※The applicants should be current Master studentsor graduates of IITH.
※This application should be submittedviae-mail with applicant’s signature. The deadline and address is as followings.
Last day of application: 20th Dec 2015
E-mail scanned copy to:
Send original to: Miki Matsuo(Ms.)
G402 Trendset Winz, Nanakramguda, Gachibowli, Hyderabad 500008
1. Personal Information
(1)Full Name (as written in passport)
(Given Name) (Family Name) (Middle Name)
(2)Date of Birth: (day) / (month) / (year) Age:
(3)Sex: [ ] M / [ ] F (4) Marital Status: [ ] Single / [ ] Married
(4)CurrentAddress:
(5)PermanentHome Address:
(6)Nearest city from your Home:______Distance in Km:______
(7) Home Phone: (8) Mobile Phone (if any):
(9) E-MAIL Address:
(10) Passport No:______Date of Issue:______Date of Expiry:______
(Attach a photocopy of the first page and last page of your Passport)
2. Educational Background
(1)Educational Background(as of application)
Level / Name of School/ Department / Location / Period of schooling you have attended / From /To(Month/Year) / Degree
(Major)
Primary Education
Upper primary
Education
Secondary
Education
Higher Secondary
Education
Universityfor Bachelor (except training)
Universityfor Master
(except training)
*Do not count short course/training course.
(2)Total years of taking formal education (from primary up to present) For years
(3)Grade Point Average (GPA) at IITH
(4)Name of your professor (supervisor) at IITH
(5)Theme of your dissertation in Master
(6)Have you been awarded anyscholarship (funding) for studying at IITH?
[ ] Yes Name of the scholarship:
[ ] No
(7)Have you already been awarded any other scholarships studying abroad for Doctoral course from 2014?
[ ] Yes Name of the Scholarship:
Country you studied: Duration From(month/year) To(month/year)
[ ] No
(8)Are you planning to apply for any other scholarships?
[ ] Yes Name of the Scholarship:
[ ] No
(9)Have you appeared for TOEFL/ IELTS/ or any other English Language testing Examination?
[ ] Yes Name of the Exam & Score(Attach copy of result):
[ ] No
(10)Have you appeared for GRE Examination?
[ ] Yes Score(Attach copy of result):
[ ] No
(11) Have you applied to any other universities in India or abroad for Doctoral course?
[ ] Yes (Mention Names of Univ if you wish to):
[ ] No
3. Work Experience
Work Experience including internships (if any)
Company/Authority/University / Department / Position / Period of Working / From /To(Month/Year)
4. Signatureof Applicants
Applicant’s signature:
Applicant’s name: (in Roman Block capitals)
Date: (day) /(month) /(year)
5. Research Proposal and Career Plan
(1)Prospective Area of Study：
(2)Title of Research Proposal:
Write a provisional title and a brief research proposal for Ph.D thesis.
(3)Research Proposal (within 700 words):
It is strongly recommended that the research proposal should be in connection with;
Prospective Field of Study
Prospective university curriculums or faculty members (1st and 2nd preference), etc.
(4)Future Career Plan (within 300 words):
Describe your future carrier plan after obtaining Ph.D.
(5)Reason to Choose Japan ( In 300 words):
END