접수번호

(Registration Number)
2020학년도 1학기
외국인 교환학생 입학지원서
※Do not write in this area.
(Application for Exchange Program
for the Spring Semester 2020)

※ 반드시 한국어나 영어로만 타이핑 할 것(Computer TYPE only in Korean or English)

수학기간 One semester  지원학과 Telecommunication

(Study Duration) Two semester  (Major) Engineering

인적사항(Personal Information)
9. 입국일자 (Date of Entry, if you are in Korea) :
1. 이름(Name)
한국어(Korean) - / -

10. 본국 주소(Address in Home Country) Jalan Sungai Raya Dalam

영 어(English) Situmorang / I Deo Kelvin Aprianta Komplek Taman Anggrek No. F6, Pontianak Tenggara, Pontianak,
West Borneo, Indonesia

모국어(Mother Language) : Indonesian

전화(Phone) : +62 81349384712

2. 국적(Nationality) : Indonesian 이메일(E-mail) : Deositumorang.963@gmail.com

3. 출생지 : Sintang / West Borneo / Indonesia 11. 입학허가서 받을 주소

(Place of Birth) 시(City) / 도(State) / 국가(Country)
4. 성별(Sex) : 남(Male) 
5. 생년월일 :
(Date of Birth)
(Address of International office where you can receive original copy
of admission letter)
ICAO Office, Tokong Nanas Building, 9th floor, Jl.
Telekomunikasi No.1, Sukapura, Kec. Dayeuhkolot, Bandung,
Jawa Barat 40257
/ 여(Female) 
전화(Phone) : (+6222) 7565567
2000 / 04 / 20
이메일(E-mail): icao@telkomuniversity.ac.id
(YYYY/MM/DD)

6. 여권번호(Passport Number) : C4111154

12. 대한민국 내 긴급 연락처(Contact Point in Korea)
7. 체류자격(Visa Type if you have) :
이름(Name) :
8. 외국인등록번호: 전화번호(Tel) :
(Alien Registration if you have)
관계(Relationship) :

학력 (Educational Background) Since High school

수학 졸업구분
학교명 주소 입학일 졸업일 연락처
교육과정 기간 (Graduation
(School name) (Address) (From) (To) O,X)
(Tel.)
(Year)
Jl. Gusti Johan
고등 SMA N 1 Idrus, Akcaya, Kec.
(+62561)73
(Secondary Pontianak Sel., Kota 2015 2018 3 2018
school)
Pontianak Pontianak, 4983
Kalimantan Barat

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 Jl.Telekomunikasi
Jl. Terusan Buah
대학 Telkom Batu, Sukapura,
2018 Now - -
(+6222)
(University) University Kec. Dayeuhkolot, 7565567
Bandung, Jawa
Barat
생활관 신청여부 (Application for the Dormitory & Meal Plan)
 신청합니다 (I want to live in dormitory.)
※ 기숙사 신청할 경우,
1) 식사 옵션 (Please check your meal option plan if you want to live in dormitory)
 no meal plan  5 days/week  7 days/week
(한식만 제공됩니다. Korean food only. No halal food.)
2) 남학생 방 옵션 (Room option for male student)
 Double room  Quad Room
※ 사정에 따라 신청한대로 방 배정이 되지 않을 수도 있습니다.
(You might not be able to get a room you select according to the dormitory circumstances)
※ 기숙사 신청 후, 8월 1일 이후로는 취소할 수 없습니다. (You cannot cancel or change dormitory reservation after August 1st)
※ 여학생은 4인실만 가능합니다. (ONLY Quad Room is available for female students)
 신청하지 않습니다 (I don't want to live in dormitory.)

유학경비 부담 서약서 (Financial Affidavit)

※ 귀하의 유학경비를 부담할 개인이나 기관명을 쓰시오.
Indicate the person, including yourself (or organization) who will be responsible for your tuition fee and living expenses.
▮ 개인 또는 기관명 (Sponsor's Name) : Antonius Situmorang
▮ 관계 (Relationship) : Father
▮ 직업: 개인인 경우 (Sponsor's Occupation) : Bussinessman
▮ 주소 (Address) : Jalan Sungai Raya Dalam Komplek Taman Anggrek No. F6, Pontianak Tenggara, Pontianak, Kalimantan
Barat, Indonesia
▮ 전화번호 (Phone No.) : +62 85245720511

※ 본인은 상기 지원자의 유학기간 중 일체의 경비부담을 보증합니다

I guarantee that I will be responsible for this applicant's tuition fee and living expenses during his study at your university.
▮ 이름 (Name) : I Deo Kelvin Aprianta
▮ 서명 (Signature) :
▮ 연월일 (Date) : 2019 / 11 / 12
연도(Year) 월(Month) 일(Date)

본인은 위 지원서의 내용이 사실임을 확인합니다.

I certify that the information provided on this form is accurate and complete.

Date(YYYY/MM/DD) :2019/11/12 Name :I Deo Kelvin Aprianta Signature :

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 자 기 소 개 서 (Self Introduction)
※ 한국어 또는 영어로 작성하세요(In Korean or English)

성명(Name) I Deo Kelvin Aprianta 국적(Nationality) Indonesia

생년월일 지원학과
April, 20th 2000 Electrical Engineering
(Date of Birth) (Department of study)

My name is I Deo Kelvin Aprianta Situmorang, my friends usually call me Deo. I am 19

years old. I was born in Sintang, West Borneo, Indonesia, On April 20th 2000 I am the
second of four siblings, I have 1 sister and 3 brothers.

I adore to play game both of Pc and Smarthphone however I can still manage the time to
study while playing game. I have another hobby that is playing basketball, I am not really
good at playing basketball, but I play it just for fun and to excercise my body and make my
body healty

Now I continue my study in Telkom University as telecommunication engineering student

and I am joining Laboratory of Physics as Practicum Asistant also student English society
as member in speech division.

Why I choose Telkom University, because Telkom University one of the best private
university in Indonesia and I love to learn calculation courses, and I interest to study about
signaling, thats why I choose Telecomunication Engineering.

My parents always support me for everthing that I want as long as it is good for me
including this student exchange program because this program is really great chance for
me to improve my knowledge. I interest to learn wireless network – Miltary Application as
far as I know KIT is good at wireless network, also I want to study about Korean culture,
share about experience to each others. If I accept to this program I hope I can make my
parents pround of me.

So, I am happy to be who I am, I am not perfect person but I am be my own self, I learn
from my experience and my mistakes. Thank you

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 수 학 계 획 서 (Study Plan)

※ 한국어 또는 영어로 작성하세요(In Korean or English)

성명(Name) I Deo Kelvin Aprianta 국적(Nationality) Indonesia

생년월일 지원학과 School of Electronic

April, 20th 2000
(Date of Birth) (Department of Study) Engineering

1. 금오공과대학교에서 수학하고자 하는 목적
(Purpose of study at Kumoh National Institute of Technology)

My purposes of study at Kumoh National Institute of Technology are to improve my

learning skill, I interest to study wireless network – Miltary Application because as I know
in KIT is good at wireless network – Miltary Application and I want to feel how learning
method in Korea because I know that education system there is more discipline also I am
intererested in culture of korea therefore, it will definetely give me new experiences of
international exposure of my life.

2. 전공하고자 하는 분야 및 선택 이유
(What major do you want and why did you select it?)

The major that I want in Kumoh Institute Technology is Electronic Engineering, That is
because that major relate with my major in Telkom University, and in this major I can get
courses that can be converted to my courses in Telkom University.

3. 금오공과대학교의 교육과정 학습계획

(Study plan of Kumoh National Institute of Technology Curriculum)
Here are the list of my study plan of Kumoh National Institute of Technology Curriculum

1. Object Oriented Programming

2. Creative Design Poject
3. Wireless Network – Military Application
4. Network Programming
5. Signal and System
6. Consumer Behavior
7. Control Engineering

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