FORMAT SURAT REKOMENDASI
1. Berapa lama Anda kenal dengan pelamar? Dari tahun________sampai________
2. Apa hubungan Anda dengan pelamar?
3. Bidang apa yang perlu dikembangkan pelamar?
4. Tolong berilah komentar tentang ketrampilan interpersonal pelamar. Bagaimana kerjanya dalam tim?
5. Jelaskan kemampuan kepemimpinan pelamar.
6. Tolong jelaskan tingkat kepercayaan diri pelamar.
7. Tolong berilah komentar tentang karakter pribadi pelamar.
8. Tolong berilah penilaian dari evaluasi secara keseluruhan terhadap pelamar.
( ) sangat merekomendasikan
( ) merekomendasikan
( ) merekomendasikan dengan catatan
( ) tidak merekomendasikan
9. Tolong berikan komentar tambahan tentang potensi studi pelamar di Jepang dan kemanfaatan ilmunya untuk diterapkan di Indonesia.
M O N B U K A G A K U S H O : M E X T S C H O Ｌ A R S H I P R E C O M M E N D A T I O N F O R M
Applicant's Name(Print):__________________________, HARYANTO, ____________________________
(Family) (First) (Middle)
To the Applicant : Please indicate your full name above. Give this form and one of the envelopes marked “confidential" addressed to yourself, to the person you have asked to recommend you. Ask this person to place the completed form in the envelope, seal the envelope, sign across the seal, and return the unopened envelope with your application.
To the Applicant and the Recommender : This recommendation will be used for an admissional purposes only.
To the Recommender : Please respond to the following questions. Please type or print. After completing this form, place it in the envelope provided, seal the envelope, sign across the seal, and return it to the applicant. This recommendation is a required part of the application process; prompt return to the candidate is important. We appreciate your assistance and would like to assure you that your comments will be carefully considered.
Recommender's name : ACHMAD SOLIKIN, S.AG
Title and Institution (if work address used) : MUHAMMADIYAH CONDONGCATUR ELEMENTARY SCHOOL
Address : NORTH RING ROAD STREET, GORONGAN, CONDONGCATUR, DEPOK, SLEMAN,
Telephone & Facsimile : (0274) 486N619/ (0274)
1. During which period of time have you had the most frequent contact with the applicant? From 2004 to now
2. What was the nature of your relationship? Head Master
3. In what areas does the applicant need improvement or growth? Science material and skill to teach science with fun
4. Please comment on the applicant's interpersonal skills. How well does he or she work within a team? He has good interpersonal skills and can good work with team.
5. How would you describe the applicant's leadership skills?
6. Please comment on the applicant's degree of self-confidence.
7. Please comment on the applicant's personal character?
8. Please indicate your overall evaluation of the applicant.
（√）Strongly recommended （ ）Recommended （ ）Recommended with reservation （ ）Not recommended
9. Please make whatever additional comments you wish about the applicant's potential for study in Japan and potential for becoming a responsible, effective person in your country. Additional pages may be attached, and the back page is also available.
Signature ________________________________________ Date: January 29, 2010
CONFIDENTIAL LETTERS OF REFERENCE
1. Name of Applicant : Haryanto
2. Name and the title of Referee : Achmad Solikin, S. Ag
3. Referee’s Institution : Muhammadiyah Condongcatur Elementary School
4. How long have you known the applicant? 5 years
5. In what capacity have you known the applicant? Head Master
6. Please evaluate the applicant compared to the other employees you have known during your professional career.
Intellectual ability : Good
Knowledge of the fields : Good
Work habits : God
Motivation to improvement : Excellent
Seriousness of purpose : Good
Initiatives : Excellent
Adaptability : Excellent
Emotional maturity : Good
Professional potential : Excellent
Social commitment : Good
Leadership : Excellent
7. Please indicate where the applicant would rank among individuals you have supervised:
8. In your opinion, why does the applicant deserve to receive a scholarship? Please explain:
Mr. Haryanto has an ability to have a good ideas or thinking. His brilliant ideas can more useful if it is supported by relevance ability academic.
9. Please provide a complete evaluation of the applicant’s past performance, intellectual ability, and adaptability to new situations, ability to pursue and successfully complete a program of study in the proposed field.
Mr. Haryanto right now expert in science. In his knowledge as far as I know, he is be able to implement interdisciplinary in good learning. He also experienced in supervising students. He makes many achievements of several competitions that his students reach weather local, national, or international even. He is also able to survive in his new environment without any difficulty. In his major that he takes now, I am sure that he can finish on time that is his commitment.
Signature:_____________________ Date: January 29, 2010