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LSSZ LAUkLLU&$.ZSp ~UL~~LJ\I~_U~L 8SSZ 'U 'D EI 85SZ 'Id's E - 2 8ssz 'u'u oz 8SSZ 'KU €1 - 6 8552 'WK OE- ZI RLP~ULU - LS 'Wl6 01 LSSZ 'IXU GE - 61 LSSTB'U EZ LS 'mu ZI - 8 LSSZ 'wrt OE - b nyu~u LRUYSLUULU ~LUK~CLUPML~LLQ&K~L~ LLLUKSLUZ~Y c~uun~prmuornicn~~,ai UQpld~~plLRuyu_n,pLUR$ LLLurtuuanru bu3unr.p ~ u Q ~ ~ ~ L $ ~ u @ ~ Y ~ G ~ ~ , R I A L u ~ muayn#muyu_nn~n~p~m~~~~opMh::sp npnn~~g~nu~~mn~nuyr~untu~urrrsu~mu ~nuyu~~a~~y~~un~1~ynnr~c~~n~~ lo~bmkflUyUm~2WUEOhLRUYUbLW&RCp /~~uyu~r~uoyn~~~y~n~w~~~sup LR~~~~~~RU~LRU~U.U~~L~~LRU~ nc? _us41 LRUYLLU~L$AL~ ~nuy~~~nt(n~~,ai~uyu~u~gi~~zrm~u k LSSZ KULOUSU 1 Pnp~ LSSZ/I ~~$tdnbn~~\us~n~ ,. ~~MO~~L~M&LKK LAU~SLU~~(LLU%LLU~U ;;:: . I nhnryunlennq~en MLU~U~ZL~~ ~Q$M$lKLLURL~plnQl LSSZ LAUgSLU&L&ZLp p&i%ibginyzs r - npnncan~~sq,rm ~nuyr~un~n_r~y~u~~_nuogi~y::~n~uprtn~~~uqi~y~~ LLURLS WYLV r*. s b E 2 r 7

ph.kku.ac.th · &SSZ R 'm £ 8552 '12 m E 8552 ~5 QZ 8SSZ '5 OZ RL~~ULU LSSZ .c) '16 I£ LS~ 'U 3 IE L $51 'u 'M zz LSSZ U M bt R~LU LAUY~LUWLU LnuyuFLuayL.Bugl

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LSSZ LAUkLLU&$.ZSp ~UL~~LJ\I~_U~L

8SSZ 'U 'D EI

85SZ 'Id's E - 2

8ssz 'u'u oz

8SSZ 'KU €1 - 6

8552 'WK OE- ZI

RLP~ULU -

LS 'Wl6 01

LSSZ 'IXU GE - 61

LSSTB'U EZ

LS 'mu ZI - 8

LSSZ 'wrt OE - b

nyu~u

LRUYSLUULU

~LUK~CLUPML~LLQ&K~L~ LLLUKSLUZ~Y

c~uun~prmuornicn~~,ai

UQpld~~plLRuyu_n,pLUR$ LLLurtuuanru

bu3unr.p

~uQ~~~L$~u@~Y~G~~,RIALu~L~~~~~~

muayn#muyu_nn~n~p~m~~~~opMh::sp

npnn~~g~nu~~mn~nuyr~untu~urrrsu~mu

~nuyu~~a~~y~~un~1~ynnr~c~~n~~~u~~~umu

lo~bmkflUyUm~2WUEOhLRUYUbLW&RCp

/~~uyu~r~uoyn~~~y~n~w~~~sup~n~~p

LR~~~~~~RU~LRU~U.U~~L~~LRU~U_~~U~~

nc? _us41 LRUYLLU~L$AL~ ~nuy~~~nt(n~~,ai~uyu~u~gi~~zrm~up~~~un~~~n~~y~p k

LSSZ KULOUSU 1 Pnp~ LSSZ/I ~~$tdnbn~~\us~n~ ,. ~~MO~~L~M&LKK LAU~SLU~~(LLU%LLU~U ;;:: . I nhnryunlennq~en MLU~U~ZL~~ ~Q$M$lKLLURL~plnQl LSSZ LAUgSLU&L&ZLp p&i%ibginyzs r - npnncan~~sq,rm ~nuyr~un~n_r~y~u~~_nuogi~y::~n~uprtn~~~uqi~y~~u~~~~i

LLURLS WYLV r*.

s

b

E

2

r

7

&SSZ R 'm £

8552 '12 m E

8552 ~5 QZ

8SSZ '5 OZ

RL~~ULU

LSSZ .c) '16 I£

LS~ 'U 3 IE

L $51 'u 'M zz

LSSZ U M bt

R~LU

LAUY~LUWLU

LnuyuFLuayL.Bugl

cumntpnLMq rwnle~atu~aau3~unk

n$yvLAUkU,"B&%WLUI9fifP LkLUWUmVU

wJukupsuegmug1 usu~s~unhqi

n~pu~~)rr~unoua$pn~iug~It~g)*b~lau~

~au~r~unkn~~~u~au~u,na~~~~u~u~~p

OD notns~sg~~nl pnhb~mrnrr~n~

-~LMPL~%~~~~~Qu~~~~~~LAu~u~o~RLLP~~N~)

6

8

L

9

LLunLS $"!?+

runi'inuGuusutttiu (Send back to Student Affairs at Khon Kaen-University)

w a ~uIu~u?~ (Within)

d ( d & M

tehmsutduranm~JnTln ~wnzidua?tua'Y&u~nntl

'lud~s%a%quais#m1 (Appllcatlon Fonn)

Yni4in~1 (AcPdemicYear)

4~ - aqn (mu1'lnu) Name- Family Name h Thai

48 - aQa (ninlnjnqu) Name- Family Name In Ewlish

' d zH"dsrdiR'?u'niln~i mo43lun' Tnsrlim' Shrderd ID No. E-mail Address Phone No.

40 - UQA o~oadi&nni Advboh Name - FsmUy Neme

&%;t-tn.~#vrd ' mw:: n i~3sl Faculty Depubnent Year Phom No.

- f!mnodlunat:: aiui1r7 &d r-scurtu hyr Year

13a%6 - &u . W.H. olt! i3 u'y5iornnui Biithday Month Year ~ e e Rellglon

ST~c~dsrdiPI'? lddcd Hiotoy

~i3ri11ui1Zu ~ I U R

HomeTavn Tambon

RUU l ~ s u b l ~ 0 Street Disbid

o'Jn% rllirld~~ciio' Tnshn' provhe Pwtcode Phone No.

do$ilop3u no~n uv. no~nd nYa4 o~uonzrnijnmiiu nogni yYtu+nuon uv. PlEseld Addms

.- . $~n$i-iut ~ B W D I T ~ d &urnurn r 2

WQM %Dt) Dormltoly's Nams Moo Sol

QUU 61Y.l~ 6 2 1 ~ dln~ Street Tambon District

im"~ ~Hir'lllslrriid Tnshn' Provinoe Postcode Phone No.

A fl%lLUUlQAUBZPfU G.PA

Tun~~b~i~tfivlhi"u s~niw4mi - w UI JIMl'dMUlBUVOUL6fI~

SchOlaIShip received during study at Kh0n Kaen University

Yn1s8nvi diu?ur?u uin SohofaM5, Name Academic Year . Amwnt

doqu . Ynnndnv? ~ ~ U ~ U L ? U u 101 Sholamhip Name Academlo Year Amwnt

40qu 3n15dn~t . Biu.ru311 u ~ n Sdroiarship Name Acsdernlc Year Amount,

!Yftndnw 61u?ui3u urn AeaIemk Year Amount

iln-iadn~l 3lu~u~311 uin Aadmic Year Amatnt

- 2 ~%l l l l lSS~ l lSV? (Fpmlly Status)

2~148 UlUtTQtt O1t! 9 FaIhatl Name Family Name

.d doiilootiwua.r3ni d~nifiiu d~u~aud nyn-vou ~ ~ n t A & n u of Faher

nuw Aiua LVPI/ 6imo street Tambon MmM

OYJnlk .~tin'lrlanniiu' . TvlshiPPn' Pfovlnce Posbde Phone No.

clhuwiia~ dj1~1nU'~ s ' I u S # ~ ~ J ~ ~ ~ J U uin Father'socupabn Position l n m per month

A SJISRI v ~ l wlola~a D I ~ TI Wdhefs Name Family Name

d Age

M"od~o~~'uvasuisni ~DN$IU y"lwtnvn WXM .A - t i f ~ ~ Present Address of Mother

nuw i t v a uvw/ b i m ~ Street Tarnbon District

fian%l sfiaads~Gu" Tms8n6 Province Postcode Phone No. . o~%vosuisni 41uwds sa%8dedou UIW Mother's Occupation Position income per month

i n m s ~ o l s ~ v o s Y ' ~ i ~ ~ a w ' ~ Maniage Status

0 ugj#9;7uflYu Maniage

0 nth D i m d

P 9~18a1irinsru Father D e d

O uismi$audnssu Mother Deoeased

D lr inr iu~~f luo~~"~i /uisni Parent's Agiess Unknown

C3 $uq (53.4) OUler

a !di%Q~fi~~l / U15R7 No Data bfparent

In case your guardian is net your parent

1 - %El - tlqfl g~d~fl lsz d Y L~U~VDJISU Guardian's Name - Fmity Name Relationship to you d n~C;ito~~uvetr$~dnx:: &v$iiiu ~ ~ U L R . U ~ - M G ~ -mu- Pmsent Address Mco sd

nuu 61ufi 1vn1 bimo Street Tambon Diibitt

c'n% sn'ar'ldsu68 'Lns&"Nui PrOviMe Postwde Phone No.

oi%~pdni5:: 6iunds s i u ~ ~ ~ o ~ ~ o u uln Ooarpation Pobition Imonmpermonth

4 w 3 . P 6 i i ? d o a % s g ~ ~ 6 1 ~ ~ ~ i i n ~ 1 nsanlroadnrnr~~~ m~!upr?~n$eavi1~%~bp1~ps"awd~1afi~~d~~'1~ Hrve you pawpated in campus or other owanlzation's actiiilies hnd have any ideas to do for the common good of what

~m!ghttodo.

medqa t$~ds::lu~~?'~nia403311) l-he reason for applying for the scholarship ( G i i thc important data of biography of applimnt and fsmity for consideration)

~wr~ir 'Yrm~ito"aniul i i~~ut~u~~1~~3~qnJ~~ni nin~~ion~1~~4iim~d~lF;IrYT4& uni'inai&uici?routrriur9udo &rr~I~iiumulrtiini3~1~~~~~ln~~im~nir1d~u~t1~tH"~m~~r

I certily t h & h abwe in famulation is trus. I all undemtamd that furnishing fault In formaner may mu# b nwoartlon dthe mhohhlp or dWptinay don

a d a

.- dd d "

g j j

Recornmendahon of Advisor1 Student Affair's Teacher

hh a~oizi$&nltv o~o~~dthu?ion~ru'ni7n~v 1 . Advsorl Student ARaYs Teacher

oi~is;i l iuw"~)]u~u"n$n~~~~~uiu/ui~ai~ nn: Of Mr./ Ms Fawny

5% iu3 - d d Bnaiui~utf lu~h~i5eru'n5uas"Yy~ni5#n~1vo~~ndn~~~~ndia

? ?Stud;nt ID - Year In offer the follow oplnlons about the student

KJii

1. n~iue~uirouos~~~aln"n~z~u'~aYu6~~4i iu~unizialn~i How much flnandal support the guardians provide?

j. . . . . .

2. rns¶#4iufiuuo~u'n#n1~i Expenditure of Student

<,., , I 3.n.nurlsewqS na~u~e~lo¶oi9unis%n~ii~~::n~~uniu~~nddi~~niz%np1~1~

At&nllvsness.'Behavlor and Potential for echbvtng guardian

' 8 , . ; . ' : 4 - * . ., ~ s.

4. Ua~motiur~u~ Y'. -.

Other Comment :* -> '. . . . - . . * \.. ~ z ~ .

t.0 -:.:

%:!: .< : : ,. Ivt+.- . ads k;:;::; ' ~ f >

. . % # - . . *-:-.. - 7 t . . . 54- 188~ . W.H. 9.':. , . - . - I, . " 4 4 ,... pwbw von?wn~rui~~oi~i~8n~sn~1nsans1m~16~~~~~~?7~1duniu11n'ilnPciin iano~iirmsu'ndmi

. ~ .. .

un~insiCwoiiilfiu ~ u n r r i i ~ l o l 5 6 i ~ i n ~ 7 l i a ~ ; t H ' s o ~ ~ o ( ~ ' i ~ i u i i ~ n n u ' n i l n ~ i n?a~isn6h~. L , . iionlru"n#mv s1olsGiliorimru"n3nnln mriuan~iu~irzuunu

..~ ~. . .

,. _ *

= - - _ _ -. - - - - . .. - I ,_I -_._ . - -- ...+- ,+~.-,4#q