ASEAN-ROK TVET Mobility Programmes

Application Form
for Mobility Programme Batch 1
 Notice

1. Each mobility programme has a different set of requirements but the following information
should be considered before applying to any of the programmes. More detailed
information can be found in Section III of Mobility Tool 1(guideline). By submitting
this application, you acknowledge that you have read and understood all the information
provided in the guideline and agree to abide by the terms and conditions outlined therein.
a. Status
All participants must be a citizen of ASEAN Member States (Brunei Darussalam,
Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand,
and Viet Nam). All participants must have valid passports(minimum 9-month validity
when applying) and have no restrictions on international travel. All students must be
currently enrolled in TVET institutions or graduated within the last 6 months
from the deadline of the application period. Faculties must be currently teaching at
TVET institutions. All of the programmes require at least a basic understanding of each
field, so all participants should check the prerequisites and curriculum before applying.
Participants can also apply for the programmes in their respective countries. In this
case, a passport and international travel are not required.
b. Age limit
All students should be between the age of 18 and 25 when applying. This is to ease
the selection process of the students and also to match the level of the curriculums
provided. There is no age limit for the faculties.
c. Skills
All of the mobility programmes will be operated in English. All participants are required
to have adequate language skills to participate in the programme. The English skill will
be screened during the application period in written form, subject to the requirement
from each faculty, and also in an online interview session. This interview will be
conducted by the host institution.
All participants must possess basic IT literacy, able to use Microsoft Office applications
such as Word, Excel, and PowerPoint.
d. Health
All of the participants must provide detailed information on any health-related issues in
the application form. Once selected as final candidates, the participants will be
required to submit a health form signed by a licensed physician. The cost of health
checkups will not be covered by the project. Participants should be mindful of the
COVID-19-related protocols of each country. The cost of any necessary vaccinations
and tests is not covered by the project. Moreover, each country or institution may have
different health requirements for incoming students. Please check the programme
profile in Section III of Mobility Tool 1.
e. Selection of the programmes
Except for the Automotive and Building Construction sector, there are 2 programmes
 available. You may apply for 1 or 2 programmes if you meet the prerequisites of each
programme. Please check the programme profile in Section III of Mobility Tool 1.
f. Support
The project will provide programme-related costs, including visa, travel/health
insurance, international transportation, accommodation, programme fee, and daily
allowance for the programme participants. Also, personal supplies such as personal
protective gear, tools and materials will be provided under the project budget.
However, each participant must bring a personal laptop to participate in the
programme.

2. The following table lists the summarized information of each programme. Depending on
your sector and major, you may choose up to 2 programmes. If you fail to be nominated
by your first choice, your application will automatically be reviewed by the second
programme.

List of Mobility Programmes

# AMS Sector Institution Programme Programme Period
Computer and 25 June to 22 July
1 Singapore Information Nanyang Polytechnic Information Technology 2023
Service
Computer and 25 June to 16
Brunei Micronet International September 2023
2 Information Network Management
Darussalam College
Service
Electrical and Preahkosomak Sequence Control 25 June to 16
3 Cambodia September 2023
Electronics Polytechnic Institute (PLC)
Hospitality and 25 June to 16
4 Indonesia BBPLK Medan Hotel Management September 2023
Tourism
Toyota Motor 25 June to 16
5 Philippines Automotive Philippines School of Automotive Servicing September 2023
Technology, Inc.
Hospitality and Phuket Vocational Hospitality 25 June to 16
6 Thailand September 2023
Tourism College Management
Construction 25 June to 16
Building Ho Chi Minh City September 2023
7 Viet Nam Engineering
Construction College of Construction
Technology
ADTEC Kemaman Electrical Low Voltage 23 July to 14 October
Electrical and 2023
8 Malaysia (Kemaman Advance Installation and
Electronics
Technology Centre) Maintenance

3. For the application schedule, please refer to the following information:

Application Apply to: (Name)

deadline: (Title)
(Email)
Online Interview: Between 15 and 26 Notification of 29 May 2023
May the result:
 APPLICATION FORM
Please TYPE on this form (DO NOT HANDWRITE).

A. Personal Information
First/Given Name HARDI (photo)

Middle Name (if any)

Last/Family Name SUKMA

Date of Birth (MM/DD/YY) 07 / 08 / 00
Gender MALE
Nationality INDONESIAN
SERDANG BLOSONG VILLAGE, KRAMATWATU SUB-
Current Address
DISTRICT, SERANG REGENCY, BANTEN, 42161
Closest international
SOEKARNO HATTA INTERNATIONAL AIRPORT
airport for departure
Is a domestic flight ☒ No
required to reach the
international airport? ☐ Yes (Name of the domestic airport: )
Any dietary restrictions, religious practices, or personal beliefs that require specific
arrangements during the programme? If yes, please specify below.
* Please note that there are no disadvantages in disclosing this information, as it is solely to ensure that we
can make necessary arrangements for your convenience.
☒ No / ☐ Yes ( )

B. Application Information
Applying Sector 4. Electrical and Electronics

Applying programme 1 Sequence Control(Cambodia)

Applying programme 2 Electrical Low Voltage Installation and Maintenance(Malaysia)

C. Education Background (Most recent education)

Name of TVET Institution BBPVP SERANG
☒ Currently Enrolled
Current status
☐ Graduated(Click or tap to enter a graduation date)
☐ Less than 6 months
Studied Period
☒ Less than 1 year
Major YOUNG ELECTRIC TECHNICIAN
☒ Certificate
Level of the training ☐ Diploma
☐ Others(specify: )
D. Contact Information
Student’s Contact Information
SERDANG BLOSONG VILLAGE, KRAMATWATU SUB-
Address
DISTRICT, SERANG REGENCY, BANTEN, 42161
Mobile (with country code) +62 81932716759
WhatsApp or other
081932716759
messengers ( )
Email [email protected]

Supervisor's Information

Name(First / Last)
Address

Mobile (with country code)

WhatsApp or other
messengers ( )
Email

Emergency Contact Information

Name(First / Last) HAYUMI

SERDANG BLOSONG VILLAGE, KRAMATWATU SUB-
Address
DISTRICT, SERANG REGENCY, BANTEN, 42161
Mobile (with country code) +62 81911050410
WhatsApp or other
081911050410
messengers ( )
Email

Relationship to Student FATHER

E. Work/Internship Experience
Company Country Period Position Responsibilities
(MM/YY to MM/YY)
PT. SURYA INDONESIAN 03/19 to 11/20 TECHNICIAN SERVICE AND
FAJAR SUPPORT CALIBRATION OF
PRATAMA DIGITAL SCALE AND
MECHANICAL SCALE

F. Language Proficiency
 Native Language INDONESIAN
English
Excellent Good Fair Basic Remarks
Listening 
Speaking 
Writing 
Reading 

Other Languages (please specify): __________________

Excellent Good Fair Basic Remarks

Listening
Speaking
Writing
Reading
1. Excellent: Refined fluency skills and topic-controlled discussions, debates & presentations. Formulates
strategies to deal with various essay types, including narrative, comparison, cause-effect & argumentative
essays.
2. Good: Conversational accuracy & fluency in a wide range of situations: discussions, short presentations &
interviews. Compound complex sentences. Extended essay formation.
3. Fair: A broader range of language related to expressing opinions, giving advice, and making suggestions.
Limited compound and complex sentences & expanded paragraph formation.
4. Basic: Simple conversation level, such as self-introduction, brief question & answer using the present and
past tenses.

G. Computer Skills
Programme Good Fair Poor None
MS-Word ☐ ☒ ☐ ☐
MS-Excel ☐ ☒ ☐ ☐
MS-PowerPoint ☐ ☐ ☒ ☐
MS-Project ☐ ☐ ☐ ☒
Others (Please specify): ☐ ☐ ☐ ☒
H. Personal Statement
Please choose 2 questions from below and provide a short statement. Please do not exceed
500 words per question.

1. What inspired you to apply to this international student exchange program, and
what do you hope to gain from the experience?
2. In what ways do you think participating in this program will help you achieve
your academic, personal, or professional goals?
3. What challenges or obstacles do you anticipate facing during the program, and
how do you plan to overcome them?
4. How will you contribute to the international student exchange program and the
host community while you are there?
5. What experience do you have working in multicultural or international
environments, and how will this experience help you in the program?
6. How do you plan to apply what you learn during the program to your future
academic or career pursuits?
7. Is there anything else you would like us to know about you that is not covered
in the application form?

Q1. (1). What inspired you to apply to this international student exchange program, and what do
you hope to gain from the experience?
I was inspired to gain experience studying electrical and electronics abroad, experience a
different education system, and help prospects for work after graduation

Q2. (3). What challenges or obstacles do you anticipate facing during the program, and how do you
plan to overcome them?
The challanges or obstacles that i anticipate during the program are system education,
language, food, a new life abroad. And plan to overcome its challanges or obstacles by
adapting and lerning quickly
I. Self Medical Check (to be completed by an applicant)
1. Present Status

a. Are you currently experiencing any symptoms or health concerns that you would like to discuss
with a healthcare professional? (Optional: If applicable, do you have any concerns related to
pregnancy that you would like to discuss?)
☒ No
☐ Yes → Please explain ( )

b. Do you have any chronic medical conditions (such as diabetes, asthma, or heart disease) that
require ongoing management or treatment?
☒ No
☐ Yes → Please explain ( )

c. Are you currently taking any medication or receiving medical treatment for any condition?
☒ No
☐ Yes → Name of Medication ( ), Quantity ( )

d. Have you had any surgeries or hospitalizations in the past year?

☒ No
☐ Yes → Please explain ( )

e. Do you have any allergies or sensitivities (such as to medications, foods, or environmental

factors) that require special attention or accommodations?
☒ No
☐ Yes → ☐ Medication, ☐ Food, ☐ Other: ( )

f. Do you have any current or past history of mental health concerns or conditions (such as
depression or anxiety)?
☒ No
☐ Yes → Please explain ( )

g. Are you up to date with your recommended screenings and vaccinations (such as
mammograms or flu shots)?
☒ Yes
☐ No → Please explain ( )

h. To ensure that we can provide appropriate support and accommodations, please indicate if you
have any needs arising from disabilities that might require additional support or facilities.

( )
Note: Please note that while we strive to provide equal opportunities for all applicants, some programmes may have specific
requirements or restrictions that could prevent the participation of individuals with certain disabilities or medical conditions.
For example, for safety reasons, colorblind students may not be eligible to participate in our Electrical programme. If you
have a disability or medical condition that you think may affect your participation in our program, please contact us to
discuss your specific needs and requirements before applying.

I am aware that any undisclosed pre-existing medical conditions may not be covered financially and
may result in the termination of the participation. I acknowledge and accept this risk and take full
responsibility for any consequences arising from my failure to disclose any relevant medical
information.

Signature of Applicant: Date(dd/mm/yy): 23/05/23

J. Final Checklist
 # Questions Answer

Do you hold citizenship of one of the participating countries in the

1 ☒ Yes ☐ No
international student exchange program?
Do you have a valid passport that will remain valid for at least 9
2 ☒ Yes ☐ No
months from now?
Are you currently enrolled, graduated in 6 months or employed in a
3 Technical and Vocational Education and Training (TVET) program or ☒ Yes ☐ No
institution?

4 Are you between the age of 18 and 25? (only applicable to students) ☒ Yes ☐ No

Do you have the required level of English language proficiency and

5 ☐ Yes ☒ No
IT skills, as specified in the program guidelines?

6 Do you meet the prerequisites described in the guideline? ☒ Yes ☐ No

Are you in good physical and mental health, and able to participate
7 in the program without any medical or health concerns that could ☒ Yes ☐ No
affect your safety or the safety of others?
Have you received all necessary vaccinations and can provide
8 ☒ Yes ☐ No
evidence of vaccination as required by the program guidelines?
Have you attached the necessary supporting documents listed on
9 ☒ Yes ☐ No
the last page?

I confirm that the information provided in response to the preceding questions is accurate,
complete, and truthful to the best of my understanding. I have read and understood the
objectives and conditions in this application, and I am committed to complying with them to
the best of my ability.

23/05/23

___________________ ____
Signature Date (dd/mm/yy)
 Supporting document list

*All documents must be written in English

Students
1. An official transcript in English (from a current or recent TVET institution)
2. A proof of enrollment/certificate of registration or a certificate of graduation/diploma
3. A proof of internship or employment experience (if applicable)
4. A recommendation letter from the TVET institution enrolled or recently graduated

Faculties
1. A proof of a certificate of graduation/diploma (final academic background)
2. A proof of current employment
3. A short CV