Financial Aid for Development of a Learning Community: Form 1
AY 2012 Application Form for Financial Aid for
Development of a Learning Community
Date of submission:
Group name
Name
College
Year
Student ID No.
Representative
Mobile phone No.
―
―
University email address
@ed.ritsumei.ac.jp
Extracurricular activity (student club, etc.)
Name
College
Year
Student ID No.
Vice representative
Mobile phone No.
―
―
University email address
@ed.ritsumei.ac.jp
Extracurricular activity (student club, etc.)
Name
College
Student in charge
Student ID No.
of financial affairs
Mobile phone No.
―
Year
―
University email address
@ed.ritsumei.ac.jp
Extracurricular activity (student club, etc.)
Nominator
(Full-time
faculty/staff
Affiliation
Name
member)
No. of members
Main base of activities
Kinugasa Campus・BKC・
）
Other site（
*If your group has more than three members, fill in and submit Form 6 (List of members).
Application category (Check the category most relevant to the main purpose of the activities of your group.)
□ 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
<Space for the university to fill in>
Date of
submission
*Leave this space blank
Document
screening
Interview
Overall
evaluation
*Personal information given in this application form will not be used for any purpose other than
selection of financial aid recipients.
○ Past achievements
Describe the activities your group has undertaken, including what motivated your group 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.
○ Goals of the group activities
○ Activity plan (outline)
Application for
other scholarship
□ + R Incentive Scholarship for Individual Students
□ Athlete and Creator Development Scholarship
□ Financial Aid for Research and Creative Activities
*Personal information given in this application form will not be used for any purpose other than
selection of financial aid recipients.
Financial Aid for Development of a Learning Community: Form 2
○ Activity plan
Specify concrete details of the plan, goals, and expenses necessary for the activities (including your calculation of
expenses).
*Personal information given in this application form will not be used for any purpose other than
selection of financial aid recipients.
Financial Aid for Development of a Learning Community: Form 3
○Estimate of expenses
No.
Example (1)
Example (2)
Purpose
Expense item
To purchase equipment
(e.g. XXX machine)
Calculation of expenses
Amount
Equipment cost
¥100,000
To participate in a training Participation fee
session (e.g. XXX training Traveling expense
session)
Accommodation expense
¥10,000/person × 3 persons
Round trip by Shinkansen
between Kyoto and Tokyo:
¥21,000/person ×3 persons
¥5,000/person ×3 persons
¥30,000
¥63,000
¥15,000
(1)
(2)
(3)
(4)
(5)
Total
*Make sure that the numbers given in the estimate of expenses correspond to the numbers in the activity plan.
*Attach supporting documents to supplement the information on expense items shown in this form. Give each document the
same number that is allocated to the relevant expense item.
*Personal information given in this application form will not be used for any purpose other than
selection of financial aid recipients.
Financial Aid for Development of a Learning Community: Form 4
○Nomination form (to be completed by a full-time faculty/staff member)
Affiliation
Name
Seal
*Personal information given in this application form will not be used for any purpose other than
selection of financial aid recipients.
Financial Aid for Development of a Learning Community: Form 5
○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 name
Document
Description (e.g. title of the work, name of the competition, date of acquisition, period of activities, your
No.
role)
１
２
３
４
５
*Personal information given in this application form will not be used for any purpose other than
selection of financial aid recipients.
Financial Aid for Development of a Learning Community: Form 6
○ List of members
*If members of your group include graduate students and/or international students, please fill in this form.
Year at the university
College/graduate school
Student ID No.
Name
(e.g. 1st year)
*Personal information given in this application form will not be used for any purpose other than
selection of financial aid recipients.