School of engineering Supported by the Chamber of Commerce and Industry of Rouen APPLICATION FORM Master of Science Business Information Systems ACADEMIC YEAR 2010 / 2011 Student s Family name : First name :.. Country :.. Photograph Please return this application to ESIGELEC Programmes «Masters of Science» Technopôle du Madrillet Avenue Galilée, BP10024 76801 Saint Etienne du Rouvray Tél : +33 (0)2 3291 5858 Fax : +33 (0)2 3291 5859 E mail : marteaux@esigelec.fr DEADLINE September 10th, 2010
STUDENT S PERSONAL DATA (to be completed by the student applying) Family name:.. Date of birth:... Sex:...Nationality:... Current address:.. Country : Current address is valid until:... Tel.:. E-mail:. First name (s) : Place of Birth:.. Permanent address (if different): Country :... Tel.:... Fax :. E-mail.:... LANGUAGE COMPETENCE Mother tongue: Language of instruction at home institution (if different):... Languages.English... I am currently studying this language I have sufficient knowledge to follow lectures I would have sufficient knowledge to follow lectures if I had some extra preparation Yes No yes no yes No.French... PREVIOUS AND CURRENT STUDY Diploma/degree for which you are currently studying: Number of higher education study years prior to departure abroad:... Have you already been studying abroad? Yes No If Yes, when? at which institution?
RECOMMANDATION LETTERS (Name of Referee you have asked to fill in a Recommandation Letter) Name and full address:...... Position :.... Employer : Full contact details (telephone, fax and e-mail)...... Date :. Student s Signature.. Please enclose 1. Personal Resume (benefit from the Master you are expecting, how do you see your career progressing, your major strengths and weaknesses, adaptation to new situations, do you consider yourself to be international in outlook, personal interests, any additional information which could help in understanding your motivations) 2. Curriculum Vitae 3. Copies of previous degrees 4. Your official academic transcripts 5. TOEFL score, or equivalent (If not possible, anyhow there will be an interview to evaluate your level of English and your motivation) 6. Copy of the passport or ID card 7. 2 letters of recommendation (to be sent with your application form or separately)
School of engineering Supported by the Chamber of Commerce and Industry of Rouen ESIGELEC offers courses in the following fields: Telecommunications Electronics Information technologies, Networks Computer engineering Embedded systems Automation and robotics Electrical engineering and transport Mecatronics Finance & Engineering Business Engineering Biotechnologies Normandy ESIGELEC ROUEN www.esigelec.fr Technopôle du Madrillet Avenue Galilée, BP10024 76801 Saint Etienne du Rouvray Tél. +33 (0)2 3291 5858 - Fax +33 (0)2 3291 5859
School of engineering Supported by the Chamber of Commerce and Industry of Rouen Confidential letter of Recommendation Master of Science Business Information Systems ACADEMIC YEAR 2010 / 2011 Dear Madam, Dear Sir, The student who has provided you with this letter is in the process of applying for a place in a Master of Science Programme at ESIGELEC Rouen School of Engineering. This is a high level educational course which serves to complete a strong initial education and/or a first professional experience. Therefore, if you would fill in this letter of recommendation and address it directly to us, we would be very grateful. Sincerely. Please return this application to ESIGELEC Programmes Masters of Science Technopôle du Madrillet Avenue Galilée, BP10024 76801 Saint Etienne du Rouvray Tél : +33 (0)2 3291 5858 Fax : +33 (0)2 3291 5859 E mail : marteaux@esigelec.fr
Student s name:.. How long have you known the candidate, and in what situation did you meet?..... What are his/her strongest points? What are the areas in which the candidate could improve? EVALUATION OF THE CANDIDATE Remarkable Very good Good Average Below average Analytical skills Creativity Summary skills Ability to communicate Sociability General assessment Your surname, First Name : Profession : Company name : Professional address : Post code : Town : Country : Phone number Email : Signature and Stamp :