Université Sorbonne Paris Cité

International Scholarship Programme MIEM

Application Form2015 / 2016

GENERAL CONDITIONS :

- Eligible Training at MIEM scholarship program:

- Engineers Training SupGalilée

- Master COLEDI: Language Sciences, contrastive specialty, vocabulary, speech

- Master EPOG: Economic Policies in the Age of Globalisation

- Master Mathematics, Basic Mathematics specialty

- Master MOSS: Management of health and social organizations

- The amount of the scholarship MIEM is 10 000 € for a period of one year.

- It is your responsibility to check that the file is completed with all attached documents.

- Lack of supporting documents or non-compliance of the internal policy of the University Paris 13 implies the automatic refund of any scholarship.

Documents to complete the application:

This application form

Your complete and up to date curriculum vitae

Courses attended and transcripts for the past three academic years, including the current year copies of your diplomas (NB: selected students will be asked to bring the original diplomas on arrival).

Language certificate.

Two letters of reference from academic or research staff, of which at least one belongs to your home university, with their exact and complete contact details(see annex 1).

Registration certificate for 2013-2014 (if presently enrolled in a higher education institution).

A photocopy of your passport.

Aneducation plan for Master or PHD degree (see annex 2)

Submission of applications:

The complete application files, containing this application form and the complementary documents, are to be sent in a single .pdf file to the International and European Relations Office (SREI)

Deadline:15thMay 2015. Incomplete applications will not be processed.

Contact:Emmanuel BENOIT -

Information concerning the applicant

PERSONAL INFORMATION:

Gender: F M

Last name: ______

First name: ______

Date of birth: ___ / ___ / ______Place of birth: ______Nationality: ______

Mailing Address for correspondence:______

Post code: ______City: ______Country: ______

Phone number: ______Mobile number:______

E-mail address: ______

ACADEMIC RECORD

Home institution name: ______

Department/Faculty: ______

Address:______

______

Phone number: ______E-mailaddress: ______Website: ______

Detail your education during the last 4 years. Include details of qualifications to be awarded:

College / University /
Awarding body/Country/City / Name of unit / Main subject(s) studied / Degree/Diploma obtained/date of award / Marks / Rank*
2014-2015 / ... / ... / ... / ... / … / …
2013-2014 / ... / ... / ... / ... / … / …
2012-2013 / ... / ... / ... / ... / … / …
2011-2012 / ... / ... / ... / ... / … / …

* For instance 3rd out of 58, or ranked 5%, etc

Please explain the grading system (for instance A,B, C…, A being the highest mark)

......

......

......

......

LANGUAGE SKILLS:

Your level of competence in French and English:

French / English
Spoken ability: / A1/A2 / B1/B2 / C1/C2 / A1/A2 / B1/B2 / C1/C2
Written ability: / A1/A2 / B1/B2 / C1/C2 / A1/A2 / B1/B2 / C1/C2

French certificate: Yes No

If yes, please include it in your application documents (DELF, DALF, TCF, TEF)

English test: Yes No

If yes, please include it in your application documents (TOEFL, IELTS)

Do you intendto take French language courses at Paris 13 ?

YESNO

INFORMATION ABOUT YOUR PERIOD OF STAY AT PARIS 13:

Graduate level at Paris 13 in 2015/2016: Master 1 Master 2

Master attendedatParis 13(full name): ______

______

Planned period of the mobility:

From : ______/ ______/ ______

Till : ______/ ______/ ______

APPLICANTS’ DECLARATION:

I hereby certify that the information contained in this application is accurate and complete.

Place______, date______
Applicant’s signature preceded by the
handwritten words«lu et approuvé»

Service des Relations Européennes et Internationales

Programme de bourses MIEM:

Université Paris 13 – Bâtiment de l’IUT – Bureau L101

99, avenue Jean-Baptiste Clément

93430 Villetaneuse

Contact: ; Fax: + 33 (0) 1 49 40 39 22

ANNEX 1:

REFEREES

Please indicate at least 2 academics of which at least one from your home institution that may provide references for your application:

1.Name and position: ......

......

Address: ......

......

Phone number: ...... Fax number: ......

E-mail address: ...... Website: ......

2. Name and position: ......

......

Address: ......

......

Phone number: ...... Fax number: ......

E-mail address: ...... Website: ......

ANNEX 2:

EDUCATION PLAN

Writing about your education plan

Why did you choose France for your studies? Please explain what aspects of the selected master’s programme are most appealing to you.

After your master’s studies do you plan to undertake a PhD thesis? Yes No

If yes, please give some more details about your plans: ......

......

......

If not, what are your future career plans? : ......

......

......

......

......

Have you already defined the research topic for your Master internship? Yes No yet

If yes, please detail your research interests (max. 1 page).

Please explain how this master programme at Paris 13 and your previous studies could help you to achieve your goals.

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Université Sorbonne Paris Cité