The Stock Exchange of Thailand 93 Ratchadaphisek Rd, Din Daeng, Bangkok 10400 E-mail: [email protected] http//www.set.or.th

SET Scholarship Application Form

Applied For:  MBA  Management University ......

1. Personal Profile:

Name: …………………………………………….……………….. Surname: ……………………………………………….…….…

ชอชช : …………………………………………….……………….. นามสกกุล: ………………………………………………..………

ชอเลล่นชช : …………………………..…………….. Military Status:  Military Exempted  Military Non Exempted

Present address: ……………………………………………………………………………………………………………………………………………

Permanent address (ID card): ..……. ……………………………………………………………………………………………………………….

Home Phone: …………………………..……… Mobile Phone: …………………..…………. Office Phone: ………………………………

E-Mail Address: …………………………..……………………… Age: ……………… Date of Birth: ………………….. (DD/MM/YY)

Nationality: …….………………………. Race: ……………………….. Religion: ……………………….. Height: ………………..cms.

Weight: ………….…….. kgs. Health:  Excellent  Good  Physical disability: ……………………………….

ID card no: ………………………………………………………… Issued Date: ………………………….. (DD/MM/YY)

Expire Date: …………………………..(DD/MM/YY) Marital Status:  Single  Married  Separate  Divorced

2. Education Background: (Highest to Lowest)

1) Degree: ……………………………………………… Institute Name: …………………………………………………………………………..

Major: ………………………………..…………………………….. GPA: ………………………. Year of Graduation: ……………………….

2) Degree: ……………………………………………… Institute Name: ………………………………………………………………………….. Major: ………………………………..…………………………….. GPA: ………………………. Year of Graduation: ……………………….

3) Degree: ……………………………………………… Institute Name: …………………………………………………………………………..

Major: ………………………………..…………………………….. GPA: ………………………. Year of Graduation: ……………………….

4) Degree: ……………………………………………… Institute Name: …………………………………………………………………………..

Major: ………………………………..…………………………….. GPA: ………………………. Year of Graduation: ……………………….

3. Activities: (Participation in school activities; e.g., Class Organization, Athletes, Publication)

1) ………………………………………………………………………………………………………………….……………………………….. …………

2) ………………………………………………………………………………………………………………….……………………………….. …………

3) ………………………………………………………………………………………………………………….……………………………….. …………

4. Skills:

English Language อชชน ๆ (Indicate: Fair, Good, Excellent) Computer Language อชชน ๆ Speak Read Write ………….. …………………………………………… TOEIC ………….. TOEFL ……………………………………………

IELTS ………….. …………………………………………… GMAT ………….. GRE ……………………………………………

Sport: ……………………………………………………………………………………………………………………………………………………….

Others: ……………………………………………………………………………………………………………………………………………………..

5. Family Profile:

 Alive Father Name: …………………………………….….. Surname: …………….………………………….. Age: ………………  Die

Nationality: ……………………………………………. Race: ……………………………………………… Religion: ………………………..

Occupation: ………………………………………….. Company Name: ………………………………………………………………………..  Alive Mother Name: …………………………………….….. Surname: …………….………………………….. Age: ………………  Die

Nationality: ……………………………………………. Race: ……………………………………………… Religion: ………………………..

Occupation: ………………………………………….. Company Name: ………………………………………………………………………..

No. of Brothers / Sisters ………………………………. Person (s) (Excluding yourself) What no. are you? ……………………..

1) Name – Surname: …………………………………………………………… Age: …………………. Occupation: ………………………..

2) Name – Surname: …………………………………………………………… Age: …………………. Occupation: ………………………..

3) Name – Surname: …………………………………………………………… Age: …………………. Occupation: ………………………..

4) Name – Surname: …………………………………………………………… Age: …………………. Occupation: ………………………..

6. Work Experience: (Present to Previous)

1) From: ……………………………. (MM/YY) To: ……………………………. (MM/YY) Total: ……………………………. Year (s)

Company Name: ……………………………………………………………………. Type of business: …………………………………………

Last Position: ……………………………………………………….……………….. Salary: …………………………… (฿)

Responsibilities: …………………………………………………………………………………………………………………………. ……………….

…………………………………………………………………………………………………………………………………… ……………………………..

Reason of Leaving: ……………………………………………………………………………………………………………………………………..

2) From: ……………………………. (MM/YY) To: ……………………………. (MM/YY) Total: ……………………………. Year (s)

Company Name: ……………………………………………………………………. Type of business: …………………………………………

Last Position: ……………………………………………………….……………….. Salary: …………………………… (฿)

Responsibilities: …………………………………………………………………………………………………………………………. ……………….

…………………………………………………………………………………………………………………………………… ……………………………..

Reason of Leaving: …………………………………………………………………………………………………………………………………….. ______

3) From: ……………………………. (MM/YY) To: ……………………………. (MM/YY) Total: ……………………………. Year (s)

Company Name: ……………………………………………………………………. Type of business: …………………………………………

Last Position: ……………………………………………………….……………….. Salary: …………………………… (฿)

Responsibilities: …………………………………………………………………………………………………………………………. ……………….

…………………………………………………………………………………………………………………………………… ……………………………..

Reason of Leaving: …………………………………………………………………………………………………………………………………….. ______

4) From: ……………………………. (MM/YY) To: ……………………………. (MM/YY) Total: ……………………………. Year (s)

Company Name: ……………………………………………………………………. Type of business: …………………………………………

Last Position: ……………………………………………………….……………….. Salary: …………………………… (฿)

Responsibilities: …………………………………………………………………………………………………………………………. ……………….

…………………………………………………………………………………………………………………………………… ……………………………..

Reason of Leaving: ……………………………………………………………………………………………………………………………………..

7. What kind of job or department do you plan to work after the completion of your education? Why?

8. Essay: Proposed Program Plan: Write a clear and detailed statement concerning your proposed major field of interest, the specific area of your field. Explain the kind of program you wish to attend and how your proposed plan relates to your previous experiences and your future goals. The statement should be printed within the space provided below. (minimum 250 words)

9. Behavior Background:

1) Are you involved in any administrative, civil, or criminal case?  Yes  Never

2) Would you mind about the proving your behavior background by finger printing?  Yes  No

3) Would you mind about asking for your back ground from your old company?  Yes  No

10. Reference: (your former employers, relatives or provide more than member of college faculty)

1) Name – Surname: ………………………………………………………………… Telephone No.: …………………………………………. Age: …………………. Relation:……………………………………………. Occupation:………………………………………. …………….

Company Name: ………………..………………………………………………. Last Position: ………………………….…….. ……………….

2) Name – Surname: ………………………………………………………………… Telephone No.: ………………………………………….

Age: …………………. Relation:……………………………………………. Occupation:………………………………………. …………….

Company Name: ………………..………………………………………………. Last Position: ………………………….…….. ……………….

11. Emergency Case: (Please fill the contact persons when has the emergency case)

1) Name – Surname: …………………………………………………………………..…… Relation.:……………………….. ………………..

Address: …………………………………………………………………………………………. Telephone No.: ………….…….. ……………….

2) Name – Surname: …………………………………………………………………..…… Relation.:……………………….. ………………..

Address: …………………………………………………………………………………………. Telephone No.: ………….…….. ……………….

I certify that my answer and supplement thereto are true. I understand that any false statements on this application or supplements will be an adequate ground for disqualification and the company can immediately discharge me without any lieu of notice or severance pay.

Signature:……………………………………….

Date:……………..……………………………….