Dÿosco 
4 GPT 44
ÿSSIþ Dÿlaÿiÿoso
5  Sþ ÿþO 45 SNGþ
TIOPIþ 4 SINGþPO 
GþON 4 S I þNKþ
8 GþNþ 48 SN
9 GÿþTÿþ þ 49 Tþ IKISTþN
 GÿINþ ISSþÿ 5 TþNþNIþ
 ÿNGþ  5 TþI þN 
 INONSIþ   5 TOGO
3 I þN 53 Tÿ K
4 þPþN 54 Tÿ KÿNISTþN
5 KþþKSTþN  55 ÿGþNþ
 KNþ 5 ÿK þIN
 K GSTþN 5 ÿKISTþN
ÿITNþÿ Danoi 
8 þOS  58
ÿITNþÿ Do
hi ÿinh
9 þNON 59 ÿN
3 ÿþ þSIþ  


%098

 7& %7 % %7& &7


 (   & : 

 English Name Spelling MUST be exactly the same as in your passport


First name / Given name / Middle name

 ఩⺅ᔥ‫ږ‬ℾᚩ☱◖ᾡ‫ږ‬₡ ⺂ᚩ⃎⺂ᨆ ⋩Όᩅ


Dþpplicaion ÿor  KGSP ÿor an ÿnÿerÿraÿae
orse



K IST DSbmission oÿ e ireÿ ocmens

   
   
    
   

Original Official Notarized


List of Required Documents
Document Translation

i ⋩Όᩅ
One Complete Application Form
& N/A

ß ᩅẦᩅ
One NIIED Pledge
& N/A

ö ₹‫ݙ‬᪵Յᩅ
One Self-introduction Essay
& N/A

ᭁ⺂‫⾶׭‬ᩅ
One Study Plan
& N/A

$ ⚽◅ᩅ 2 ᚩ
2 Recommendation Letters
& N/A

Σ ₹‫֝ ݙ‬Ծ ⋭఑ᩅ & N/A


On e Per s ona l Med ica l Ass ess ment
Τ ₁᧕ ᕅܲ ֝Ծ⋆ᩅ
On e Hea lt h Cert ifica t e aut h or ized b y a M. D.
' ؉บ⺂‫⺂ ٹ‬‭⋆ᩅ
One Copy of High school Diploma
& N/A

Φ ؉บ⺂‫ ٹ‬ᩚK⋆ᩅ
One Copy of High school Grade Transcript s
& N/A

Χ ᘡ₡ ἕÿ ᧕ᘡ
One Copy of the Applicant's Passport
& N/A

ƒ ᘡ₡ ᔸ ᚩᏑ ‫ږ‬K ⋆ᩅ
One Certificate of Citizenship of the Applicant and his/her Parents & &
: birth certificate, passport, etc .
š ⺅‫ږ‬ờ ༹஽ Ἢờ ௎ᅎ ₡ ₡⋆ᩅ Ƒ K.P. N/A
One Copy of Certificate of Korean or English Proficiency & E.P.
T ‫ ⧩ݙ‬Others [;rite down the name(s) below]

Portfolio & N/A

1/3
 þPP I
þTION
Ę    &
   
        


k ₡K ᧕  1  2(English Name Spelling MUST be exactly the same as in your passport)
₹‫ږ‬ờ ™™ 
 ™™ -
(Native
ᩚ language) ᩚ(Family Name) ₝ÿ(First Name) Middle Name
(Full Name) ἕÿ ᧕⋭
Ἢờ* SIRISORNPATTAPON PONPASSORN - (Passport Photo)
(English) 3cm ×4cm
ᩚ(Family Name) ₝ÿ(First Name) Middle Name
ᩚÿ k Male ᨆ´₥(Date of Birth: yyyy/mm/dd) 1992/10/12
(Gender) & Female ἕᚩ(Marital Status) & Single k ÿarried
⛅ᨆ⋩ Bangkok/Thailand ἕÿ ⽡ E956179
(Place of Birth) City/Province and Country (Current Passport Number)
‫ږ‬K Thai ἕÿ ⁉ ‫ݙ‬ԭ 11 OCT 2015
(Nationality) (Passport Expiration date)
ĘIn English only.
᪵
88 Soi Ramkhamhaeng60 Yeak2 Ramkhamhaeng Rd., Huamark, Bangkapi, Bangkok, Thailand
(Address)
Postal-Code10240 
ℭÿ + 66 -2 - 7293608
₹
(Phone) Country Code / Area Code / Phone Number
(Home)
఩ℭÿ + 66 - 83 -2692179
(Cell Phone) Country Code / Cell Phone Number
₝፽₥
so-what1@live.com
(E-mail)
ĘIn English only
᪵
Triam Udom Suksa School, 227, Phya Thai Road, Bangkok, Thailand
(Address)
Postal-Code 10330
⛅ᰉ؉บ⺂‫ٹ‬ ℭÿ + 66 -2 - 2527302
(High School) (Phone) Country Code / Area Code / Phone Number
ᯍ + 66 -2 - 2511889
(Fax) Country Code / Area Code / Fax Number
k ᚭấ Desireÿ ielÿ & ÿaÿor
& ₡ᑡ᧕⾵‫׭‬ Dmaniies & Social Sciences  ℭ
 ‫׭‬
k ₹Ἑ⺂‫׭‬ DNaral Sciences & nÿineerinÿ Desireÿ Teleÿision & ilm
Desireÿ ielÿ
k ἱ◝௎‫׭‬ Dþrs anÿ Phÿsical ÿcaion ÿaÿor
k ÿờ௎ᅎ 1;(2 
ÿờ ᰅÿ ᩚK ᰅÿ₥ ᭁÿ(Level)

(Language) (Title of Test) (Score) (Date of Test) Adv. Int. Beg.


⺅‫ږ‬ờ (Korean) - - - - - -
Ἢ ờ (English) TOEIC 745 2010/10/26 - - -

k ⺂ᅎ 16 !<4 2! Please list most recent first .


‫ݙ‬ԭ: Ἑ´₥ ‫ةݙ‬ ᪵⃕⋩ ᩚK ✑ฆ⺂‭

(Period: yyyy/mm/dd) (Institution) (Location: city/country) (Grade) (Diploma)

2008/05/15 ± 2011/02/25 Triam Udom Suksa School Bangkok/Thailand 10 ± 12 Certificate

2005/05/15 ± 2008/02/25 Bodin Decha (Sing Singhasenee) School Bangkok/Thailand 7-9 Certificate

1999/05/15 ± 2005/02/25 Bann Bangkapi School Bangkok/Thailand 1-6 Certificate

2/3
k ÿᅎ 1=>6?2!Please list most recent first.
᪵⃕⋩
‫ݙ‬ԭ: Ἑ´ ÿ◁ ⋩‭ ℭÿ
(Location)
(Period:yyyy/mm) (Institution or Company) (Position) (Phone)
city/country
- 9 9 9 9
k ԩÿ᧕  1, (@>2
‫׭ة‬ ᩚ ᨆ´₥ Ữ ⋩
(Relationship) (Name) (Date of Birth) (Occupation) (Address: district, city)
88 Soi Ramkhamhaeng60 Yeak2
Mother SIRISORNPATTAPON PAKLID 1954/07/13 Business owner Ramkhamhaeng Rd., Huamark,
Bangkapi, Bangkok, 10240, Thailand
88 Soi Ramkhamhaeng60 Yeak2
Father TATANA;AT ;ATCHARA;ONG 1952/05/31 Housewife Ramkhamhaeng Rd., Huamark,
Bangkapi, Bangkok, 10240, Thailand
k ⺅‫ةݙږ‬ỹᩅ ᭁἕᕄ⁩ ⃎⺂ܱ 1
 &)%
    2
⃎⺂ܱ ‫ݙ‬ԭ: Ἑ´₥ ᚭấ ᔸ ᭁἕ‫ةݙ‬
(Title of Award) (Period: yyyy/mm/dd) (Field & Institution)
- - -
k ‫إ‬ ⺅‫ږ‬ỹᩅ₁  ༹஽ ◝ኁ ᧕ᰍ 1
A  2
‫ݙ‬ԭ: Ἑ´₥ ⋩ ᏒK  ༹஽ ◝ኁ‫ة‬ÿ‫ةݙ‬
(Period: yyyy/mm/dd) (City or Region) (Purpose of Stay) (Organization Concerned)
- - - -
k ᰉΌᘝ⋆₡ ఑ 1; %2
ᩚ ⋩‭ ‫ةݙ‬ ℭÿ ₝፽₥᪵
(Name) (Position) (Organization) (Phone) (E-mail Address)
Ê

THE ANS;ERS I HAVE GIVEN ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNO;LEDGE.
IF MY ANS;ERS CONTAIN ANY KIND OF FALSEHOOD, I ;ILL TAKE ANY LEGAL RESPONSIBILITY.

DATE(yyyy/mm/dd): . .

SIRISORNPATTAPON PONPASSORN

NAME OF THE APPLICANT SIGNATURE OF THE APPLICANT


3/3

%09c8 
ᩅ Ầ ᩅ
12

 ু஽ ⺅‫ږ‬ℾᚩ☱◖ ⺂ᚩ⃎⺂ᨆ⁥ᆅᩅ ఍⁵ ᧕  ⋩ÿ ÿ ᩅẦÿ௱఍


(1)Ê ⺅‫ ږ‬ঢ় ఩⺂₁ ⺂ บỹᩅ ℾ⺅ ‫ ܅‬ỹ ÿႥ ⚅  ఍ᩅ ⺂Ữ‫ إ‬Ἑÿỹ ℭ ⺅఍
(2)Ê ⺅‫ږ‬₁ ᧕⾵⋱ᩅእ ‭ÿ⺁⋩ ṳ೭ᆆ ം⺉ ÿ₝ÿ, Ꮡฉ ℾ➁ÿം Dℾ➁ᏒK₁
⋺⾵ÿᰅ‭ỹ₁ ╡ԩ, ℾ➁ ᧕, ℾ➁K₡ થᑡÿ ÿ₁ ᕅ บ ⺁⋩ ṳ஽఍
D3 ⺅‫ږ‬ỹᩅ ÿእ ⋭ ÿῙD‫ږ‬ঢ় ‫ݙ‬ԭ ঢ় ₹‫ݙ‬ԩ ÿ₭⋩؉ ÿⅅ⺅఍
D4 ⺅‫ږ‬ờἙᭁ ᔸ ⺂‭‫إ‬ℾ ᭁ⺂‫ة إ‬ÿ⺁ἕ ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Ό₝ ℾ⺅ ᕒ ỹ ờ ⺅
₝₁೭ ⅅ‫ ⋩⺁ݙ‬ṳ؉ ÿ఍
D5 ‫ږ‬ዦ‫ږ‬ⅅ‫⁊ٹ‬Ό₝ ℾ⺅ ⺂᧕ ℾ ↙➁᧕ ỹ Kÿ ↙⺁؉ ₝እ ÿᭁ⺅఍
D  ⸭ᆅ‫ܡ‬ბ Ἢ᧪ ⹭᾽⺁ ু ⧩ ℾᚩ ‫ةݙ‬₁ ᾽◖₝ ₱஽ ÿῙ ᘡ₡₁ Յ₡ℾᘝ
D₝ÿ,
Ἑÿ◁, ᪵ ⺂‫ ٹ‬บ ᧕ ỹ ം₁⺅఍

 ᧪‫  ᧕ ݙ‬‭ÿ⺅ ÿῙ, ⃎⺂ᨆ ⋩Όᩅኁ₁ ‫ ᧕⃕ݙ‬₝ ÿ‭᧕ᰍᆅ ൅ ÿῙ,


఩⺂ỹᩅ ‫◁׭‬ᚭ, ᩚKᚱÿ บ ᭁ⺂௎ᅎ₝ ữ఍؉ ₡ℾ൅ ÿῙỹ஽ ⃎⺂ܱ ⋩ܲ ∺⋩
⺁ Ⴅ೭ ₝₁እ ⅅ‫ ⋩⺁ݙ‬ṳ ÿ₭ ᩅẦÿ௱఍

1. As a grantee of the Korean Government scholarship, I pledge to abide by the following rules;
(1)ÊTo refrain from violation of university regulations, and to fulfill my obligations as a student to the
best of my ability.
(2)ÊTo behave in a manner appropriate to the Korean culture and society, and not to participate in any
form of political activity (such as organizing a political party, joining a political party, 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 abide by the NIIED's policy concerning the Korean language course and the degree course
without any objection.
(5) To abide by all of the terms and regulations set by NIIED.
(6) To agree to the use of my personal information (name, contact number, institutions I belong to, etc)
when it is needed for the operation of the program or upon the request of other governmental
institutions.

2. If I am proved to have violated any of the above articles, to have made a false statement in my
application documents or to have failed to comply with academic standards or the rules of university or
research institute, I shall accept the decision of NIIED, even though it may include the suspension or
revocation of the scholarship.


DATE(yyyy/mm/dd): 2010/11/02

SIRISORNPATTAPON PONPASSORN
NAME OF THE APPLICANT SIGNATURE OF THE APPLICANT

%09+8

₹ ‫ ݙ‬᪵ Յ ᩅ
1 9  6(2

₹‫ݙ‬᪵Յᩅእ ⳁ₝⋩ ₝ঢ়ᆅ ᩅÿᰆ⁥ᆅ ÿᩚDþ4, ఑ ⁥ᆅ ÿᩚ⺁ÿ, ṭჁ ঢ়  ⴕ⺑⺁೭ᆆ ⺁ÿ, ঢ়  ÿ


ṭᘥ ᭁ ₱೭ᆆ ⧩₝ÿ ⺁ ু ₡ ⺁ᰅὍ ;rite an essay of self-introduction not exceeding 2 pages on an A4 size
format, one-sided only. The essay should contain the following things and must be clearly typed or printed in black ink.

- Motivations with which you apply for this program


- Personal background in family and education,
- Significant experiences you have had; risks you have taken and achievements you have made, (a) person(s) or (an)
event(s) that has(have) had a significant influence on you
- Extracurricular activities such as club activities, community service activities or work experiences
- If applicable, describe awards you have received, publications you have made, or skills you have acquired, etc.

DATE(yyyy/mm/dd): . .

SIRISORNPATTAPON PONPASSORN
NAME OF THE APPLICANT SIGNATURE OF THE APPLICANT

%09u8

ᭁ ⺂ ‫ ⾶ ׭‬ᩅ
1 (2

ṭჁ ᭁ⺂‫⾶׭‬ᩅእ ⺅‫ږ‬ờ ༹஽ Ἢờᆅ  ⳁ₝⋩ ₝ঢ়ᆅ þ4 ‫⋩ ג܅‬ỹ ఑ ⁥ᆅ ÿᩚ⺁ᰅὍ ṭჁ ᩅᰆ
╡؉⺁ἕ ᭁ⺂ ༹஽ Ἑÿ ᏒK ᔸ ‫ ⾶׭‬ÿᩚ⺁ᰅÿ, ÿ ᭁ⺂ ༹஽ Ἑÿ ⿭ ÿ ‫₹◅⚽ ⁩⾶׭‬ ₁ ⿭
ÿᩚ⺁ᰅὍ ঢ়  ÿ ờᘥ ᭁ ₱೭ᆆ ÿ⺁ֵ ⧩₝ÿ⺁ ু ₡ ⺁ᰅὍ
(;rite a study plan not exceeding 2 pages in Korean or English on an A4 size format, one -sided only. The study plan must be
written either in Korean or English. Please refe r to the sample format below and include your purpose and plans for future academic
study or research. In particular, 'how you will utilize your knowle dge acquired in Korea' must be written after discussion with the
referees. It must be typed or printed cl early using black ink.

ᩚ  (Name) SIRISORNPATTAPON PONPASSORN

ᨆ´₥ (Date of Birth) 1992 Oct. 12


⛅ᰉ‫ ږ‬ℭ
(Previous Study Experience and Arts - German language
major in home country)
1) Television & Film
ᭁ⺂  ℭ
(Preferred academic major)
2) Advertising & Public Relations
⺅‫ږ‬ờ ௎ᅎ
k؉ܲ (Adv.) k∺ܲ (Int.) k☱ܲ (Beg.) ᰅÿ(Title of Test) - ᩚK(Score) -
(Korean Language Proficiency)
Ἢờ ௎ᅎ
k؉ܲ (Adv.) k∺ܲ (Int.) k☱ܲ (Beg.) ᰅÿ(Title of Test) TOEIC ᩚK(Score) 745
(English Language Proficiency)
ᭁ⺂ᏒK ᔸ ᩡᚩ‫( ⾶׭‬Purpose of Academic Study or Research and Detailed Plan)

⺅‫ږ‬ỹᩅ ᭁ⺂ ༹஽ Ἑÿ ⿭ ÿ ‫⾶׭‬
(How would you use your knowledge acquired in Korea after returning to your home country? Pleas e write a plan)

DATE(yyyy/mm/dd): . .

SIRISORNPATTAPON PONPASSORN
NAME OF THE APPLICANT SIGNATURE OF THE APPLICANT

%09"8

⚽ ◅ ᩅ
1; %  2 

  (  ! 
Full Name
(Last Name/M/First name SIRISORNPATTAPON PONPASSORN
Preferred Institution

Preferred Study Field Media Studies (Television & Film)


----------------------------------------------------------------------------------------------------------------------
 
!
Thank you for writing this letter on behalf of the person named above. Please indicate your candid and prompt assessment of t he
above named applicant. Fill out the present form with additional comments, enclose it in an envelope, sign across the flap, a nd hand
it to the applicant for submission to the institution in charge of recommendation of candidates. You may attach additional sheets if
necessary.

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

2. ;hat are the strengths and aptitude of the applicant?

3. ;hat are the applicant's weaknesses? ;hat weak points does she/he need to improve?

4. How do you think the applicant can apply his or her study plan at an educational institution in
Korea? Do you think s/he will succeed in utilizing his/her knowledge acquired in Korea in the
future?

1/2
5. Please assess the applicant's qualities in the evaluation table given below. Rate the applicant
compared to other individuals whom you are familiar with.
Truly Below
Excellent Very Good Good No Comments or
Exceptional Average
Not applicable
Top 2% Top 10% Top 25% Middle 50% Lower 25%

Leadership Potential

Interpersonal Skills

Communication Skills

Creativity

Motivation

Independence

Flexibility

6. Please provide us with some comments on the ratings you have made in Section 5.

Referee's Information
1. Full Name (Last/First/Middle) 2. School or Firm

3. Position or Title 4. Address

5. Phone 6. Fax

Country code / Area code / Phone number Country Code / Area Code / Phone Number

DATE(yyyy/mm/dd): 2010/11/02

NAME OF THE REFEREE SIGNATURE OF THE REFEREE

2/2

%09.8  
₹ ԩ ֝ Ծ ⋭ ఑ ᩅ
15&  2

Please provide accurate information for the following questions.

GUESTION YES NO EXPLAIN

i ;hen and for what reason did you last consult a physician?
School¶s Annual Health Check in June 2010
(Please explain)

ß Have you had any serious ailment, injuries or diseases in the


&
last five years? (If yes, please explain)

ö Have you been hospitalized in the last two years?


&
(If yes, please explain)

Have you ever been treated by a doctor for any mental,


emotional, or anxiety disorder? &
(If yes, please explain and attach a report from your doctor)

$ Have you ever been addicted to any substance?


&
(If yes, please explain)

Σ Do you have any allergies? (If yes, please list them) &

Τ Are you taking any prescribed medication?


&
(If yes, please explain)

' Are you on a special diet?


&
(If yes, please explain in detail)

Φ Have you ever suffered from depression?


&
(If yes, please explain)

THE ANS;ERS I HAVE GIVEN ABOVE ARE TRUE AND CORRECT TO THE BEST OF MY KNO;LEDGE.
IF MY ANS;ERS CONTAIN ANY KIND OF FALSEHOOD, I ;ILL TAKE ANY LEGAL RESPONSIBILITY.

Date(yyyy/mm/dd): 2010/11/02

SIRISORNPATTAPON PONPASSORN
NAME OF THE APPLICANT SIGNATURE OF THE APPLICANT

%09o8
  4 
 Personal Inÿormaion
ll Name:
þÿe: Sex:
ae oÿ irh:
Naionaliÿ:

 Phÿsical xaminaion
looÿ Pressre: Sÿsolic iasolic mmÿ
ÿision: iÿh  eÿ 
olor ÿision

orreceÿ: iÿh 5 eÿ 5
enal ÿalaion: Gooÿ D  air D  Poor D  Neeÿs þenion D 

linical ÿalaion:

lassiÿicaion Normal þbnormal
lassiÿicaion Normal þbnormal
Sin ear
eaÿ & ace þbÿomen
ÿes ecm
ars Genialia
ÿoh & Throa xremiies
Nose & Sinses ac & Spine
Nec Neroloÿical

hes & nÿs ÿenal
Oher
Iÿ þbnormal:
3
hes »raÿ xaminaion
ae aen:
inÿinÿs:
4 aboraorÿ xaminaion
emoÿlobin: Gm ÿl
ÿrine: SG Sÿar ÿicro
epaiis :
Sool ÿor Parasie Oÿal:
Seroloÿical Tes ÿor Sÿphilis & þIS :
Oher:

This is o ceriÿÿ ha he aboÿe nameÿ applican has ÿone hroÿh a ÿeneral meÿical
examinaion anÿ he ÿinÿinÿs inÿicaeÿ here are re o he bes oÿ mÿ no leÿÿe In mÿ
opinion his her healh conÿiion is
xcellen D  Gooÿ D  air D  Poor D 

ae ospial or Insie


ÿ
Siÿnare

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