AY 2012 Application Form for + R Incentive
Scholarship for Individual Students
Date of submission:
College
Department
Major
Year
Name
Student ID
No.
Mobile phone No.
University email
address
@ed.ritsumei.ac.jp
Extracurricular
activity
(student club, etc.)
*Personal information given in this application form will not be used for any purpose other than selection of
scholarship recipients.
Application category (Check the category most relevant to the main purpose of your activity.)
□ Category 1
Activities to achieve the educational goal of Ritsumeikan University
□ Category 2
Activities to facilitate community development on or off campus
□ Category 3
Activities to meet the demands of society in line with the educational philosophy of
Ritsumeikan University
○ Theme (Give a theme to the activity for which you will use this scholarship.)
○ Past achievements
Describe the activities you have undertaken in line with the above theme, including what
motivated you to embark on the activities.
* If you have any documents or materials that provide evidence of your achievements, affix copies, etc. to the
accompanying sheet.
○ Describe the goal you aim to achieve by pursuing the above theme.
○ Describe how you are going to use this scholarship in your efforts to achieve your goal. (“Your
plan for this academic year” and “How to use the scholarship”)
<Space for the applicant to fill in> Specify your GPA. If you have also applied for any of the
following scholarship/financial aid programs, check the applicable box.
Academic criteria
Application for
other scholarship
GPA you earned during AY 2011 (
)
□ Copy of academic record
□ Athlete and Creator Development Scholarship
□ Financial Aid for Development of a Learning Community (support for
developing various learning groups)
<Space for the Student Office to fill in> *Leave this space blank.
Date of
Document
Interview
submission
screening
Overall
evaluation
Cover sheet:
Documents/materials concerning your achievements
*Fill in this form and staple the document(s) using this form as a cover sheet. Attached documents
should be A4 sized.
*Attach documents/materials that provide supplementary information on your achievements, such
as a certificate of commendation, newspaper article, magazine article or other publication. If the
achievements have resulted from your activities as a member of an external organization, also
attach a profile of the organization.
Document
No.
Document name
Description (e.g. title of the work, name of the competition, date of acquisition,
period of activities, your role)
1
2
3
4
5