APPLICATION FOR ADMISSION



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M.Sc. in Petroleum Geoscience Department of Geology, Faculty of Science Chulalongkorn University APPLICATION FOR ADMISSION Photograph (Please complete this Application Form with using Block Letters) Biographical Information Official Identification Number/Passport Number Name (English) First Middle Last (Thai) First Last Mailing address Street address City Post code Country Telephone number at mailing address Business telephone Area code Number Area code Number E-mail Mobile Phone Permanent Home address (If different from Mailing address) Street address City Post code Country Telephone number at home address Area code Number Birth date Month Date Year Citizenship Thai Place of Birth Other Name of Country Place of Birth Gender Male Female Marital Status Single Married Divorced Number of Family member Status Information Have you taken the Test of English as a Foreign Language? Yes/Date you took TOEFL/CUTEP Please enclose a copy of your test scores. No/Date you plan to take TOEFL/CUTEP

Indicate your source of financial support. If no scholarship is available, you would Self-supporting Business/Organization sponsored Scholarship requested Withdraw your application Make own alternative arrangement School History Secondary School(s) Attended: Year of attendance Secondary School Attended City/Country Diploma/Certificate Colleges and Universities Attended List in chronological order all colleges and universities attended. It is your responsibility to request a transcript from the registrar of each institute to be included with your application package. Year of attendance Institution attended (City/Country) Degree obtained (Specify major field) GPA Date of Award or Anticipated Award (Month/Year) Honors received or other evidence of high scholastic achievements (scholarship, mention with credit,etc.) Describe part-time work while at colleges/universities

Have you ever been suspended or required to withdraw from any school or college? Yes No If you have any physical or emotional problems that you wish to call to our attention, please give details and indicate any kind of special consideration you may require whilst attending the College. Collegiate Extra-Curricular Activities and Professional Memberships Activities/Professional Memberships Dates Offices held, if any Employment History Account for all time periods from the start of your undergraduate studies to the present, beginning with your most recent activities. Include part-time, summer, and full-time work experience. Use additional sheets if necessary. Dates (From-To) Employer Job title Primary responsibilities Statement of Purpose In no more than two type-written pages, write a concise statement outlining your most valued experience and accomplishments, your reasons for graduate study, your professional and research interests, and your career expectations, The Admission Committee places strong emphasis on this statement so remember to sign your name and attach this Statement of Purpose to your application.

Name and Address of Recommenders 1. Name (English) Name (Thai) Address Email: Tel: 2. Name (English) Name (Thai) Address Email: Tel: I certify that all statements made in this application for admission to the M.Sc. in Petroleum Geoscience are correct, and I realize that all documents submitted in support of this application become the property of the M.Sc. in Petroleum Geoscience Program. I authorize the M.Sc. in Petroleum Geoscience to release information from this application and supporting documents to any organization sponsoring scholarships for the College to permit my being considered for scholarship support. I understand that I will be notified of any organization to which information is given. Signature Date / /

The M.Sc. in Petroleum Geoscience Department of Geology, Faculty of Science Chulalongkorn University LETTER OF RECOMMENDATION (confidential) Name of candidate (print or type) First Middle Last The person whose name appears above has applied for admission to the M.Sc. in Petroleum Geoscience. Please answer the questions below in as specific and candid a manner as possible. Your comments will be an important factor in the admission decision. Name of recommender (print or type) Position/Title Organization Address Telephone number E-mail address 1. How long have you known the applicant? years months 2. Under what circumstances have you known the applicant? 3. What do you consider the applicant s most outstanding talents or characteristics? 4. In comparison with other candidates for graduate study that you have known, how would you rate the applicant with respect to the following qualities: Below average (Bottom 1/3) Average fair (1/3) Good (Top 1/3) Unusually good (Top 15%) Outstanding (Top 5%) Truly exceptional (Top 2%) Inadequate opportunity to observe Intellectual ability Knowledge in chosen field Self-reliance, Motivation and seriousness of purpose Written skills in English Oral skills in English Ability to get along With others 5. I strongly recommend recommend recommend with some reservation do not recommend that this applicant be admitted to the M.Sc. in Petroleum Geoscience. Signature ( ) Date / / Please return this form directly to the applicant in the attached envelope after placing your signature across the sealed envelope flap, or inform the applicant that you are mailing it directly to the M.Sc. Petroleum Geoscience Office at Room#233, Department of Geology, Faculty of Science, Chulalongkorn University, Pratumwan, Bangkok 10330 Thailand. Thank you for your assistance on the matter.

The M.Sc. in Petroleum Geoscience Department of Geology, Faculty of Science Chulalongkorn University LETTER OF RECOMMENDATION (confidential) Name of candidate (print or type) First Middle Last The person whose name appears above has applied for admission to the M.Sc. in Petroleum Geoscience. Please answer the questions below in as specific and candid a manner as Possible. Your comments will be an important factor in the admission decision. Name of recommender (print or type) Position/Title Organization Address Telephone number E-mail address 1. How long have you known the applicant? years months 2. Under what circumstances have you known the applicant? 3. What do you consider the applicant s most outstanding talents or characteristics? 4. In comparison with other candidates for graduate study that you have known, how would you rate the applicant with respect to the following qualities? Below average (Bottom 1/3) Average fair (1/3) Good (Top 1/3) Unusually good (Top 15%) Outstanding (Top 5%) Truly exceptional (Top 2%) Inadequate opportunity to observe Intellectual ability Knowledge in chosen field Self-reliance, Motivation and seriousness of purpose Written skills in English Oral skills in English Ability to get along With others 5. I strongly recommend recommend recommend with some reservation do not recommend that this applicant be admitted to the M.Sc. in Petroleum Geoscience. Signature ( ) Date / / Please return this form directly to the applicant in the attached envelope after placing your signature across the sealed envelope flap, or inform the applicant that you are mailing it directly to the M.Sc. in Petroluem Geoscience Office at Room#233, Department of Geology, Faculty of Science, Chulalongkorn University, Pratumwan, Bangkok 10330 Thailand. Thank you for your assistance on the matter.