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.