Contoh Berkas Beasiswa Tiongkok Achmad Badaruddin (Surat kesehatan belum menggunakan format yang seharusnya).

1. APPLICATION FORM FOR CHINESE GOVERNMENT SCHOLARSHIP
Personal Data:
Agency No.
3602
Agency Name
Embassy of P.R. China in Indonesia
Photo
Last Name
KOTO
Surname
ACHMAD BADARUDDIN
Chinese Name Gender
Male
Date of Birth
1988-07-28
Marital Status
Single
Nationality
Indonesia
Native Language
Indonesia language
Passport No.
A325132
Country of Birth
Indonesia
City of Birth
Malang
Religion
Moslem
Permanent Contact Tel Permanent Contact Fax Permanent Contact E-mail
achmad_badaruddin@yahoo.com
Permanent Contact Address
SMK Tunas Harapan
Jl Cempaka Putih Barat 14 Cempaka Putih
Jakarta Pusat
DKI Jakarta
Present Contact Tel Present Contact Fax Present Contact E-mail
achmad_badaruddin@yahoo.com
Present Contact Address
SMK Tunas Harapan
Jl Cempaka Putih Barat 14 Cempaka Putih
Jakarta Pusat
DKI Jakarta
Education Background and Employment Record:
Highest Diploma
Institution
Universitas Negeri Padang
Years Attended
From 2008-07-07 To 2015-03-16
Fields of Study
Guidance and Counseling
Certificates Obtained or to Obtain
Bachelor of Education with Honours
Other Certificate I
Institution
Quantum College
Years Attended
From 2007-07-06 To 2008-09-06
Fields of Study
Computer Information System_____________________________________________________________________________________________________________________
Serial Number: 653047 Generated: 6 Apr 2016Page 1 of 4

2. Certificates Obtained or to Obtain
One Year Integrated Skill Education
_____________________________________________________________________________________________________________________
Serial Number: 653047 Generated: 6 Apr 2016Page 2 of 4

3. Other Certificate II
Institution
Sekolah Trainer Indonesia
Years Attended Fields of Study
Training For Trainers
Certificates Obtained or to Obtain
Non Degree
Current Employment
Employer
SMK Tunas Harapan Cempaka Putih
Time Engaged
From 2015-08-03 To 2016-04-06
Work Engaged
Education Counselor
Posts Held
Counseling
Language Proficiency and Proposed Study in China:
Chinese Proficiency
Fair
Level of HSK test or other certificates
English Proficiency
Good
I can be taught in English
yes
Other Language
Indonesia
Apply for
Master's Degree
Disciplines
Education
Majors
Information Engineering of Psychology
Preferences of Institution I
EAST CHINA NORMAL UNIVERSITY
Preferences of Institution II
BEIJING NORMAL UNIVERSITY
Preferences of Institution III
TSINGHUA UNIVERSITY
Duration of the Major Study
From 2016-09-05 To 2019-09-05
Do You Need Elementary Chinese Study prior to the Major Study
yes
Duration of Your Elementary Chinese Study (not included in the length of the major study)
From 2016-06-01 To 2016-08-01
Have you ever Studied or Worked in China
no
Institution or Employer Time(from/to)
Contact in China and Family Members:
Guarantor's Name Tel
E-mail Fax
Address
_____________________________________________________________________________________________________________________
Serial Number: 653047 Generated: 6 Apr 2016Page 3 of 4

4. Spouse's Name
Age Employment
Father's Name
Age Employment
Mother's Name
Age Employment
◆ Supporting Documentation Attached(Please Indicate with 'X' in the Bracket.):
□ Two Application Forms.
□ Two Letters of Recommendation.
□ Admission Letter or Admission Notice of Chinese Universities.
□ Transcripts of the Most Advanced Studies(Notarized Photocopy).
□ Diploma of the Most Advanced Studies(Notarized Photocopy):
Bachelor's□ Master's□ Doctor's□ Others□
□ Foreigner Physical Examination Form(Photocopy).
□ Study Plan in China.
□ Articles or Papers Written or Published.
□ Examples of Art(6 color pictures)and Music(1 audio tape)Work(Only for the applicants applying for Fine Arts and Music).
□ Other Attachments(List Needed)：_______________________________________________________________
Note:Each Set of the complete materials should not exceed 20 pages．Please use DIN A4.
Whether the candidates are accepted or not,all the application materials will not be returned.
◆ I Hereby Declare That:
1. All information and supporting documentation provided for this application are complete, true and correct.
2. During my stay in China,I shall abide by the laws and decrees of the Chinese government,and will not participate in any activities
in China which are deemed to be adverse to the social order of China and are inappropriate to the capacity as a student.
3. I will agree to the arrangements of my institution and specialty of study in China made by CSC,and will not apply for any changes
in these two fields without valid reasons.
4. During my study in China,I shall abide the rules and regulations of the host university,and concentrate on my studies and researches,
and follow the teaching programs arranged by the university.
5. I shall go through the procedures of the Annual Review of Chinese Govemment Scholarship Status as required.
6. I shall return to my home country as soon as l complete my scheduled program in China,and will not extend my stay without valid
reasons.
7. If I am judged by the Chinese laws and decrees and the rules and regulations of the university as having violated any of the above,
I will not lodge any appeal against the decision of CSC on suspending,or withdrawing my scholarship,or other penalties.
Signature of the Applicant:_____________________Date:_________
(The application is invalid without the applicant's signature)
_____________________________________________________________________________________________________________________
Serial Number: 653047 Generated: 6 Apr 2016Page 4 of 4
06 April 2016
x
x
x
x
x
x
x
x Diploma Suplement and Other Certificate (plus Mandarin)
x

6. April 24, 2014
To Whom It May Concern:
I do not have firsthand knowledge of Achmad Badaruddin as a student but I have corresponded
with him and have looked over his academic credentials. Mr. Badaruddin is an energetic and
dedicated young man. He appears to be especially passionate about counseling and its practice in
Indonesia. His grades are very solid and combined with his enthusiasm and knowledge of
English, I think he is a very good candidate for an advanced degree in counseling.
Mr. Badaruddin has told me he is applying to your master’s program in counseling. His
application is one that I can and do support enthusiastically. I realize that Mr. Badaruddin may
make some mistakes in his English (a second language for him) but I think his conceptualization
of what counseling is and how to practice it is excellent. He will only get better with time!
Mr. Badaruddin has read my orientation to counseling book and thus he has a broader knowledge
of what counseling is than most international students. Furthermore, Mr. Badaruddin is focused
on helping counseling become a more regulated and appreciated profession in Indonesia. He
recognizes what counseling is compared to other helping profession. His attention to
development, wellness and prevention is something to be admired and respected.
Overall, I recommend Mr. Badaruddin to you as a counseling student. His ability is one that will
come through over time. His passion will be contagious. His focus will be one that students in
you program will admire and respond to. In short, Mr. Badaruddin is a winner. He will bring
honor to all involved and devote himself to learning at the highest level possible. He is a “player”
who has much to offer now and the future.
Sincerely,
Samuel T. Gladding, Ph.D.
Chair and Professor of Counseling
Wake Forest University

16. Study Plan
I have plan to study in East China Normal University (ECNU). Because East China
Normal University (ECNU) is a key university under the direct auspices of the Ministry of
Education of China. ECNU was ranked among 100 key universities of 211 Project of China
and was among 39 national key universities of 985 Project of China. It is a research
university with an extensive range of disciplines including education, social sciences,
humanities, natural sciences and technologies, and administrative sciences. The University
has 19 full time schools consisting of 48 departments with 65 undergraduate programmes,
177 Master’s programmes, 120 doctoral programmes and 14 post-doctoral programmes.
Since the 1960s, the University has had over 15,000 international students, both degree
students and non-degree learners of Chinese.
This University has unique magister programs. One of all, that program is Information
Engineering of Psychology. This major is only one in China that I know. And not yet in
Indonesia.
I am interesting in that program. I’m in Second Championship Science Olimpiad in
Computer Study of Padang Pariaman District (Indonesia) for two periods. And I have
graduated from Guidance and Counseling (Accredited “A”) of State University of Padang
(Accredited “B”). I learnt a lot of study Psychology in my undergraduate program. So,
basicly, I believe I will succes in this major with my competency and knowledge.
I will study from August 2016 until September 2019. Because this program for 3
years. I am planning to design research for R&D in Information Engineering of Psychology,
especially counseling or therapy based on technology development. I will make more specific
theme for research after I learn more there.
1st
Semester
2nd
Semester
3th
Semester
4th
Semester
5th
Semester
6th
Semester
Course
Research

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