JAPANESE CUISINE BURSARY PROGRAMME APPLICATION FORM

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LE CORDON BLEU JAPAN JAPANESE CUISINE BURSARY PROGRAMME APPLICATION FORM Contact person: Date of application: Contact mail: Student ID: LE CORDON BLEU JAPAN, INC Tokyo - Roob-1, 28-13 Sarugaku-cho, Shibuya-ku, Tokyo, 150-0033, Japan Kobe - The 45th 6F, 45 Harima- Machi, Kobe city, Hyogo, 650-0036, Japan

------------------------------------------------------------------------------------------- Table of Contents 1. APPLICATION PROCEDURE... 1 2. APPLICATION INFORMATION... 3 3. RESUME... 6 4. STATEMENT OF MOTIVATION... 7 5. PROFESSIONAL GOALS... 8 6. CONDITIONS... 9 ------------------------------------------------------------------------------------------- 1. APPLICATION PROCEDURE For any inquiries or questions, contact us at: infojapan@cordonbleu.edu IMPORTANT DATES 1- Application period begins on March 23 nd and ends May 22 nd, 2016, 23:59 Japan time (GMT/UTC + 09:00 hour). 2- Selected candidates will be contacted by email on May 27 th, 2016 and must confirm their participation to the programme no later than June 3 rd, 2016, 23:59 Japan time (GMT/UTC + 09:00 hour) by submitting their confirmation package. IMPORTANT INFORMATION 1- When candidates apply, they are responsible for participating in the programme upon selection. 2- The Application Form must be completed, dated, signed by the candidate, and sent as a PDF by the due date. The other required original documents will need to be sent to the address below after the PDF is submitted: Le Cordon Bleu Tokyo (Japanese Cuisine Bursary Programme) Deborah Latreuille Roob-1, 28-13 Sarugaku-cho, Shibuya-ku, Tokyo, 150-0033, Japan 3- By applying, dating, and signing the documents, the candidate acknowledges that all information given is true and correct. 4- This Application Form, including Resume (P.6), Statement of Motivation (P.7), and Professional Goals in relationship with the Japanese cuisine (P.8), must be completed and sent along with the documents below: recommendation from place of employment or culinary institute (Outline of Dispatching Entity (Attachment 1)) one of the following documents proving that the knowledge and techniques acquired through the programme will be applied relevantly: a) Certificate of Reinstatement (Attachment 2a) b) Certificate of Employment (Attachment 2b) c) proof of education in a culinary school (e.g. Le Cordon Bleu Diploma) copy of your Passport ID page 1

ID photo (4cm x 3cm, no hat, no background, taken in or after March 2016, your name written on the back in alphabet) 5- The date of expiry on the candidate s passport must extend past April 16, 2017. 6- The Professional Goals explain in detail the purpose and motivation for participating in programmes relating to Japanese Cuisine. It should also detail how the completion of this programme will support you professionally. Additionally, participants will be required to submit a report documenting the progress of their professional goals. 7- Alumni of Le Cordon Bleu Institutes or of other culinary art institutes must provide proof of graduation, in English. Alternately, industry professionals must provide reference letters from their place of employment, in English. 8- By applying to the programme, the candidate agrees to respect the Terms and Conditions and rules of each institution he/she will attend. 9- Candidates will be considered equally irrespective of age, sex/gender, nationality, religious or community belonging, political opinion, marital status, sexual orientation, colour, social origin or other status. Selection will be based on the relevance of the required elements with regards to the programme. 10- Any application that does not fulfil the requirements will not be considered for selection. 2

2. APPLICATION INFORMATION 1- Personal Information (please write all names as stated on your passport) Mr. Mrs. Miss Ms. Family Name Family Name (alphabet) Add Picture (4cm x 3cm) First Name(s) First Name (alphabet) Preferred Name / Middle Name Profession Marital Status Single Married Divorced Widowed Current Address Bldg., Street Postal Code & City Country Tel (+ ) Mobile (+ ) E-mail Permanent Address (if different) Bldg., Street Postal Code & City Country Tel (+ ) Mobile (+ ) E-mail 2- Visa Application Nationality Passport Number Passport valid from (DD/MM/YY) Passport valid until (DD/MM/YY) Place & Date of Birth (DD/MM/YY) Visa Application Site (country, city) Have you ever been to Japan before? No Yes How many times Please detail the latest dates and length of stay: Do you have any criminal antecedents? No Yes Please detail: Have you ever been restricted from entering any country or deported or repatriated from any country? No Yes Please specify the country and reasons: 3

Do you have any relatives living in Japan? No Yes Please detail below: Family Name Relation to the candidate First Name(s) Resident Registration Card Number Nationality Date of Birth (DD/MM/YY) Workplace / School or University contacts: 3- Emergency Contact / Financial Guarantor Family Name Guardian Financial Guarantor Other First Name(s) Relation to the candidate Bldg., Street Postal Code & City Country Tel (+ ) Mobile (+) E-mail 4- Language Proficiency It is the Student s responsibility to ensure that he/she is proficient in the language of the applied programme. English: Native Fluent Conversational Poor Language certificate, score, year: Japanese: Native Fluent Conversational Poor Language certificate, score, year: Chinese: Native Fluent Conversational Poor Language certificate, score, year: Other languages: please precise: 5- Programme & Session Dates Application to the full programme of 8 months is compulsory. I wish to participate in the programme upon selection. PROGRAMME DATE & PERIOD VENUE Japanese Language Training July (1 month) Tokyo International Japanese School Japanese Cuisine Initiation Certificate August (1 month) Le Cordon Bleu Tokyo On-the-job Training (Internship) Sept. 2016 - Feb.2017(6 months) One of the 15 restaurants in the list below It is possible to choose up to 2 preferred venues in each category (Sushi restaurant/japanese restaurant) for the inrestaurant training portion of the programme. Indicate your preference by checking ( 1) or ( 2); however, there is no guarantee that the appointed restaurant will be one of the desired choices. 4

Akasaka Kikunoi http://kikunoi.jp/english/store/akasaka Tsukiji Tamura http://www.tsukiji-tamura.com/ Nihonbashi Yukari http://nihonbashi-yukari.com/ Kurogi http://www.kurogi.co.jp/ SANPI-RYORON http://www.sanpi-ryoron.com/ RyuGin http://www.nihonryori-ryugin.com/ Kikunoi (main restaurant) http://kikunoi.jp/ Tankuma Kitamise (Kyoto Main) http://www.tankumakita.jp/ Kinobu http://www.kinobu.co.jp/open.html Uosaburo http://www.uosaburo.com/access.html Gion Sasaki http://gion-sasaki.sakura.ne.jp/ Minokichi Honten Takeshigero http://www.takeshigero.com/ Arashiyama Kumahiko http://www.kumahiko.com/index.html CATEGORY A: JAPANESE CUISINE RESTAURANT Restaurant name Location Selection Akasaka, Tokyo 1 2 Tsukiji, Tokyo 1 2 Nihonbashi, Tokyo 1 2 Yushima, Tokyo 1 2 Ebisu, Tokyo 1 2 Roppongi, Tokyo 1 2 Higashiyama, Kyoto 1 2 Kamiya-Cho, Kyoto 1 2 Shimogyo, Kyoto 1 2 Fushimi, Kyoto 1 2 Higashiyama, Kyoto 1 2 Sakyoku, Kyoto 1 2 Arashiyama, Kyoto 1 2 Ginza Sushiko Honten http://hitosara.com/0006066076/ Sakaezushi http://sushi-skills.com/sakae2/ CATEGORY B: SUSHI RESTAURANT Restaurant name Location Selection Ginza, Tokyo 1 2 Chiba City, Chiba 1 2 6- Medical & Disability Information Do you have any medical conditions or disabilities? No Yes (Please provide brief details) 5

3. RESUME EDUCATION Start and End Date UNIVERSITY/INSTITUTE NAME AND LOCATION SUBJECT NAME/COURSE LEVEL Start and End Date UNIVERSITY/INSTITUTE NAME AND LOCATION SUBJECT NAME/COURSE LEVEL WORK EXPERIENCE Start and End Date COMPANY NAME AND LOCATION JOB TITLE each bullet should describe responsibilities and achievements Start and End Date COMPANY NAME AND LOCATION JOB TITLE each bullet should describe responsibilities and achievements Start and End Date COMPANY NAME AND LOCATION JOB TITLE each bullet point should describe responsibilities and achievements SKILLS AND ACTIVITIES list any computer skills, licenses, and languages etc. here personal hobbies or activities can also be listed here 6

4. STATEMENT OF MOTIVATION How will you apply the skills acquired from this programme to your job/career? (100-200 words) Why did you decide to apply for this programme? (300-500 words) 7

5. PROFESSIONAL GOALS Select one of the 4 statements below, indicating your general plan upon returning to your country of residence. (a) resume current job (b) change job/career (c) become self-employed/start a business (d) other ( ) Select one of the following options, then outline how you will realise this goal below. (i) increase the number of Japanese products in your business by at least 30% (ii) increase the use of Japanese ingredients in the menu by at least 30% (iii) increase the amount of Japanese ingredients in your business by at least 30% (iv) open a Japanese-related business, incorporating Japanese ingredients/products (300-500 words) 8

6. CONDITIONS 1- Programme cancellation Cancellation of the programme may occur in the case of: - natural or accidental disaster through which courses can no longer be held in safe conditions - funding body withdraws from the programme entirely In the unlikely event of said circumstances, applicants will be officially informed. 2- Conduct, Behaviour & Discipline Candidates are expected to uphold the importance of courtesy, integrity, good manners, good discipline and respect for the needs of others. Individual rights and freedoms are to be respected through understanding the freedom and needs of others. Candidates are expected also to take part in the activities of the institute(s), attend each scheduled session, be punctual, and comply with the policies of the institute(s), including those relating to conduct and behaviour, uniform and dress code, cleanliness and hygiene, and any other pertinent regulations. The candidate accepts the authority of the institute(s) to take all reasonable disciplinary action under necessary circumstances, including actions taken by the Academic Committee summoned in the event of expulsion. The institute(s) reserve the right to refuse candidates entry into class if they are found to be under the influence of drugs or alcohol. 3- Medical Information & Insurance Medical information: Candidates are responsible for all precautions and risks when deciding whether to taste, touch without protection, or use ingredients during class. Any information given regarding a medical condition is confidential and shared only if considered in the candidate s own interest or absolutely necessary for the protection of other parties present. Insurance: Le Cordon Bleu Japan, Inc., covers only the accidental events that are of the institute s responsibility. Le Cordon Bleu Japan, Inc., will not be liable whatsoever to any student for any losses, damage, personal injury or death caused by negligent acts by students on institution premises, except for personal injury, loss or damage caused by a Le Cordon Bleu Japan Institute, its employees, and collaborators. 4- Data Dissemination & Intellectual Property 4-1. Data Dissemination At Le Cordon Bleu Japan, taking photographs during classes for the sole purpose of learning is tolerated given prior approval. Students are permitted to take the picture of final dishes made by lecturers and teaching teams. The pictures taken by students shall be for their personal use only and shall not be disseminated. Le Cordon Bleu Japan, Inc., reserves the right to use promotional work taken in the form of photography or video for the purpose of advertising, promotional use, educational purposes, as a part of the curriculum, activities, or for press and media purposes. Use of student work can appear in print or digitally, including on the institute s official website, social media, brochures, and/or other promotional materials. 4.2- Intellectual Property At Le Cordon Bleu Japan, course programmes, course materials, original recipes, logos, names, crests, domain names, and trademarks are the sole property of Le Cordon Bleu International B.V.; use, reproduction, or modification by students in any form before, during, or after their enrolment is forbidden, except with the prior written permission of the institute s senior management. Additionally, the school uniform cannot be worn by students or alumni for the personal or business purposes or promotion. 9

PLEDGE I wish to apply for the Programme mentioned in the point 5- Programme Selection & Session Dates of this Application Form. I understand that admission to the programme is contingent on my selection, which is contingent on my timely provision of all required documents and conditions. I acknowledge that all the information provided on this form is correct and true. I understand that any misrepresentation can result in non-acceptance or termination of enrolment. In the event of any changes, I will immediately inform Le Cordon Bleu Japan in writing. I have read and understood all information contained in the documents provided and shall follow all instructions therein from the time of application until completion of courses. I hereby consent to and comply with the above. Date (DD/MM/YYYY): Name in Full of the Candidate (alphabet): Signature: 10