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(Form 1)
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Application for 2025 Iida Scholarship
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Application date:
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To the Selection Committee,
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I hereby agree to the all regulations of the 2025 Iida Scholarship application guidelines and submit my application. I also consent to the disclosure and provision of the information contained in this application to donors for the purposes outlined in Article 15 of the application guidelines. Furthermore, should I be selected as the scholarship recipient, I will not decline this scholarship in order to receive other scholarships.
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NAMESir NamePhoto Data
(Put on this plase)		//
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Given and Middle Name//
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Date of Birth//SexCLICK HERE▼
←申請時点年齢
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daymonthyear
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Nationality/
Region		OccupationCLICK HERE▼
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Name of Affiliation
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Accecptance in NAISTName of laboratoryName of SupervisorAlready received an internal agreement?
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CLICK HERE▼
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Duration of stay as a scholarship student//to//※If the period changes after submitting your application, please notify us in advance.
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daymonthyeardaymonthyear//
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DAY COUNT:
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●Researching plan during the stay in NAIST as a scholarship recipient
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Research title
（Summary if none）
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Specific activities you are plannning at NAIST
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