APPLICATION FORM
Master of Sciences and Technology
Fluids Engineering for Industrial Processes
I am applying to:
- Master 1 (first year) o
- Master 2 (second year) o
Personal data
Family name (in block capitals):
First name(s):
Date of birth (D/M/Y):
Place of birth: City: Country:
Gender: o M o F
Citizenship:
n Current address:
City: Postal code:
Country:
Phone: Fax:
E-mail: This address is valid until:
n Permanent address (where you can be reached at all times):
Tel: Fax: E-mail:
n Person to contact in home country(in case of emergency):
Name: Tel:
Academic record
Home institution (Full name): ……………………………………………………………………..
Number of study years in higher education:
Field of study:
n Degree(s) obtained: Year:
Year:
Year:
n Degree in preparation:
Expected date of graduation:
Description of your main previous university courses (course titles related to this application)
Languages
Mother tongue:
Language used in higher education:
Proficiency in English: Beginner o Intermediate o Advanced o Excellent o
Proficiency in French: Beginner o Intermediateo Advanced o Excellent o
Non native English or French speakers are requested to submit a certificate of proficiency, issued by a recognized institute.
Professional experiences and internships
Documents to be attached
Ø Do not send any original documents
Ø All copies must be translated into English or French by an accredited translator.
- 2 passport-size photos
- Photocopy of passport or ID card
- Results of English language test (if your native language is not English): TOEIC (750) or TOEFL (550)
- Certified academic transcripts
- Certified copies of academic diplomas
- Curriculum Vitae in English or French (max. 2 pages)
- Short statement of motivation in English
■ Accommodation: please precise which kind of accommodation you would prefer:
Room in a student hall of residence (depending on availability) o Private accommodation* o
* We regret we cannot assist students in finding private accommodation
■ Financial resources
How do you intend to finance your stay in France (fees, living expenses, …)?
■ How did you hear about this Master course?
Statement
I hereby declare that I have answered the above questions truthfully.
Date: Signature:
This application form and the required documents should be sent by April, 15th to:
INSA de Toulouse
LISBP - Equipe TIM (Nicolas DIETRICH)
135 avenue de Rangueil
31077 Toulouse cedex 4 - FRANCE
or directly by e-mail(including supplementary electronic documents) to:
e-mail:
Tel : +33 (0) [5-61-55-97-81]
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