Fellowship Application Form

This application form is composed of five parts (part A to part E) and should be completed in triplicate. Part A to part D should be completed by the candidate and part E by the government authority in typewritten form. Each question must be answered clearly and completely. Detailed answers are required in order to make the most appropriate arrangements. Official authority of the nominating Government will then forward three copies of the certified application forms to the Thailand International Development Cooperation Agency, 962 Krung Kasem Road, Bangkok 10100, Thailand, through the Royal Thai Embassy in the nominating country. The nominee is required to attach medical report or health status certification.

	(a)	carry out such instructions and abide by such conditions as may be stipulated by both the nominating government and the host government in respect of this course of training;
	(b)	follow the course of training, and abide by the rules of the University or other institutions or establishment in which I undertake to train;
	(c)	refrain from engaging in political activities, or any form of employment for profit or gain;
	(d)	submit any progress reports which may be prescribed;
	(e)	return to my home country promptly upon the completion of my course of training.

I also fully understand that if I am granted a fellowship award, it may be subsequently withdrawn if I fail to make adequate progress or for other sufficient cause determined by the host Government.