APPLICATION FORM

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1 APPLICATION FORM Master 1st year Citizenship : Last name :. PHOTO First name :. DIPLOMA CERTIFYING THE ACCESS TO HIGHER EDUCATION: School-leaving certificate: Speciality:... Distinctions:.... Delivery date:.. Delivery place:. Registration number/index:..... Personal data on the applicant Date of birth:.. City / State:.. Country: Personal address: Phone :.... Correspondence address (if different from mentioned above): Code INE/BEA: Page 1 sur 7

2 Summary on the preceding education Years Institution Country - City Diploma An incomplete application form will be rejected If you are graduated in 2013/2014, you should submit us the application form before obtaining your diploma. You will forward us later the photocopies of the certificate of your successful graduation and the list of grades obtained as well as their legalized translation to French. Page 2 sur 7

3 PROFESSIONAL EXPERIENCE AND INTERNSHIPS Dates Laboratory or Company Nature of activity Duration Internship report The undersigned applicant certifies upon his honour the accuracy of the present declaration Date: Signature: Page 3 sur 7

4 ELEMENTS TO JOIN THE DEADLINE TO SUBMIT THE APPLICATION FORMS IS May the 31 st 2014 All the elements requested below are mandatory to your application form and will become the subject of examination by a corresponding pedagogical commission Application form completed, dated and signed Curriculum vitae Birth-certificate original and translated to French Attention: check the orthography of your names and the birth city List of courses attended or the program of your education Photocopies of all your diplomas, including the photocopy of your school-leaving certificate. Legalized translation is obligatory. Photocopies of grades obtained, by academic years. Legalized translation is obligatory Photocopies of preliminary grades for the current year, if it exist Reference letter (confidential): to complete the form enclosed Motivation letter Certificate TOEFL (Test of English as a Foreign Language) or an equivalent certificate: for originate from non-anglophone countries only Certificate TCT (Test de Connaissance du Français) For candidates resident in France: - The photocopy of your resident card (carte de séjour); - The photocopy of your passport, including the entrance visa; - The certificate of your registration for the academic year starting from your arrival to France Page 4 sur 7

5 Warning: FOR THE DOCUMENTS SUBMITTED IN FRENCH! These documents should be certified - Either by the Original Institution - Or by the French Embassy Warning: FOR THE DOCUMENTS SUBMITTED IN FOREIGN LANGUAGE! You should provide the photocopy of original documents and their legalized translation to French by an accredited translator. If you do the photocopy of translations, it must be also certified by translator. If the seals on documents are affixed in foreign language, they must be translated and legalized by an accredited translator. No documentation certified by City Administration (Mairie) or by Police Commissariat will be accepted For candidates resident in foreign countries, for the first registration in French Higher Education, you should be registered in the French Embassy in your country (Centre pour les Etudes en France CEF) in order to obtain all the information necessary for your arrival to France, via the address: of your country.campusfrance.org You must inscribe your identification number CEF which has been assigned to you. Page 5 sur 7

6 CONFIDENTIAL REFERENCE LETTER To complete by the Head of the last Institution you attended or by the President of Graduation Jury/Commission This letter must be put in a sealed envelope and enclosed to the application form (to enclose obligatory) T O C O M P L E T E B Y S T U D E N T LAST NAME: FIRST NAME: Registration for 2014/2015: Master 1 (Réservoirs Souterrains pour l Energie: Hydrodynamique Géophysique Modélisation) Courses during which you were the lecturer of the candidate and their education level/degree: Number of students attended this courses The rank and the average grade of the candidate Ranking the candidate within the student stream: 1 st quarter 3 rd quarter 2 nd quarter 4 th quarter Appreciation on the level of the candidate aptitude to continue the education in the selected Master: Your recommendation of the candidate is: Very favourable Reserved Favourable Not recommended NAME AND TITLE/FUNCTION OF THE SIGNATORY: Date and signature Official Seal of the Institution (obligatory) Page 6 sur 7

7 WHERE TO SEND YOUR APPLICATION FORM Ecole Nationale Supérieure de Géologie 2, rue du Doyen Marcel Roubault TSA Vandœuvre-lès-Nancy Cedex Tél : Page 7 sur 7

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