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Sirindhorn International Institute of Technology (SIIT)

ThammasatUniversity

Application Form for Student Exchange Program

Academic Year 2018

Tick one: 1stSemester (August – December) 2ndSemester (January –May)1st and 2nd Semester


Please type or write with a good handwriting in Englishand read all remarks carefully.

Name:Mr. / Ms.
  1. Personal Information

Gender: Male Female

Date of birth (dd/mm/yy): Age: years

Religion: Place of birth:

Nationality: Citizenship:

Passport no. : Issued by:

Date of issue (dd/mm/yy): Date of expiration (dd/mm/yy):

Native language:

Blood Type

E-mail address:

Permanent Address:

Address: City: Country: Postal code:

Telephone: Mobile:

Mailing Address (if different from above):

Address: City: Country: Postal code:

Telephone: Mobile:

  1. Current Study Enrollment (Please attach a copy of your transcript or official academic record)

University/ Institute:

City: Country:

Major in:

Starting date of academic program: Expected graduation date :

Currently study in: Bachelor’s in the 1st2nd3rd4thother year

Master’s in the 1st2ndother year

Remark: Study year and level of exchange student must be clarified. Since most courses are in undergraduate programs, students in Master level may not be able to enroll in some courses.

Last GPA (cumulative):

3.Field of interest

Building Facilities EngineeringComputer Engineering

Civil EngineeringEngineering Management

CommunicationsEnvironmental Technology

Electrical Power EngineeringInformation Technology

Industrial Engineering Mechanical Engineering

Chemical EngineeringManagement Technology

4. List of course(s) you wish to take

No. / Course Code / Course title
1
2
3
4
5
6
7
8

Remark: Making a selection abovedoes not guarantee enrollment.All students will receive list of courses and course schedule in 2 weeks before semester starts. Students have to select courses and manage course schedule again prior to arrival. Your application will be considered by the faculty members of the department concerned (highest selected major). You will be assigned the academic advisor and study program at SIIT according to your highest selected courses in the application form.

5. Do you need to transfer credits to your home university when you finish your exchange semester at SIIT?

Yes/ (Please specify number of credits)No

6. I certify that all of the given statements above are true.

Applicant’s signature: Date:

List of required documents

  • Application form
  • Letter of application (Motivation letter)
  • Regulations for exchange students with a signature of an applicant
  • Resume
  • Transcript (If you are a Master student, please also submit the transcript of your Bachelor’s degree.)
  • English Proficiency test score (TOEFL or IELTS, or an equivalent, or letter confirming applicant’s English proficiency)
  • Recommendation letter from an academic advisor
  • Two photos, taken within 6 months, 1’ x 1.5’, need to be submitted. One must be pasted on the application form. The other photo should be submitted with the original application form.
  • A copy of passport

Updated March 2018