ASEAN-ROK TVET Mobility Programmes

Application Form
for Mobility Programme 3rd Batch
 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 Electrical and Electronics and Hospitality and Tourism 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 27 August to
Brunei Micronet International
1 Information Network Management
Darussalam College 19 November 2024
Service

Electrical and Preah Kossomak 5 August to

2 Cambodia Sequence Control (PLC)
Electronics Polytechnic Institute 28 October 2024

Building 6 August to
3 Indonesia BBPVP Medan Drawing Architecture
Construction 28 October 2024

Skills Development 21 August to

4 Lao PDR Automotive Automotive Servicing
Institute 12 November 2024
Toyota Motor 30 July to
5 Philippines Automotive Philippines School of Automotive Servicing
Technology, Inc. 23 October 2024

Computer and 8 October to

Nanyang Polytechnic
6 Singapore Information Information Technology
International 7 November 2024
Service

Hospitality and Phuket Vocational 7 August to

7 Thailand Hospitality Management
Tourism College 28 October 2024

Building Ho Chi Minh City Construction Engineering 1 August to

8 VietNam
Construction College of Construction Technology 23 October 2024
APPLICATION FORM
A. Personal Information
* Please TYPE on this form (DO NOT HANDWRITE).
** The information should be the same as on the PASSPORT.
*** Please refer to the Appendix 1 and Appendix 2 (attached at the end of the document) for the
supporting documents for the application.

First/Given Name Barita (ID photo)

Middle Name (if any) Martupa
Last/Family Name Nababan
Date of Birth (DD/MM/YY) 25 / 05 / 1984

Gender Male

* Passport photo(3x4)
is preferred
Nationality Indonesia

Passport Number * If your passport is in the process of issue at the time of submission,
please fill in the expected receipt date.
Mutiara gadingTimur Blok N6 No 17 Residental West Java,
Current Address
17158, Indonesia
Closest international Soekarno 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
Status Faculty

Applying Sector 4. Electrical and Electronics

Applying programme 1 Sequence Control(Cambodia)

Applying programme 2 Please select the programme
C. Education Background (Most recent education)
Name of TVET Institution
Currently Enrolled
Current status ✘ Graduated
(Graduation Date((DD/MM/YY): )
Less than 6 months
Studied Period
Less than 1 year
Major Engineering Electrical
✘ Certificate
Level of the training Diploma
Others(specify: )

D. Contact Information
Contact Information

Mobile (with country code) +6285210384112

WhatsApp or other
+6285210384112
messengers ( )
Email (Gmail, if any) nbbn.barita@gmail.com

Supervisor's Information

Name(First / Last)

Mobile (with country code)

WhatsApp or other
messengers ( )
Email

Emergency Contact and Insurance Beneficiary Information

Name(First / Last) Rita Simanjuntak

Mutiara gadingTimur Blok N6 No 17 Residental West Java,
Address
17158, Indonesia
Mobile (with country code) +6285358710408

Email rita.simanjuntak1984@gmail.com

Relationship Wife
E. Work/Internship Experience
Company Country Period Position Responsibilities
(MM/YY to MM/YY)
Educate and train job
training participants in
Ministry of terms of knowledge,
Manpower skills and attitudes so
Republic Indonesia 2009 - Present Instructor that they can work well
Indonesia in industry,
entrepreneurship and
in other sectors

F. Language Proficiency

Native Language

English
Excellent Good Fair Basic Remarks
Listening √
Speaking √
Writing √
Reading √

Other Languages (please specify): Indonesia languuage__________________

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.

● What inspired you to apply to this international student exchange program, and what
do you hope to gain from the experience?

● In what ways do you think participating in this program will help you achieve your
academic, personal, or professional goals?

● What challenges or obstacles do you anticipate facing during the program, and how
do you plan to overcome them?
● How will you contribute to the international student exchange program and the host
community while you are there?
● What experience do you have working in multicultural or international environments,
and how will this experience help you in the program?
● How do you plan to apply what you learn during the program to your future
academic or career pursuits?
● Is there anything else you would like us to know about you that is not covered in the
application form?

Q1.
● to improve the ability of Sequence Control Program both in terms of knowledge and
skills, as well as being able to share culture between countries and after completing
the training I also want to implement the existing training system at my workplace
● in terms of developing training systems, both synchronized, syllabus or material
delivery techniques
● Regional differences in culture, food, climate, language, and surrounding society will
influence the teaching and learning process.
● and the way to overcome this is by communicating well and being able to create
cooperation between participants and the teaching team and learning with the
culture of Cambodia.
● I will contribute to student exchange by building good comics and providing input or
criticism
● I have studied in South Korea along with friends from other ASEAN countries,
especially from Cambodia
● I will implement this training in my country through my workplace which is engaged
in training and improve the quality of training in my country through a curriculum
system, teaching method techniques or improving the quality of equipment
● Thanks so much, it is complete

Q2.
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.

( No, Thanks )
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):

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
months from now?
2 ✘ Yes No
* If you have already applied for the passport at the time of submission,
please check “yes”.
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?

* Please note that if any item on the checklist is not fulfilled (indicating “No”), the applicant will
be regarded as ineligible at the screening process.

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.

___________________ __ ___________________ __
Barita Martupa Nababan 05 July 2024
[Appendix 1] Supporting document list

*All documents must be written in English.

Students
1. Passport Copy (page 1, minimum 9-month validity)
* The passport copy is mandatory for both International and Domestic Travel.
** If you have already applied for the passport at the time of submission, please
submit the official
2. An official transcript in English (from a current or recent TVET institution)
3. A proof of enrollment/certificate of registration or a certificate of graduation/diploma
4. A proof of internship or employment experience (if applicable)
5. A recommendation letter from the TVET institution enrolled or recently graduated

Faculties
1. Passport Copy (page 1, minimum 9-month validity)
* The passport copy is mandatory for both International and Domestic Travel.
2. A proof of a certificate of graduation/diploma (final academic background)
3. A proof of current employment
4. A short CV
[Appendix 2] Visa and Insurance Requirements

Visa Requirements
- Visa Fee: 20 USD(in cash at the arrival, will be
Brunei reimbursed)
Arrival Visa(Ordinary Visa(E))
- Visa Fee: 35 USD(in cash at the arrival, will be
Cambodia reimbursed)
- 2 passport-sized ID Photos
- Passport Copy (cover+page with stamps)
Indonesia - Personal Information Form (will be provided)
- Statement Letter Form (will be provided)
Student Visa(ST-B2)
Application by visiting the Lao embassy in your country
- Visa Fee: 30 or 45 USD depending on your nationality(will be
reimbursed)
LaoPDR
- Passport Copy (remaining blank pages for stamp)
- Visa Application Form (will be provided)
- 2 passport-sized ID photos
eTravel Registration
Philippines - https://etravel.gov.ph/
SG Arrival Card
- https://eservices.ica.gov.sg/sgarrivalcard/
Singapore Public Health Requirement
- https://www.ica.gov.sg/enter-transit-depart/entering-
singapore
Single entry (90 days)
Online Application or by visiting the Vietnamese embassy
in your country
Vietnam - Visa Fee: 80 USD (will be reimbursed)
- Passport Copy (clear, neat, full of information)
- 1 passport-sized ID Photo (white background)
- At least 5 working days to process the visa
Single entry (90 days) / Non-Immigrant "ED" Visa
Application by visiting the Thai embassy in your country
- Visa Fee: 60 or 80 USD depending on your nationality(will be
reimbursed)
Thailand - Passport Copy
- Photo (2.8 X 3.5cm / blue background / with uniforms of
school or company)
- Registration Form (will be provided)

Insurance Requirements
Indonesian Participants
ID Card Copy
Myanmar Participants