<p> Center for EU Relations Pukyong National University 599-1 Daeyeon-dong, Nam-gu, Pusan 608-737, Rep. of Korea Phone: (+82 51) 629 5330~2 Fax: (+82 51) 629 5334 e-mail:: [email protected]</p><p>APPLICATION PACKAGE (Use this sheet as the top cover of the Package) Application deadline: October 30 for the first semester (from March to June) April 30 for the second semester (from September to December)</p><p>Please send this application in a complete package Containing all the following documents</p><p>Check List</p><p>1) A Completed Application Form □ 2) A Completed Study Plan Form □ 3) A Transcript of Academic Records (undergraduate and graduate school) □ 4) A copy of English proficiency certificate (TOEFL, TOEIC, IELTS) □ 5) A copy of Diploma (graduate students only) □ 6) A Recommendation Letter □ 7) A copy of Passport □ 8) A Housing Application □</p><p>APPLICATION FOR STUDY ABROAD PROGRAMS</p><p>Note : Application should be typewritten or printed clearly This form should be filled in English Numbers should be in Arabic numerals Proper nouns should be written in full; no abbreviations</p><p>Page 1 / 5 1. Personal Details</p><p>Title Mr □ Mrs □ Miss □ Ms □ Other □ Gender Female □ Male □ 1) Name </p><p>Last Name(Family Name) First(Surname) Middle(If you have one) 2) Date of Birth / / in , </p><p>Month Day Year City Country 3) Country of Citizenship 4) Permanent Mailing Address: No. and Street Suburb/City State/Country Zipcode Phone Fax Mobile Email 5) Name of home University : Major Field of Study 6) GPA(Grade Point Average) : Undergraduate ( / ), graduate( / )</p><p>2. Academic Information</p><p>1) Period of Exchange Academic Year : / Semester : □ Spring □ Fall</p><p>2) Intended Field of Study at chosen university Field of Study </p><p>3) Major Field of Study at Home University: </p><p>4) Language Proficiency English : □ Excellent □ Good □Fair □ Poor Korean : □ Excellent □ Good □Fair □ Poor : □ Excellent □ Good □Fair □ Poor</p><p>3. Dormitory 1) Do you need to apply for accommodation at university dormitory? □ Yes □No If ‘No’, give the address where you plan to stay: </p><p>Page 2 / 5</p><p>4. Signature I declare that to the best of my knowledge the information given in this application is correct and complete in every particular. I recognize that it is my responsibility to provide all necessary documentary evidence of my qualification and studies. I understand the university reserves the right to withdraw my offer or enrollment at any stage during my course where false or misleading information has been provided.</p><p>Applicant’s signature date / / </p><p>5. Study Plan Name in Full: Home University: Details of Proposed Study Abroad Program Please list below the titles of courses you wish to take Department Course Title Credit Professor</p><p>Please write a clear and detailed description of your study objectives and give your reasons for wanting to pursue them. And, please explain how your study plan and experiences of this exchange program can fit with your life goals. </p><p>Page 3 / 5 6. Recommendation Letter</p><p>University : Major : E-mail Address :</p><p>Professor’s Name : Signature: </p><p>Housing Application</p><p>Name: Last First Middle Home Address: </p><p>Page 4 / 5 Birth Date: Phone No: Mobile No: E-mail address: </p><p>□ Master Degree □ Doctoral Degree □ Research Student □ Exchange Student</p><p>□ I apply for dormitory. □ Daeyeon Campus □ I do not apply for dormitory.</p><p>□ You should attach Medical Certificate including the result of Hepatitis B and Tuberculosis or you will not allowed to stay in campus residences. - You can also get the medical check-up on your arrival. </p><p>Name : (Signature) </p><p>Page 5 / 5</p>