Application Form Master Course Altervilles First Year M1

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http://altervilles.universite-lyon.fr/ Application Form Master Course Altervilles 2015-2016 First Year M1 Application form to be sent to: christelle.morel.journel@univ-st-etienne.fr harold.mazoyer@sciencespo-lyon.fr dept@univ-st-etienne.fr Deadline for receipt of application : May 2015 4 th PLEASE NOTE INCOMPLETE FORMS AT THIS DATE WILL NOT BE CONSIDERED Your application form should be accompanied by the following documents: - Curriculum Vitae - Motivation letter - Academic transcript (grade sheet) Contact for educational informations : christelle.morel.journel@univ-st-etienne.fr harold.mazoyer@sciencespo-lyon.fr

Application Form - Master Course Altervilles 2015-2016 University Jean Monnet, Saint-Etienne (UJM), France Sciences Po Lyon, France please insert a recent photo of yourself A. Personal Data (each heading must be completed) Surname / family name: First and other names: Passport number: Gender l l l male / female Date of birth l l l l Day, month, year Number of children: l l Place of Birth: Nationality 2 nd nationality (if any): Address for admission letter: Street Name and Number Postal Code and City Country: Address (if different from above): Street Name and Number Postal Code and City Country: E-mail address Telephone(s) Fax

B. Previous Higher Education Records (University or other degree-awarding institution. Please list all institutions, regardless of the length of attendance. Begin with the most recent one. Please do not interpret grading scales by attempting to convert your country s system into the French one. In addition, do not translate your official academic degree) University name and location (include city and country) from (month/year) until (month/year) Major field of study Degree conferred or expected GPA or % University name and location (include city and country) from (month/year) until (month/year) Major field of study Degree conferred or expected GPA or % University name and location (include city and country) from (month/year) until (month/year) Major field of study Degree conferred or expected GPA or % Describe briefly the main subjects of your recent study. What interests you most? In which field would you like to do research and/or to work in?

C. Work Experiences, Professional Training from month/year until month/year Employer Location Job title, Department from month/year until month/year Employer Location Job title, Department from month/year until month/year Employer Location Job title, Department from month/year until month/year Employer Location Job title, Department Describe briefly your tasks and responsibilities

D. Language skills 1. What is your native language? 2. Which other languages do you speak? Please indicate your level of proficiency. Levels: - perfect, - independent, - basic Level spoken, written, Level spoken, written, Level spoken, written, Level spoken, written, F. Scholarships Are you going to apply to any scholarships? YES NO If YES, which ones? In case I do not receive any scholarship: please ignore my application. I am still interested to integrate into the Altervilles course and will pay the tuition fees/housing/etc.

G. Additional Questions 1. To which other Master courses or any other programs have you applied or will you apply? (optional question) EM Master course name University name and location EM Master course name University name and location EM Master course name University name and location 2. How did you find out about the Altervilles program? Information source about Altervilles

H. Essays (in French and English) The following essay questions give you the opportunity to provide more information about yourself. An English version and a French one are required. 1. What is your motivation to do apply for the Altervilles Master course? What are your plans after completing this program?

2. Tell us anything about yourself that you have not had the opportunity to present in other parts of this application. List, for example, extracurricular activities in university or community, your awards, publications, experience abroad, computer skills, or hobbies. I. Statement of Understanding All the information in this application is true, accurate, and complete to the best of my knowledge. I understand that withholding, misrepresenting, or giving false information will invalidate my application and make me ineligible for admission. Signature of the applicant Day Month