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KEMENTERIAN RISET, TEKNOLOGI DAN PENDIDIKAN TINGGI

INSTITUT PERTANIAN BOGOR FAKULTAS PERTANIAN

Jln. Merantl, Kampus IPB Darmaga, Bogor 16680; Telp. (0251) • 8629354, 8626350 Fax. 8629352 Email: faperta@lpb.ac.ld http://www.faperta.lpb.ac.ld

Nomor : /?.1 /IT3.1/AK/2018 Lampiran : 1 (satu) berkas Perihal : Penyampaian lnformasi

Kepada Yth. Ketua Departemen ITSL, AGH, PTN dan ARL Fakultas Pertanian IPB Bog or

Bogor, 13 Maret 2018

.,._.,_, __ , ______ ___ l AGENDJ.\ DEPT AGH

~~~WJ8-_· Bersama ini kami teruskan informasi dari Direktur Program lnternasional melalui surat No.

3464/IT3.27/KM.02.00.012018 tentang informasi program pertukaran mahasiswa yang

ditawarkan Kagoshima University untuk tahun 2018-2019.

Mohon dapat diinformasikan kepada mahasiswa dan dosen dilingkungan Departemen

Saudara.

Atas perhatian dan kerjasamanya, kami ucapkan terima kasih.

/

Nomor Lampi ran Hal

KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI

INSTITUT PERTANIAN BOGOR Kampus IPB Darmaga, Bogor 16680

Telepon (0251) 8622642, Facsimile (0251) 8622708, http://www.lpb.ac.ld

: 34f,tl /IT3 .27//KM.02.00.012018 : 1 (satu) berkas : lnformasi mengenai program pertukaran mahasiswa di

Kagoshima University. Jepang

()8 Maret 2018

Ytlt. Para Wak.il Dekan Fak.ultas Bidang Akademik dan Kemahasiswaan Institut Pertanian Bogor Kampus IPB Darmaga Bogor

Dengan hormat kami sampaikan informasi tentang program pertukaran mahasiswa yang ditawarkan Kagoshima University, Jepang untuk tahun 2018-2019. Formulir aplikasi dan persyaratan selengkapnya dapat di1ihat pad a berkas terlampir. Pertanyaan mengenai program dapat disampaikan via e-mail ke ico@apps.ipb.ac.id dengan format subjek pesan "Kagoshima Exchange 20 18-Nama-NIM-Departemen".

Sehubungan dengan hal tersebut, mohon informasi ini dapat disebarluaskan kepada mahasiswa yang berminat di lingkungan Saudara. Berkas lamaran yang sudah lengkap dapat diserahkan ke Direktorat Program lnternasional sebelum tanggal 16 April 2018 (Fall semester) dan 17 September 2018 (Spring semester) untuk selanjutnya akan kami kirimkan secara kolektif ke Kagoshima University , Jepang.

Demikian kami sampaikan, atas perhatian dan kerjasamanya, diucapkan terima kasih .

· Plh ., Direktur Program lnternasional.

r;_::, ' ,_ '

Ff :·· ~· \. .... . .' ,.

~ ·::.~~- -\ Dr. Sintho) rVahyuning Ardie

Tembusan: "''· . ..._.._ .19.82;0706 20050 I 2 00 I Yth. Wakil Rektor Bidang Kerjasama dan Sistem lnfo·~;)~isi ·. Yth . Para Dekan Fakultas Yth. Direktur Kemahasiswaan dan Pengembangan Karir

Outline of Student Exchange Dear Exchange Partners,

We appreciate your continual support and kind cooperation for the mutual development of our relationship. This is a basic guide for student exchange between Kagoshima University and exchange partner universities.

Selection of Exchange Students We would like to request your office to select qualified students prior to the application deadline for student exchange. Direct application from the individual student cannot be accepted. The number of students should be within the limit shown in the agreement of student exchange. The final selection will be done by Kagoshima University after receiving all applications from all exchange universities. Application deadline : May 111 for Fall semester

October 1'' for Spring semester

Necessary documents Please instruct applicants to prepare the following and send them together to the International Student Office. Mailing Address

International Student Office Kagoshlma University 1-21-30 Korlmoto, Kagoshlma City 890-0065 Japan E-mail: rvugaku@kuas.kagoshlma-u.ac.lp Phone: +81 99 285 7325 Fax: +81 99 285 7083

1) Application Form (Form A) *A person who holds N1 or N2 in the Japanese Language Proficiency Test, please fill out Form A in Japanese.

2) Application Form (Form B) 3) Reference Form (Form C) 4) Official Transcript in English 5) Three Identical Photos (L40mm x W30mm)

*The photos must be taken within 3 months 6) Certificate of Japanese Language Proficiency Test, TOEFL, IELTS, etc.

to prove student's language ability 7) Certificate of Student Registration/Enrollment 8) Photocopy of Passport 9) Health Certificate in Engl ish(Form D)

Announcement of the result The final list of exchange applicants will be announced in about three months at latest after the application deadline . Prior and later inquiry about the selection process will not be available, b•.Jt questions about application procedures will be welcome. .1 ·

* For your reference we attach the selection check points in the following . The exchange applicants will be strictly selected through discussion by the

International Exchange Committee, its exchange student selection board, and each faculty related to the applicant's study/research interest.

Selection check points We will decide admission of exchange applicants based on the following points. 1) Academic motivation: Applicants should write their purposes and plans for

study/research and activities at Kagoshima University clearly in detail. - I .

2) Academic performance in the institution applicants belong to. 3) Language ability related to their study/research plan:

1 Students are required to have the Japanese proficiency at a minimum of the N2 level of the Japanese Language Proficiency Test, if they would like to attend classes conducted only in Japanese and to earn credits for those classes.

2 However, all students who do not meet the required level of Japanese language can enroll in the Study Japan Program at the International Student Division in the Global Initiative Center regardless of their Japanese proficiency. The students can take classes of Japanese language and culture and earn those credits.

Otherwise, if there are classes given in English or in another language and the professor allows the students to take the class, it is possible to take the class and earn credits, though the number of the classes is limited.

4) Correct application procedure: All application procedures must be followed correctly: in particular, all applications must be submitted by the deadline.

Note Exchange students must arrange by themselves the minimum amount of money needed for accommodation, meals and dailv expenses for the whole period of their stay at Kagoshima University. Please check the Living Costs and Prices from the URL as follows. http://www.g-studyinjapan .lasso. go. jp/en/modules/picolindex.php?content id= 16 The International Residence Hall Building No.1 may undergo renovation from October 2018 to March 2019. In that case the Exchange Students staying there will have to move to other buildings during that period.

Sincerely Yours

Aoi FUKUZAKO (Ms) Exchange Officer International Student Office Kagoshima University Korimoto 1-21-30 Kagoshima 890-0065 Japan TEL +81 99 285 7325 FAX +81 99 285 7083 e-mail: ryugaku@kagoshima-u .ac.jp

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Application (Form A)

Kagoshlma University

Application Form for Exchange Student r--··--·----·····-·--·-···-------1 ! Paste your

Important: A) Please write clearly when completing this form, either In E1gllsti1Cmgraph ! In Japanese. *A person who holds N1 or N2, p/ease'fflfWiPiin ! the past~ months this form In Japanese. 1 (40mm x 30mm)

Deadline May 1st for Fall Semester (October-March)

B) Be sure to send all the documents necessary. l October 1st for Spring Semester (Apr/1-Septem .. rJ .......................... .

C) The result will be announced in three months through the exchange coordinator of your university

Mailing Address International Student Office Kagoshlma University 1-21-30 Korlmoto, Kagoshlma City 890-0065 Japan E-mail: ryugaku@kuas.kagoshlma-u.ac.lp Phone: +81 99 285 7325 Fax: +81 99 285 7328

Personal Information (Family name) (First name) (Middle names if any)

1)Name __________ _

2) Nationality ____ _ 3) Sex o Male o Female

4) Age years old 5) Date of birth (day/month/year) __ ! ___ ! __

6) Address Present address (for correspondence) I Permanent address

I

Postal code : Postal code : Phone : Phone :

(Country code Area code Number) (Country code Area code Numberj Fax : Fax :

Email : Email :

7) When do you wish to start your study at Kagosh1ma University and how long?

Starting from: Year: oSpring Semester(April) oFall Semester(October)

Period: oOne year oOne semester

"Please note that students will not be able to prolong the duration of exchange after submitting this application form.

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Application (Form A) Academic Information *The person who hold JLPT N1&N2, write in Japanese. 8) Describe specifically what you are planning to study/research at Kagoshlma University or In Japan. (http://www.kagoshlma-u.ac.jp)

) Please check your 1 ii) Please select the faculty you prefer to belong to . Write "1. for the 1" choice

____ £Q.I!I..~~-l~~~-( ........... --·· · ---~-~-~d .'1." fo!_!h.f?..~s.~oice. - -------·-··-- ····- ···-------···-···-······················-0 Undergraduate : ( ) Laws, Economics and the Humanities ( ) Education 0 Graduate ! ( ) Science ( ) Medicine

j ( ) Dentistry ( ) Health Scinece i ( ) Agriculture ( ) Engineering

···-····-····-----···· ·· · · ·-····-· ··· ·Ll_.l.Y.~!~.r:!~'Y.M.~-~!~!n.~ ............ _______________________ L.J.E.~;;.h~.r:!~~-- - - ··-··· - -- · ·· - - - -- -- - -- · ··-- ---Piease remember that vour olacement will be decided by Kagoshima University. Iii) Explain specifically the purpose why you have applied for our exchange program and what you are planning to study/research at Kagoshima University. Insufficient explanation will effect on placing you to an adequate faculty or department. Please type In English or Japanese within this frame. Handwriting In Japanese Is acceptable.

iiii) Do you also wish to study Japanese language and culture in the Study Japan Program?

(http://www. gic. kagoshima-u_~ac.jplisdlinde x _english. html)

o Yes, very much o Yes, but not very much. o No, I am not interested . ---------- ----------- - -··-·- - ·---·

2

Application (Form A)

) What year are you in?:

Faculty/Department you belong to :

·---- Major : ------·--·------- - ------------------------------------------------------------------------------·-·--------------·-----------------·-------··---··-·--··············· ) Write in detail about what you have studied/researched so far in your major field. Please type In

English or Japanese within this frame. Handwriting In Japanese Is acceptable.

1 0) Evaluate your proficiency In foreign languages using five scales. (1: Nil, 2: Poor, 3: Fair, 4: Good, 5: Excellent)

~ II h d h d' d th I d f h e us ow an w ere ' ou stu 1e ose angua!; es an or ow many years. Language Reading Speaking Years of How and where did you leam the language?

study

I

Japanese

--JLPT new test (held in or after 2010)

If you passed the Japanese Language Proficiency o N1 level o N2 level o N31evel Test, please mark the level. o N4 level o N51evel Or if you have taken other kind of Japanese language test, please attach a photocopy of the

*Attach a photocopy of certificate, too .

JAPANESE-LANGUAGE PROFICIENCY TEST CERTIFICATE OF RESULT AND SCORES.

- --;1 · ·-----·------ · -- --- - -- . --·- ·· . ..

I

·----

English

----If you have any qualifications in English proficiency Name: test, please give the name and score. (TOEFL, Score: IELTS, TOEIC etc.) *Attach a photocopy of the certificate Other language(s) if any

3

If you have taken a language proficiency test other Name: than Japanese or English, please give the name Score: and score.

11) Educational backaround and emplovment record Period from (month.year) to

Educational background (month .year)

after high school

Period

Employment record

Period

Other background including military services.

Declaration

Application (Form A)

*Attach a ohotocoov of the certificate

Name of school

Kind of occupation, name of organization, etc.

I hereby declare that the information given on this form is correct to the best of my knowledge and complete in every detail. I promise to arrange by myself the minimum amount of money needed for living expenses for the whole period of my stay at Kagoshima University. I also promise that, in the event of being admitted to the University, I will comply with all disciplines and regulations of Kagoshima University.

____ ! I ~------L------L-------~

Signature of the applicant Day Month Year

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4

Application (Form B)

Kagoshima University

Application Form for Exchange Student All the following information provided on this form will be used in applying for the Certificate of Eligibility which is issued by the Ministry of Justice, Japan. Write clearly and specifically either in English or in Japanese.

(Family name) (First name) (Middle names if any) 1) (7~:b't)

a~ Name _____ _

If you are a Chinese or a Korean, please give the name in Chinese letter, too.

(i~~~) ________________ _

(7~:b't)

2) ttl~it!! Place of Birth: ----------:-:----:--~ *include city and province/prefecture/states

3) ~cf~*o)1f~ Marital Status: )1f Married )~Single

4) '*~Passport: :fl:% Number--------1fWJWl~ll Expiry Date(y/m/d) ___ _

5) J:.~.:Y.:ii::~ Port of Entry:----:-----:--:-•name of the airport/port/station of your arrival in ~Iapan

6) ~liE~n\-T-:ii::.l:tB Place( city) to Apply for Visa:----:-------:-----:---•the nearest Japanese embassy of your region

7) itifl:l:20)WA00m! Past Entry into/Stay in Japan: ( )~Yes @]~Times __

illEErO)tf:l.Affi]lfr.The latest entry: from____ (year/month/day) to (year/ month/ day)

)~No

8) ~a&~ (~·~·~AA~·~·R~~~~~) &V~~~ Family in Japan: (Father. Mother, Spouse. Son. Daughter. Brother, Sister or others) or co-residents

Relationship Name Date of birth Nationality Residing with applicant or Place of employment Status of not I school residence

yes I no

yes I no

--- --l- --->-:-- ----- yes I no

L-------L-----------~---------L-------L--------------L-------------~-------~

9) {rj~fF-~ Total Period of Education: ( ) years • /; , '¥-'!J( .--... Jtl# '¥-"!!if From elementary school to last institution of education

10) -¥:5iJZI'i~~~i6.7:f.-l:f-.FJ f3 Date of expected graduation of your present school I I (year/month/day)

11) r#f~~o) 5(jf-)5'it~J; Method of support to meet the expenses while in Japan (A) 5Z#/Ji~&V.Fl iJZJ$]5Z#tfi

Method of support and an amount of support per month (average)

Application (Form B) *More than70,000 yen is needed for living cost per month. ( ) ;<f;:}dH!! Self yen

) 51-~ t.J • r:, O)j!~ Remittance from outside Japan yen

51-00t.J• r:, O)mfi Carrying from abroad yen

mrr;g- Who mrrs~M When-------~~§Z Scholarship yen

f£ 13 *.Ht :J( :Jt. ;g-j\ ffi. Guarantor in Japan yen

-tO) It!! Others: specify ________ ..L;ye~n

(B) ~-~#;g- Financial supporter **IMPORTANT** a) ~~ Name: ---------

f±?Jf Address: ___________ _

Tel: ----------b) .m~ Occupation: _________ _

itJ~;£0)~ ft- Name of Company: ______ _

Tel : ----------c) if=.IC( Annual income: yen

d) Ef! ~-A c O)M~ Relationship with you : _____ _

(C) ~~~:Ji:~~Ull'il Organization which provide scholarship (In case that your answer in the question A is scholarship) ( ) 91-!E~Jff Foreign government

( ) -t- O)ft!:! Others

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2

Reference (Form C)

Kagoshima University Reference Form The student named below is applying for Kagoshima University as an exchange student. This form should be written by his/her academic or professional advisor in the institution the applicant belongs to. Please return this form to the applicant after signed and sealed.

Please evaluate applicant's abilities in the following areas by circling the appropriate scales. Name of Applicant

Family name First name Middle name

Ability Very high Very low Unknown Academic study ability 5 4 3 ') 1 X L.

Language study ability 5 4 3 2 1 X

Ability to adapt to 5 4 3 2 1 X

the environment Leadership skills 5 4 3 2 1 X

Maturity 5 4 3 2 1 X

Please give your personal assessment of the applicant with the following information either in E r h · J ng!IS or rn apanese.

(1 )Relationship to applicant

(2)length of time you have From To known the applicant.

(3)Your evaluation of the applicant's ability to adapt to other cultures and academic ability

'---------- --· ·- ----·-~

Reference Name: ~--------------

Title'-: _________ F acuity'-: ___________ _

Phone'-: _________ E-mail'-: ____ _

Signature'--: ______ Date'-: ______ _

,I .

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CERTIFICATE OF HEALTH (to be completed by the examining physician)

::tn~t-if!.m L.u #a&xtmm1:: .t "IJ'I~l.:Ea-t ~.:.c. Pleue ase UU bm&t and 611 out (PRINT> in Japanese oc Enalish.

~~

Name: -=~~-~------------- Middle name

1 . .,.flt#t)ltlfflal.:-?~·-r. UtiJ.!:: xQYtq)M.-f:JeA L. -r < ~!\-. x•~:fttn a f~bfV.."t-!>:..!:: (3.,.. J11:l...tA11~:.U.> Please describe the re.ult. o( physical and X-ray euminati0111 o( the appliant'a chest X-111yw (X-nya taken more than

IMe monthl prior to tJ1e certification are NOT valid).

D:iE~ Nom1lll DA11!' Aboorm;al (Des.cSO"qll:D;'PL!osiOir..r --------------~-

Dlte: F'llm No.;

2. lJttfttAtrf'Dlf!tl DisaH currently bcina treated

DYes (Ouise:lle:~SA~!-.-----------+ ONo

MouiH and rubtlle lfJL.AI M.aslcl ll.l..AI Rubolla/Genun MeteiM

Form D

cttt? DYes DNo D~Unknown OYOI ONo O~IIJ UnkDOWD

Past hlttory? ( ) ( )

'f-ili~fl ( 2 !§J.I<J.J:) ? DY~s ONo O'f-IJI Unknown DYes DNo

V11<:<:inatlon (more than twice)? ( )( ) ( )( )

No 'i t:.l:t;r-IJ1D>t9-A'I'i. :mll!.Wtiff::l;cn"'f·IW!IlU:~It !>-<! "t.'1',

lCNo or Unknown, the npplicant is recommended to bo vaccinated.

{'lf.>fn">l:!Ett!lll If there is a pa$t hi~tory, please checlt ~nd fill in the date or recovery.

Tuberc\llosia ..... .D( ) EpileJl'y _,.,.0( . . ) Food allcrgo,· .. ... 0( . . )

4 . ;em:t·O)f:t:tt~. li~ · lll!:l:EQ)~fl·~*L. -c. J.!l.tfD>~IfiQ)tkiXI:1~~~.::\ll~I:IM:t ~ ~ t.'1>.!:: .l!nn10-tn·? In view ol the applicllnt't hislory and the above 6ndi~. is it yola' observation !hal hi~ mental end ~yliC31 hmlth status

Ia ildcquatc to PW'11UC atudic5 in Japan?

Yes D

IHt Date:

No o

~ Signntu.ro:

O=FIJ! Unknown

----------- -----------------------------------------m M ~ ~

Ph,ya.k:!An's Namo in Pr!n....._ _______________________ _

~~:lt:t.

Ollkc:/lnstitutiQil:

l'Jrff.Jt!!