<p> DUKSUNG WOMEN’S UNIVERSITY</p><p>DUKSUNG WOMEN’S UNIVERSITY </p><p>APPLICATION FOR EXCHANGE PROGRAM 2011-2012</p><p>Note: Please ensure that all the information must be typed with a word processor.</p><p>1. PERSONAL DATA</p><p>Full Name </p><p>First name Middle name Last/family name Please attach a Date of birth Gender  M  F recent photo</p><p>Day Month Year</p><p>Enter name & date of birth exactly as it appears on your passport.</p><p>Country of Birth Country of Citizenship E-mail Address Permanent Home Address </p><p>Number and Street</p><p>City State Country Postal Code</p><p>If different from above, please give your mailing address for all admission correspondence.</p><p>Mailing Address </p><p>Number and Street</p><p>City State Country Postal Code</p><p>Phone at Mailing Address Permanent Home Phone </p><p>Predominant language spoken in your home Indicate your fluency of the foreign languages listed below. KOREAN  fluent  good  a little  none</p><p>TOPIK Score  Level 6 Level 5 Level 4  Level 3</p><p>ENGLISH  fluent  good  a little  none OTHERS ( )  fluent  good  a little  none</p><p>1 DUKSUNG WOMEN’S UNIVERSITY</p><p>2. EDUCATIONAL DATA Name of Institution you’re currently enrolled at Academic Field: </p><p>Major Name of Department & College</p><p>Academic Level:  Freshman  Sophomore  Junior  Senior  Graduate Student</p><p>Educational Background (from high school level)</p><p>Name of Institution Country Duration(MDY-MDY)</p><p>Please list any academic distinctions or honors you have won</p><p>Possible area(s) of academic major(s) to study at Duksung Women’s University or undecided  Intended Semester(s) to Study:  Spring 2011  Fall 2011  Spring 2012  Fall 2012 </p><p>Advisor’s Contact Information (at your institution) Name Position Department Address Telephone Fax Email </p><p>3. FINANCIAL DATA Indicate the person or organization that will be responsible for your expenses during your study term at Duksung Women’s University. Name Relationship Address Telephone Fax Email </p><p>Approximate Amount of Support during the semester(s) US$ NOTE: The Korean Consulate may ask you to submit the sponsor’s ‘Certificate of Deposit Balance’ along with other financial documents to prove the sponsor’s financial abilities.</p><p>The Sponsor’s Certification “I guarantee that I will be responsible for the applicant’s all the expenses for the duration of the exchange program.”</p><p>2 DUKSUNG WOMEN’S UNIVERSITY</p><p>Name Signature Date</p><p>4. ACCOMODATION Please check what kind of accommodation you would like to stay during the exchange program.  Duksung Dormitary  Off Campus (arranged by the student personally)</p><p>5. CHECK LIST I have included the followings with the application form.  One original copy of ‘Academic Transcript’ - in English  One original copy of ‘Certificate of Enrollment’ - in English  ‘Letter of Recommendation’ from a professor in the Dept. focusing on academic performance – in English  A ‘Study Plan’ (personal essay, 1 ~ 1.5p) – in English  A photo copy of passport (the page with the photograph)  1 passport size photo(For the Student ID card)</p><p>I certify that all the information in my application is true and correctly written:</p><p>Name Signature Date</p><p>Note: Documents for the spring semester should be sent in by no later than Dec. 10th and May 10th for the fall semester.</p><p>3 DUKSUNG WOMEN’S UNIVERSITY</p><p>Office of International & Public Relations Duksung Women’s University 419 Ssangmun-Dong, Dobong-Gu, Seoul 132-714, Korea Tel) +82-2-901-8216 Fax) +82-2-901-8220 Email) [email protected] Homepage) http://www.duksung.ac.kr</p><p>4</p>