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Enrolment 2027 Autumn
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 (JICA Knowledge Co-Creation Program)(KCCP) for Long-Term Participants
(JICA Development Studies Program)
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OFFICIAL APPLICATION FORM
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To be confirmed and signed by the head of the relevant department / divison of the applying organization
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1. Course Title
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(Southeast Asia) SDGs Global Leader
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2. Country Name
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3. Name of Applying Organization:
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4. Name of Nominee(s):
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1)3)
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2)4)
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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.
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DateSignature
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Name
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Designation / PositionOfficial Stamp
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Department / Division
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Office Address and Contact InformationAddress
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TelephoneFAXE-mail
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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。
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　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
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DateSignature
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Name
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Department / Division
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Position
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Part A: Information on the Applying Organization
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1. Profile of Organization
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１）Name of Organization
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2) The mission of the Organization and the Department / Division:
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2. Purpose of Application
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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.
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2) Objective: Describe what your organization intends to achieve by participating in KCCP.
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3) Future Plan of Actions: Describe how your organization shall make use of the expected achievements, in addressing the said issues or problems.
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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.
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