Application to UNS Master Courses in the UD niceCAMPUS

(For office use only) Candidate number:

UNS Master Courses in
the UD niceCAMPUS
University of NiceSophia-Antipolis
28, avenue de Valrose, 0610 N!"#
"#$#% 2, &'AN"#

University of $a Nan(
)1 *+ $u,n, -u.n /0i "h1u
2h3nh ph4 53 N6n(, Vi+t Na7
Application for7
to one and only 7aster fro7
"o7puter sciences
#-touris7
#lectronic and e78edded syste7s
/ydro9rotech
!nternational la:
;<A =!nternational &inance >' ;ar?etin(@

Notes for applicants
Please fill in the application as fully as you can to assist in the selection process
You will be notified on receipt of your application when completed. Final decision
on your application will be made by the Curriculum Board meeting in eptember !
"ctober per year. You will be informed immediately thereafter.
#hen completed, this form should be sent by email as an attach7ent to:
ttbich$ac.udn.%n and anhtuan.dhdn$gmail.com
& completed S!AN#$ copy of the form and rele%ant photocopies of
documents should be posted to:
N!"# "A;9US - 5B! /C" 5D NENA
'( )* +u,n, -u.n /0i Ch1u, 2h3nh ph4 53 67ng
You must also send a copy of the referee form 8at the end9 to at least two
referees.
2he referees should post or email the references $!'#"2*F to:
N!"# "A;9US - 5B! /C" 5D NENA
'( )* +u,n, -u.n /0i Ch1u, 2h3nh ph4 53 67ng
"ontact infor7ation
2h. 2:;6 2/< B=C/ > 6ice Campus > 5?i h@c 53 67ng
'( )* +u,n, 53 67ng > 2el: AB(( C DEF BAC > Gmail: ttbich$ac.udn.%n
C6. 6HIYJ6 &6/ 2IK6 > 6ice Campus > 5?i h@c 53 67ng
'( )* +u,n, 53 67ng > 2el: AECB DDD AFC > Gmail: anhtuan.dhdn$gmail.com
For office use only:
Page ( of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
9ersonal data
Certified Photocopies of Passport or Identification Cards should be subitted
2itle 8+r, Mr., Mrs., Miss, MsN9
urname 8family name9
First name 8gi%en name9
6umber or /ouse 6ame
treet
2own
Post code
Country
2elephone
FaO
Gmail
Hender 8MPMale, FPFemale9
+ate of birth 8++>MM>YYYY9
Place of birth 82own, Country9
6ationality or 6ationalities
For office use only:
Page F of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
#ducationG *ast Hualifications co7pleted or certified
Certified Photocopies of Diploas should be subitted
Qnstitution
+ates 8from R to9
2itle of -ualification &warded
ubSect 8s9
+ate of &ward
)e%el
:esult!MarT
Insert forer !ualifications
#ducationG -ualifications not yet co7pleted or certified
Qnstitution
+ates 8from R to9
2itle of -ualification &warded
ubSect 8s9
GOpected +ate of &ward
)e%el
Ni"eau (#$M$D)
Insert further !ualifications
For office use only:
Page C of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
9rofessional Hualifications
Certified Photocopies of Diploas should be subitted
-ualification
+ates 8from R to9
+ate of &ward
Insert further !ualifications
>ther relevant Hualifications
Certified Photocopies of Diploas should be subitted
-ualification
+ates 8from R to9
+ate of &ward
Insert further !ualifications
Non-(raduates should (ive their reasons for :ishin( to underta?e this course
(space not liited)
Before final acceptance, candidates will be required to submit proof of their qualifications
For office use only:
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Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
*an(ua(e S?ills
Mother 2ongue 8s9
Qs your first language GnglishU
(Please supply I%#&S or &'%F# scores and
transcripts if appropriate)
Qndicate your proficiency in Gnglish.
Your own Sudgment: Gnglish :eading sTills
Your own Sudgment: Gnglish #riting sTills
Your own Sudgment: Gnglish Verbal sTills
Qs your language FrenchU
Qndicate your proficiency in French.
Your own Sudgment: French :eading sTills
Your own Sudgment: French #riting sTills
Your own Sudgment: French Verbal sTills
>ther *an(ua(es
Certified Photocopies of Diploas should be subitted
)anguage
:eading sTills 8CPeOcellent FPgood (P basic9
#riting sTills 8CPeOcellent FPgood (P basic9
Verbal sTills 8CPeOcellent FPgood (P basic9
)anguage
:eading sTills 8CPeOcellent FPgood (P basic9
#riting sTills 8CPeOcellent FPgood (P basic9
Verbal sTills 8CPeOcellent FPgood (P basic9
)anguage
:eading sTills 8CPeOcellent FPgood (P basic9
#riting sTills 8CPeOcellent FPgood (P basic9
Verbal sTills 8CPeOcellent FPgood (P basic9
)anguage
:eading sTills 8CPeOcellent FPgood (P basic9
#riting sTills 8CPeOcellent FPgood (P basic9
Verbal sTills 8CPeOcellent FPgood (P basic9
Insert further lan(ua(es
For office use only:
Page B of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
#7ploy7ent
+ates 8from R to9
6ame and address of employer
2ype of business or sector
"ccupation or position held
Main acti%ities and responsibilities
Insert other eployent
;e78ership of 9rofessional Societies or Associations
ociety !&ssociation
+ates
)e%el 8member! presidentN9
Insert others
2eachin( #Iperience
Qnstitution
ubSect
)e%el 8indicate age group9
+ates
Insert others
'esearch #Iperience
ProSect 2itle
Main disciplines
Funding body
)ocal!regional!national!international
+ates
Insert others
Any other relevant infor7ation
For office use only:
Page L of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
9ersonal State7ent
Guidelines:
&his is to (i"e the Uni"ersity Adissions a chance to (et to )no* you$ your aspirations$ interests$
e+perience and talents$ professional$ acadeic and personal, Interests and hobbies (- a+iu)
Cultural acti"ities (draa$ usic$ dance$ paintin($ sculpture$ photo(raphy.- a+,) Sports (- a+iu)
Personal tatement: (iniu font si/e 01 point)
Do not use ore than this space
For office use only:
Page W of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
;otivation
%+plain *hy you are applyin( for this course,
Moti%ation : (iniu font si/e 01 point)
Do not use ore than this space
For office use only:
Page D of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
'eferences
Please gi%e or send the reference forms at the end of the application to your
chosen referees.
2hey should be able to comment on your academic and professional suitability for
your chosen course.
Please urge your referees to respond XuicTly.
+ifficulty in obtaining references can prolong the delay in the application
procedure.
Gmail may be used for the references, but a signed copy MI2 also be sent.
Please fill out your name on the referee form BGF":G sending it to the referee.
2he name should correspond GY&C2)Y to that gi%en under the personal details
Hi%e the names and addresses of your referees below.
:eferee number (!N
6ame:
&ddress:
2elephone:
e>mail:
:eferee number F!N
6ame:
&ddress:
2elephone:
e>mail:
:eferee number N!N
6ame:
&ddress:
2elephone:
e>mail:
$eclaration of "andidate
I hereby confir that the inforation (i"en on this for is true$ coplete and accurate
and no inforation re!uested or other aterial inforation has been oitted,
I hereby a(ree to confor to the rules for the re(ulation and conduct of students at the
Uni"ersity and to subit to the concerned Authorities in all atters of discipline,
+ate:
For office use only:
Page E of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
ignature:
>pen 'eference
2ou ha"e been as)ed by the student belo* to act as a referee for their application for a place in
this Master Course, &he Uni"ersities *ill be (rateful for your assistance in assessin( their
suitability for acadeic$ professional and residential life,
:eferees may be assured that all information pro%ided will be treated in strict confidence.
Please consider this applicant in comparison with other young people of the same age,
educational attainment and educational opportunity.
2he moral integrity of applicants is of great importance as a Xualification for li%ing in a
residential community other than his!her home country..
6ame of Candidate urname
First name
6ame of :eferee
&ddress
2elephone
Gmail
Post!"ccupation of referee
/ow long ha%e you Tnown the candidateU
Qn what capacity ha%e you Tnown the candidateU
/ow do you rate the candidateZs ability to comprehend and use GnglishU
/ow do you rate the candidateZs ability to comprehend and use FrenchU
/ow do you rate the candidateZs ability to carry out independent studyU
/ow do you rate the candidateZs ability to carry out independent researchU
/ow do you rate the candidateZs ability to carry out professional practiceU
/ow do you rate the candidateZs social sTills and competences 8li%ing and worTing with
other people, in multicultural en%ironments, in positions where communication is
important and situations where teamworT is essential9U
&re you aware of any professional, financial or personal reasons why the candidate
would eOperience difficulty during a prolonged period of study 8(>F years9U 2es or No
If yes$ please e+plain:
For office use only:
Page (A of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
Qn your opinion, is the candidate moti%ated, capable and able to follow a demanding post>
graduate course in a foreign country successfullyU 2es or No
If no$ please e+plain:
For office use only:
Page (( of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
6ame of Candidate urname
First name
6ame of :eferee
"n the following characteristics how would you rate the applicant compared with other
students you ha%e TnownU Please place a ticT in the appropriate column where you feel
you ha%e sufficient Tnowledge of the applicant to maTe an assessment.
>utstandin(
2op 2J
;uch
8etter than
avera(e
2op 10 J
<etter
than
avera(e
2op 2KJ
Avera(e <elo:
avera(e
Not a8le to
co77ent
Acade7ic a8ility
9rofessional a8ility
Lor? load capacity
*eadership potential
!nitiative
>r(aniMin( a8ility
Aptitude to
independent study
;oral Hualities -
honesty, inte(rity
'espect for
authority
"onsideration for
others
Socia8ilityG a8ility to
7iI :ith others in
co77unity livin(
Self-discipline
"o77on sense and
Nud(7ent
Adapta8ility to ne:
situations
;aturity
#7otional sta8ility
and capacity to cope
:ith stress
For office use only:
Page (F of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
6ame of Candidate urname
First name
6ame of :eferee
9lease assist us in the selection process 8y tic?in( one or 7ore of the follo:in(, as applica8le
Q would strongly recommend this applicant for this Master course.
2his applicant would benefit greatly from the eOperience of this Master course.
2his applicant would definitely maTe a positi%e contribution to this Master course.
Q would ha%e some reser%ations about this applicantZs suitability for this Master
course.
Q am unable to comment on this applicantZs suitability for this Master course.
2his applicant and this Master course would be incompatible.
+ate: ignature:
Please return this for by eail to
ttbich$ac.udn.%n > anhtuan.dhdn$gmail.com
and post a si(ned copy to
N!"# "A;9US - 5B! /C" 5D NENA
Ph[ng E.A(B, t\ng E, '( )* +u,n, -u.n /0i Ch1u, 2h3nh ph4 53 67ng
For office use only:
Page (C of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
>pen 'eference
2ou ha"e been as)ed by the student belo* to act as a referee for their application for a place in
this Master Course, &he Uni"ersities *ill be (rateful for your assistance in assessin( their
suitability for acadeic$ professional and residential life,
:eferees may be assured that all information pro%ided will be treated in strict confidence.
Please consider this applicant in comparison with other young people of the same age,
educational attainment and educational opportunity.
2he moral integrity of applicants is of great importance as a Xualification for li%ing in a
residential community other than his!her home country..
6ame of Candidate urname
First name
6ame of :eferee
&ddress
2elephone
Gmail
Post!"ccupation of referee
/ow long ha%e you Tnown the candidateU
Qn what capacity ha%e you Tnown the candidateU
/ow do you rate the candidateZs ability to comprehend and use GnglishU
/ow do you rate the candidateZs ability to comprehend and use FrenchU
/ow do you rate the candidateZs ability to carry out independent studyU
/ow do you rate the candidateZs ability to carry out independent researchU
/ow do you rate the candidateZs ability to carry out professional practiceU
/ow do you rate the candidateZs social sTills and competences 8li%ing and worTing with
other people, in multicultural en%ironments, in positions where communication is
important and situations where teamworT is essential9U
&re you aware of any professional, financial or personal reasons why the candidate
would eOperience difficulty during a prolonged period of study 8(>F years9U 2es or No
If yes$ please e+plain:
Qn your opinion, is the candidate moti%ated, capable and able to follow a demanding post>
graduate course in a foreign country successfullyU 2es or No
If no$ please e+plain:
For office use only:
Page (' of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
6ame of Candidate urname
First name
6ame of :eferee
"n the following characteristics how would you rate the applicant compared with other
students you ha%e TnownU Please place a ticT in the appropriate column where you feel
you ha%e sufficient Tnowledge of the applicant to maTe an assessment.
>utstandin(
2op 2J
;uch
8etter than
avera(e
2op 10 J
<etter
than
avera(e
2op 2KJ
Avera(e <elo:
avera(e
Not a8le to
co77ent
Acade7ic a8ility
9rofessional a8ility
Lor? load capacity
*eadership potential
!nitiative
>r(aniMin( a8ility
Aptitude to
independent study
;oral Hualities -
honesty, inte(rity
'espect for
authority
"onsideration for
others
Socia8ilityG a8ility to
7iI :ith others in
co77unity livin(
Self-discipline
"o77on sense and
Nud(7ent
Adapta8ility to ne:
situations
;aturity
#7otional sta8ility
and capacity to cope
:ith stress
For office use only:
Page (B of (L
Application to UNS Master Courses in the UD niceCAMPUS
(For office use only) Candidate number:
6ame of Candidate urname
First name
6ame of :eferee
9lease assist us in the selection process 8y tic?in( one or 7ore of the follo:in(, as applica8le
Q would strongly recommend this applicant for this Master course.
2his applicant would benefit greatly from the eOperience of this Master course.
2his applicant would definitely maTe a positi%e contribution to this Master course.
Q would ha%e some reser%ations about this applicantZs suitability for this Master
course.
Q am unable to comment on this applicantZs suitability for this Master course.
2his applicant and this Master course would be incompatible.
+ate: ignature:
Please return this for by eail to
ttbich$ac.udn.%n > anhtuan.dhdn$gmail.com
and post a si(ned copy to
N!"# "A;9US - 5B! /C" 5D NENA
Ph[ng E.A(B, t\ng E, '( )* +u,n, -u.n /0i Ch1u, 2h3nh ph4 53 67ng
For office use only:
Page (L of (L