The University of Hong Kong



Keio University

Office of Student Services (International)

JASSO Scholarship Nomination Form 2010 (Form A)

Instructions

1) This Nomination form should be filled out by the coordinator of the partner universities, not by the applicants. Please return this form along with “JASSO Scholarship Application Form 2010 (Form B)” and “the Certificate of Enrollment of the Applicant for Student Exchange Support Program”.

2) Please write clearly the students’ GPA (Refer to the method of calculating GPA on the “Application Guide for 2010 JASSO Student Exchange Supporting Program”

Please complete the following:

|University: | |

|Office: | |

|Contact person and email | |Signature |

|address: | | |

| | | |

| |

|Details of nominees (Please rank the students if you nominate more than one student) |

|Nominee 1 (1st Ranking) |

|Student Name: | |

|JASSO GPA | |

|Program at Keio |□ Japanese Language Program |

| |□ Keio International Program |

| |□ Research Program |

|Nominee 2 (2nd Ranking) |

|Student Name: | |

|JASSO GPA | |

|Program at Keio |□ Japanese Language Program |

| |□ Keio International Program |

| |□ Research Program |

|Nominee 3 (3rd Ranking ) |

|Student Name: | |

|JASSO GPA | |

|Program at Keio |□ Japanese Language Program |

| |□ Keio International Program |

| |□ Research Program |

|Nominee 4 (4th Ranking ) |

|Student Name: | |

|JASSO GPA | |

|Program at Keio |□ Japanese Language Program |

| |□ Keio International Program |

| |□ Research Program |

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