Application Guidelines In completing the attached application form, please be advised to


declaration for terms and conditions  13  e. Signed and filled in every part of  Medical History Questionnaire



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declaration
for terms and conditions 
13 
e. Signed and filled in every part of 
Medical History Questionnaire
14 
f. Had an authorized official from your government to complete and sign the 
Nomination
form 
15 
g. Have a 
copy of passport
ready for submission 

This is to certify that I have completed every part of the application form 
to apply for the KOICA Scholarship Program. 
 
 
Date: 
24.02.2022
Applicant's Name:
Shukurloev Bekzod
Signature: 


 

Homepage : http://www.koica.go.kr/sites/ciat

Email : koica.sp@koworks.org 
825 Daewangpangyo-ro, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13449, Korea 
Application Form for the KOICA Scholarship Program 
This form is to be used to apply for the Scholarship Program of the Korea International 
Cooperation Agency (KOICA), which is implemented as part of the Official Development 
Assistance Program of the Government of Korea. Please complete the application form 
and consult with your 
respective country’s KOICA Office - or the Embassy of Korea in 
charge of your country, if the former is not available - for further information. 
PART 1. APPLICANT INFORMATION (to be completed by the applicant)
I. PROGRAM OF APPLICATION
 
(as in the Program Information)
Program Title 
Civil Society Leadership (Asia) 
Name of Degree 
Master Degree 
Duration 
from to
(DD-MM-YYYY)
II. PERSONAL DATA
Name 
(as in the passport) 
First Name 












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