ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMANAOAPAQARASATAUAVAWAXAYAZBABBBCBDBEBF
1
2
3
Enrolment 2027 Autumn
4
 (JICA Knowledge Co-Creation Program)(KCCP) for Long-Term Participants
(JICA Development Studies Program)
5
OFFICIAL APPLICATION FORM
6
To be Comfirmed and sighed by the head of the relevant department / divison of the applying organization
7
1. Course Title:(Please write down an shown in the General Information)
8
(Africa) SDGs Global Leader
9
10
11
2. Country Name
12
13
14
15
3. Name of Applying Organization:
16
17
18
19
4. Name of Nominee(s):
20
1)3)
21
2)4)
22
Our organization hereby applies for Knowledge Co-Creation program (KCCP) of the Japan International Cooperation Agency and proposes to dispatch qualified nominees to participate in the programs.
23
24
25
DateSignature
26
27
Name
28
29
Designation / PositionOfficial Stamp
30
31
Department / Division
32
33
Office Address and Contact InformationAddress
34
35
TelephoneFAXE-mail
36
37
38
Confirmation by the organization in charge (if there is no Letter from the government nominating the applicant) ※1
I have examined the documents in this form and found them true. Accordingly I agree to nominate this person(s) on behalf of our government.
※1. Signature及びOfficial Stampは必須、どちらか一つでも取り付けられない場合は代替書類（援助窓口機関等関係省庁からのレター）は必須であり、いずれも無い場合、研修員の受入、来日手続きが不可となるため留意すること。
39
　ただし、ABEイニシアティブなど、民間人材を対象にしている一部のプログラムにおいてはこの限りではない
40
DateSignature
41
42
Name
43
44
Department / Division
45
46
Position
47
48
49
50
Part A: Information on the Applying Organization
51
52
1. Profile of Organization
53
54
１）Name of Organization
55
56
57
58
59
2) The mission of the Organization and the Department / Division:
60
61
62
63
64
65
66
2. Purpose of Application
67
1) Current Issues: Describe the reasons for your organization claiming the need to participate in Knowledge Co-Creation Program (KCCP), with reference to issues or problems to be addressed.
68
69
70
71
72
73
74
2) Objective: Describe what your organization intends to achieve by participating in KCCP.
75
76
77
78
79
80
81
82
3) Future Plan of Actions: Describe how your organization shall make use of the expected achievements, in addressing the said issues or problems.
83
84
85
86
87
88
89
90
91
92
4) Selection of the Nominee: Describe the reason(s) the nominee has been selected for the said purpose, referring to the following view points; 1) Course requirement, 2) Capacity /Position, 3) Plans for the candidate after the KCCP, 4) Plan of organization and 5) Others.
93
94
95
96
97
98
99
100