THAMMASAT UNIVERSITY Thailand

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1 THAMMASAT UNIVERSITY Thailand Please enclose 4 photos (2x2 inch) EXCHANGE STUDENT APPLICATION FORM Application deadlines: May 20 for Semester 1 / September 20 for Semester 2 Personal information This application form is to be typed in or written in BLOCK LETTERS. First name : Middle name : Last name : Gender : Male Female Date of birth (dd/mm/yyyy) : Marital status : Single Married Others (please specify...) Nationality : Native language : Address for correspondence : Permanent address: City : Postcode : Country : Tel. : Address in Thailand (if available) : City : Postcode : Country : Tel. : Passport number : Country of passport issued : Expiry date : Have you ever been to Thailand? : Yes No Do you know anyone in Thailand : Yes No If yes, please fill in the next page.

2 Detail of Thai person whom you may know Name : Gender : Male Female Relationship to you : Relative Friend Business associate School official Others (please specify...) Address : Tel : Your personal interest: Sport Music.. Performance. Others (please specify...) Emergency Contact Information Name :.. Address :.. Tel. :... Relationship to you :. Home Institution Name of institution : Address : Academic Information Major field of study at home university:. Degree/diploma of your current study : Bachelor Master Doctorate Others (please specify...) Current year of your study : 1 st year 2 nd year 3 rd year 4 th year Others (please specify...) Cumulative GPA : Awards : Expected date of graduation :

3 Language proficiency Language of instruction at home institute : Is English your first language? : Yes No (if no, please give details of your English standard test ) English English proficiency assessment standard : TOEFL ( IBT, CBT, PBT ) IELTS TOEIC Others (please specify..) Score Listening : Speaking : Reading : Writing : If you apply for the program conducted in Thai, please provide some information about your Thai proficiency below. Name of assessment institution : Thai Listening Speaking Reading Writing Excellent Good Fair Underperformed Exchange study information Faculty/program of Thammasat University that you are applying for. Level : Undergradate Graduate Duration of your exchange Academic year 2014 Semester 1 : August December Semester 2 : January - May Duration of exchange One semester Two semesters Anticipated date of arrival in Thailand (dd/mm/yyyy)

4 Statement of purpose Please provide a brief personal information about yourself and describe reasons why you are interested in studying at Thammasat University. If possible, please also describe what you expect to obtain through your study at Thammasat University, and after you return to your home country. This section can be submitted on a separate sheet of paper.

5 Study plan Please note that a non-seeking degree student is able to enroll in courses offered by Thammasat University in condition as follow : A student must meet eligible criteria determined by the host faculties. Courses are available in that semester to enroll. Not all listed courses are offered every semester or year. Please be flexible when enrolling the subject. Check a list of tentative courses per semester on the host faculty/program websites. You may choose other courses that you are interested in from the complete list. If you are interested in credit transfer, you need to consult with your academic advisor at your home university. Course submission for credit transfer approval should be completed prior to your departure. Applicants must have the necessary pre-requisite background, if required by the host faculty. You are required to enroll at least 9 credits per semester. However, it is normal that the international students are enrolling between 9 18 credits per semester. An approval to enroll in courses that is made by the host faculty. Office of International Affairs is not able to guarantee that your intended courses will be available when you register for courses. You need to be flexible in seeking for the alternative courses. Please contact the Office of International Affairs in advance if you are interested in studying in regular Thai classes. Links to the information about the international programs and course offerings can be found on the Office of International Affairs website. Regular Thai program information can be found on the Thammasat University homepage. First Semester Course ID Course name Credits Faculty offering the course Second Semester Course ID Course name Credits Faculty offering the course

6 Student Health Insurance Do you have International full health insurance? : Yes No (if yes, please specify details.) Are you certain that your insurance covers all accidents, injuries, medical costs while studying in Thammasat University as an international student? : Yes No If yes, please submit a proof of your medical insurance as a part of processing your student application. Your medical insurance can be either from international or local source and is able to cover your studies at Thammasat University. If no, please provide what are your plan and financial plan when you need medical attention, or when you are injured or hospitalized. Where did you learn about TU? Check all that are applicable Information Session Exchange Fair Orientation Week Website Poster Incoming Exchange Student Lecture/Faculty Friend Returned TU Exchange Student Personal visit Others, specify... Agreement As a student of Thammasat University I agree: To comply with rules and regulations of Thammasat University, the Office of International Affairs, and the program/faculty enrolled. To acknowledge that all statements in this application are true. I completed this application to the best of my ability. I am aware that it is my responsibility to obtain all visas and to arrange my air travel. that as a student admitted through the Office of International Affairs, I may not have any access to restricted courses determined by the host faculties. that this is not a registration form and it is merely a course listing that I am intended to enroll. I realize that Thammasat University cannot guarantee registration in some restricted courses. that all your submitted documents are property of the host faculty and the Office of International Affairs. that I am aware of all required costs and living expenses and having sufficient funding to cover the full period of study. Thammasat University is unable to provide you with financial support for your studies and living expenses.

7 The list of application and supporting document Thammasat exchange student application form A form of English proficiency (if English is not your first language) Academic Transcripts (must be in English or with accompanying translation) The official nomination letter issued by an authorized department of home university 4 of ID photos (2x2 inch and comply with passport ID format.) A copy of your passport Letters of recommendation (if available) Proof of a medical insurance for duration of yours studies at Thammasat University. (Your insurance can be either local or international.) Signature Signature Date Student Name of Exchange Coordinator or Authorized Person : Coordinator Title : Signature : Institution stamp (If available) Date :

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