APPLICATION FOR ADMISSION

M.Sc. in Petroleum Geoscience

Department of Geology, Faculty of Science Chulalongkorn University

APPLICATION FOR ADMISSION

(Please complete this Application Form with using Block Letters)

Biographical Information _______________________________________ Official Identification Number/Passport Number

Name (English)_________________________________________________________________ First Middle Last

(Thai)___________________________________________________________________ First Last

Mailing address_________________________________________________________________ Street address

_________________________________________________________________

City Post code Country

Telephone number at mailing address________________Business telephone ________________

Area code Number Area code Number

E-mail_________________________________Mobile Phone_____________________________

Permanent Home address__________________________________________________________

(If different from Mailing address) Street address

___________________________________________________________________

City Post code Country

Telephone number at home address___________________________________ Area code Number Birth date___________________________________

Month Date Year

Citizenship  Thai ___________________________________ Place of Birth

 Other ___________________________________ Name of Country Place of Birth

Gender  Male  Female

Marital Status  Single  Married  Divorced  ___________ Number of Family member_____________

Status Information

Have you taken the Test of  Yes/Date you took TOEFL/CUTEP_______ English as a Foreign Language? Please enclose a copy of your test scores.  No/Date you plan to take TOEFL/CUTEP_____

Indicate your source of financial support.  Self-supporting

 Business/Organization sponsored  Scholarship requested

If no scholarship is available, you would  Withdraw your application

 Make own alternative arrangement

School History

Secondary School(s) Attended:

Year of attendance Secondary School Attended City/Country Diploma/Certificate

Colleges and Universities Attended

List in chronological order all colleges and universities attended. It is your responsibility to request a transcript from the registrar of each institute to be included with your application package.

Year of attendance

Institution attended (City/Country)

Degree obtained

(Specify major field) GPA

Date of Award or Anticipated Award

(Month/Year)

Honors received or other evidence of high scholastic achievements (scholarship, mention with credit,etc.)

_____________________________________________________________________________ _____________________________________________________________________________ Describe part-time work while at colleges/universities__________________________________ _____________________________________________________________________________

Have you ever been suspended or required to withdraw from any school or college? Yes  No

If you have any physical or emotional problems that you wish to call to our attention, please give details and indicate any kind of special consideration you may require whilst attending the College.

_____________________________________________________________________________________________ _____________________________________________________________________________________________

Collegiate Extra-Curricular Activities and Professional Memberships

Activities/Professional Memberships Dates Offices held, if any

Employment History

Account for all time periods from the start of your undergraduate studies to the present, beginning with your most recent activities. Include part-time, summer, and full-time work experience. Use additional sheets if necessary.

Dates

(From-To) Employer Job title Primary responsibilities

Statement of Purpose

In no more than two type-written pages, write a concise statement outlining your most valued

experience and accomplishments, your reasons for graduate study, your professional and research interests, and your career expectations, The Admission Committee places strong emphasis on this statement so remember to sign your name and attach this ‘Statement of Purpose’ to your application.

Name and Address of Recommenders 1. Name (English)____________________________________________________________ Name (Thai)_______________________________________________________________ Address__________________________________________________________________ ___________________________________________________________________ Email: ___________________________________Tel:_____________________________ 2. Name (English)____________________________________________________________ Name (Thai)_______________________________________________________________ Address__________________________________________________________________ ___________________________________________________________________ Email: ___________________________________Tel:_____________________________

I certify that all statements made in this application for admission to the M.Sc. in Petroleum Geoscience are correct, and I realize that all documents submitted in support of this application become the property of the M.Sc. in Petroleum Geoscience Program. I authorize the M.Sc. in Petroleum Geoscience to release information from this application and supporting documents to any organization sponsoring scholarships for the College to permit my being considered for scholarship support. I understand that I will be notified of any organization to which information is given.

Signature________________________ Date______/________/______

LETTER OF RECOMMENDATION

Department of Geology, Faculty of Science Chulalongkorn University

(confidential) Name of candidate (print or type)___________________________________________________

First Middle Last

The person whose name appears above has applied for admission to the M.Sc. in Petroleum Geoscience. Please answer the questions below in as specific and candid a manner as possible. Your comments will be an important factor in the admission decision.

Name of recommender (print or type) ________________________________________________ _______________________________________________________________________________

Position/Title Organization

_______________________________________________________________________________________________________________________

Address Telephone number E-mail address

1. How long have you known the applicant?____________________________________________

years months

2. Under what circumstances have you known the applicant?

_____________________________________________________________________________ _____________________________________________________________________________ 3. What do you consider the applicant’s most outstanding talents or characteristics?

_____________________________________________________________________________ _____________________________________________________________________________ 4. In comparison with other candidates for graduate study that you have known, how would you rate the applicant with respect to the following qualities:

Below average (Bottom 1/3) Average fair (1/3) Good (Top 1/3) Unusually good (Top 15%) Outstanding (Top 5%) Truly exceptional (Top 2%) Inadequate opportunity to observe Intellectual ability

Knowledge in chosen field Self-reliance, Motivation and seriousness of purpose Written skills in English

Oral skills in English Ability to get along With others

5. I  strongly recommend

 recommend that this applicant be admitted to  recommend with some reservation the M.Sc. in Petroleum Geoscience.  do not recommend

Signature_______________________ (______________________) Date_______/__________/______

Please return this form directly to the applicant in the attached envelope after placing your signature across the sealed envelope flap, or inform the applicant that you are mailing it directly to the M.Sc. Petroleum Geoscience Office at Room#233, Department of Geology,

The M.Sc. in Petroleum Geoscience

Department of Geology, Faculty of Science Chulalongkorn University

LETTER OF RECOMMENDATION

(confidential) Name of candidate (print or type)___________________________________________________

First Middle Last

The person whose name appears above has applied for admission to the M.Sc. in Petroleum Geoscience. Please answer the questions below in as specific and candid a manner as Possible. Your comments will be an important factor in the admission decision.

Name of recommender (print or type) ________________________________________________ _______________________________________________________________________________

Position/Title Organization

_______________________________________________________________________________________________________________________

Address Telephone number E-mail address

1. How long have you known the applicant?____________________________________________

years months

2. Under what circumstances have you known the applicant?

_____________________________________________________________________________ _____________________________________________________________________________ 3. What do you consider the applicant’s most outstanding talents or characteristics?

_____________________________________________________________________________ _____________________________________________________________________________ 4. In comparison with other candidates for graduate study that you have known, how would you

rate the applicant with respect to the following qualities?

Below average (Bottom 1/3) Average fair (1/3) Good (Top 1/3) Unusually good (Top 15%) Outstanding (Top 5%) Truly exceptional (Top 2%) Inadequate opportunity to observe Intellectual ability

Knowledge in chosen field Self-reliance, Motivation and seriousness of purpose Written skills in English

Oral skills in English Ability to get along With others

5. I  strongly recommend

 recommend that this applicant be admitted to  recommend with some reservation the M.Sc. in Petroleum Geoscience.  do not recommend

Signature_______________________ (______________________) Date_______/__________/______ Please return this form directly to the applicant in the attached envelope after placing your signature across the sealed envelope flap, or inform the applicant that you are mailing it directly to the M.Sc. in Petroluem Geoscience Office at Room#233, Department of Geology,