APPLICATION FORM

ACADEMIC YEAR 2016/2017

Cnam engineering school, international master degree

Major: ______

1. Home University

University/School name
Field of Study
Town
Country

2. Legal informations

Family name
First name
Date of birth
Place of birth
Gender
Nationality
Personal cell phone
Home Town adress
Email adress

3. Education

Current status at home university
Level / Major’s heading / List of courses
Diplomas obtained
Year / Grade / Heading of diploma / University name

4. Professional experience and/or internship

Start date / Duration / Lab or company name / Mission completed

5. Langage proficiency

Mother tongue: ......
Hours of classes taken already / 0 - 100 / 100 - 200 / 200 - 300 / Over 300 : specify / Specify the learning context / level reached
French
Hours of classes taken already / 0 – 300 : specify / 300 - 400 / 400 - 500 / Over 600 / Specify the learning context / Certified level reached
English

6. Statement of purpose

Briefly state the reasons why you wish to study abroad :

Date:

Signature

preceded by the handwritten words: I hereby certify that the statements and information in this application form are true and correct to the best of my knowledge

Documents to be joined

1. Copy of bachelor original diploma

2. Certified french translation of original diploma.

3. Marks and ranking of all courses attended at master program

4. Certified English level

5. Curriculum vitae (résumé)

6. Reference letters from teachers and/or tutors will be considered (page 5)

Beware

1) Never send original documents

2) Copies will not be returned

3) Incomplete application forms will not be considered

Return application form both by post and email to :

Conservatoire Nationale des Arts et Métiers

MR. Mingjun ZHANG

Ecole d’Ingénieurs

Case courrier 2ASP10

2 Rue Conté

75003 PARIS

France

You may find more information (in French) at: http://portail-formation.cnam.fr/ecole-sciences-industrielles-technologies-de-l-information/informatique/architecture-et-integration-des-systemes-logiciels/master-international-de-l-ecole-d-ingenieurs-du-cnam-mention-informatique-specialite-architecture-et-integration-des-systemes-et-du-logiciel--511064.kjsp?RH=205

Reference letter

Family name and first name :

Position :

Scientific department :

Email adress :

University or company’s name :

Town :

Country:

Candidate’s family name and first name :

Candidate’s date of birth :

Title of master program followed by the candidate :

Assessment of the candidate’s qualities :

Done at : ……………………..

Date : ………………………… Signature and university’s stamp