부산대학교

Pusan National University

Application for Student Exchange Program

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APPLICATION PACKAGE 2011-2012

(Use this sheet as the cover of the package.)

Application deadline: October 30 for the first semester (from March to June)

April30 for the second semester (from September to December)

HomeUniversity: ______
Date (mm/dd/yyyy): ______
Name of Applicant: ______
(Please write your family name in capitals)

Please send this application in a completed package

containing all the following documents.

Check List

(1)
(2)
(3)
(4)
(5)
(6) / A completed Application Form
A completed Study Plan Form
A Transcript of Academic Records
A Certificate of Enrollment
A copy of Passport
A Recommendation Letter by HomeUniversity / □
□
□
□
□
□

This application package should be sent to the following address

through the office responsible for student exchange at applicant's home university.

Institute of International Exchange and Education

PusanNationalUniversity

30 Jangjeon-dong, Geumjeong-gu

Busan 609-735, KOREA

Tel: +82-51-510-3652 Fax: +82-51-582-6980 E-mail:

Personal Data

Paste your photo here
Size : 5x4cm
taken within the past 3 months.
Plain background

Note:

Application should be typewritten or printed clearly.

This form should be filled out in English.

Numbers should be in Arabic numerals.

Proper nouns should be written in full; no abbreviations.

1. Name in Full (in block capitals)

Family Name: ______
Given Name: ______/ Chinese characters(if applicable): ______
Middle Name: ______/ Preferred Name(if applicable): ______

2. Nationality: ______3. Sex: □M □F 4. Date of Birth: _____/_____/______

(mm / dd / yyyy)

5. Mailing Address

______
______
______/ Tel: ______
Mobile: ______
E-mail: ______

6. Person to be Notified in Applicant's Home Country in Case of Emergency

Name in Full: ______
Relationship: ______
Address: ______/ Tel: ______
Mobile: ______
E-mail: ______
Official Use Only

Academic Information

7. Intended Period of Study at Pusan National University(mark "×" where appropriate)

I wish to study for □One semester □Two semester

I plan to begin study in □1st semester AY 2011(From March to August)

□2nd semester AY 2011(From September to February)

□1st semester AY 2012 (From March to August)

□2nd semester AY 2012 (From September to February)

8. Intended Field of Study at PusanNationalUniversity

(Website: →Undergraduate/graduate School)

□Undergraduate: College of ______, Department of ______

□Graduate: Field of Study ______

9. Major Field of Study at HomeUniversity:______

10. Academic Advisor

Is there any particular professor of PNU you would like to be supervised by? □Yes □No

If ‘yes’, give the professor’s name and the college which he/she belongs to.

Name: ______College: ______

Have you ever contacted him/her? □Yes □No

11. Language Proficiency (Evaluate your level and mark "×" where appropriate.)

Korean □Excellent □Good □Fair □Poor

English □Excellent □Good □Fair □Poor

______□Excellent □Good □Fair □Poor

※On the basis of my language proficiency,

□I am able to take classes conducted in Korean.

□It is necessary for me to take classes conducted in English.

12. Current Studies

Please attach a certified copy of your transcript. In addition, please list below any subjects in which you are currently enrolled that are not included in your transcript. Please leave the space blank if you have none.

(1) ______(2) ______

(3) ______(4) ______

Signature of Applicant: ______

DORMITORY

13. Do you need to apply for accommodation at the university dormitory? □Yes □No

If ‘No’, give the address where you plan to stay: ______

VISA APPLICATION

14. We need the following information for preparing your document for VISA application.

Personal information
Name:
Sex:
Nationality:
Place of Birth:
Marital Status:
Date of Birth:
Place to Apply for VISA: / Passport Information(If applicable)
Passport Number:
Date of Issue:
Date of Expiration:
Issuing Authority:
Date of Entry:
Port to Entry:
Past Entry into/Stay in Korea:

CERTIFICATION

by Applicant

I hereby certify that my statements contained on this application form are true and complete to the best of my knowledge. I also understand that any willful false statement is sufficient cause for rejection of the application, or dismissal from the program.

Date: ______Signature of Applicant: ______

by HomeUniversity

I hereby certify that the above student is nominated to study at PusanNationalUniversity as an exchange student under the Student Exchange Program between PNU and ______.

(Name of HomeUniversity)

Date: ______

Signature of the person in charge: ______

Name: ______

Title/Office: ______

Tel: ______

Fax: ______

E-mail: ______

Study Plan

Name in Full: ______

HomeUniversity: ______

Please write a clear and detailed description of your study objectives and give your reasons for wanting to pursue them at PusanNationalUniversity. And, please explain how your study plan and experiences of this exchange program can fit with your life goals.

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