ExchangeStudentProgramApplicationForm打.docVIP

EXCHANGE STUDENT PROGRAM APPLICATION FORM (Fall Semester 2011) Photo (Affix your real, most recent studio photo here) I. Personal Information1. Name (as shown on passport)  First Middle Last (Family)2. Gender (Male/Female) 3. Date of Birth (yyyy/mm/dd)4. Nationality 5. Passport No.6. E-mail addresspennyheart@7. Religion□ Christian□ Muslim□ Hindu□ Others(or no religion)8. Dietary Preference□ Non-vegetarian□ Vegetarian9. Current AddressCountry:Postal Code:Home phone: Mobile Phone: II. Academic Information1. Home UniversityHuazhong Agriculture University2. Major at Home Univ.Geographical Information System3. Study Level at Home Univ.□ Undergraduate □ Graduate4. Campus of Konkuk□ Seoul □ Chungju5. Study Level at Konkuk□ Undergraduate □ Graduate6. School Year at Konkuk□ Freshman □ Sophomore□ Junior □ Senior7. Intended Major at KonkukGeography8. Length of Study at Konkuk □ 1 Semester□ 2 Semesters (1 Academic Year)9. Semester(s) at Konkuk □ Fall 2011□ Fall 2011 Spring 2012 III. Emergency Contact (parent, brother, sister etc.) 1. Name2. Relationship3. Address Country: ChinaPostal Code:Home Phone: Mobile Phone: E-mail:  I certify that all information given on this form is true and correct. I understand that falsifying or omitting information on this form, or at any other time during the admissions process, disqualifies me from admission. I have also read and understood the Exchange Student Admissions Guidelines and the KU HANDBOOK 2011. APPLICANT’S SIGNATURE: DATE(yyyy/mm/dd): 2011.05.11 院系推荐意见 该生入校以来，始终以提高自身的综合素质为目的，以个人的全面发展为奋斗方向，积极向上，乐于助人。并积极参加政治学习，??心国家大事，坚持四项基本原则，坚决拥护和执行党的方针和路线。 彭馨同学在校期间还能充分利用课作时间参加各类校园文化活动，综合素质能力强。而且奉献精神可嘉，团队合作意识及服务意识强。 总之，我院完全同意并支持彭馨同学关于赴韩国建国大学科学院地理学系交换学习的项目申请。 推荐人： 资源与环境学院 2011年5月11日