Science Master Course Application (For official use only)

Nice Sophia Antipolis University (France) Candidate number:

Application form

Master of Science in Ubiquitous Networking and Computing
Master Informatique: Fondements et Ingénierie, Parcours Ubinet
Polytech’Nice-Sophia, Nice Sophia Antipolis University, France

Candidate Name: .

(please indicate your name here)

Notes for applicants
Please fill in the application as fully as you can to assist the Scientific Committee in the selection process. Incomplete applications will not be considered. The final decision regarding your application will be made by the Scientific Committee. You will be notified when your application is received and completed.
The following documents are required for your application. You should concatenate them into only one pdf or doc file:
  1. Curriculum vitae
  2. MSc Application filled form
  3. Copies of certificates and diplomas from previous education at an internationally recognized University
  4. Transcript of Records (all courses taken in the last year, all grades received, all honors received)
  5. Photocopy of passport pages where name, birthdates and birthplace appear.
Any requested document not written in English or in French must be translated into English.
Then follow the instructions described on the following page to submit your form:
You must send a copy of the referee form (available on MSc website) to at least two referees. The referees should send us their reference by email only directly to the address indicated in the referee form.
Do not send the application or the form by surface mail. Original copies will be requested at registration in case you admitted to the program.
Personal data
Certified Photocopies of Passport or Identification Cards should be submitted
Title (Dr, Mr., Mrs., Miss, Ms…)
Surname (family name)
First name (given name)
Gender / Female Male
Number or House Name
Street
Town
Post code
Country
Telephone
Fax
Email
Date of birth (DD-MM-YYYY)
Place of birth (Town, Country)
Nationality or Nationalities

How did you heard about the master Ubinet?

Education

Institution name and City/Country / Title and level of Qualification / Subject / Diploma obtained / Dates / Results/Mark
Diploma not yet Completed / No Yes
Higher Diploma obtained / No Yes
Other Diploma / No Yes

Professional Qualification or other relevant qualification

Qualification 1: / Date of award:
Qualification 2: / Date of award:
Qualification3: / Date of award:

Current/Past Activities History

Please list your current and/or past activities during the last 4 years:
Current Year (Y) / Y-1 / Y-2 / Y-3
Name of Employer/Institution:
City:
Country:
Postal or Mail address:
Diploma prepared or position held:
From (m/yyyy):
To (m/yyyy):
Please use this space to list any special skills you may have that relate to the master applied for:
Please list any professional, teaching or research experience that may be related to the master applied for. Include date granted, name of institution, level, discipline, and any other relevant information.
Any other relevant information
Language Skills
Mother Tongue (s)
Is your first language English?
(Please supply IELTS or TOEFL scores and provide the transcripts if appropriate)
Indicate your proficiency in English.
Note that an interview in english will be done in case of admission. / Yes or No
Your own judgment: English Reading skills / (3=excellent 2=good 1= basic)
Your own judgment: English Writing skills / (3=excellent 2=good 1= basic)
Your own judgment: English Verbal skills / (3=excellent 2=good 1= basic)
Is your language French?
Indicate your proficiency in French. / Yes or No
Your own judgment: French Reading skills / (3=excellent 2=good 1= basic)
Your own judgment: French Writing skills / (3=excellent 2=good 1= basic)
Your own judgment: French Verbal skills / (3=excellent 2=good 1= basic)
Personal Statement
Guidelines:
This is to give the University Admissions a chance to get to know you, your aspirations, interests, experience and talents; Professional, academic, and personal interests. If you apply to the scholarship, please provide support elements.
Personal Statement: (minimum font size 10 point, in English or French)
Do you candidate to the first semester scholarship: / Yes / No
Do not use more than this space
Motivation
Explain why you are applying for this course.
Motivation: (minimum font size 10 point, in English or French)
Do not use more than this space
References
  • Please give or send the reference forms available on the MSc website to your chosen referees.
  • They should be able to comment on your academic and professional suitability for your chosen course.
  • Please urge your referees to respond quickly.
  • Difficulty in obtaining references can prolong the delay in the application procedure.
  • Email may be used for references.
  • Please fill out your name on the referee form BEFORE sending it to the referee.
  • The name should correspond EXACTLY to that given under the personal details
  • Give the names and addresses of your referees below.

Referee number 1/…
Name:
Address:
Telephone:
e-mail:
Referee number 2/…
Name:
Address:
Telephone:
e-mail:
Referee number …/…
Name:
Address:
Telephone:
e-mail:
Declaration of Candidate
I hereby confirm that the information given on this form is true, complete and accurate. No information requested or other material information has been omitted.
I hereby agree to conform to the rules for the regulation and conduct of students at the University and to submit to the concerned Authorities in all matters of discipline.
Date:
Signature:

For official use only:

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