COLENORMALESUPRIEUREDECACHAN

Relations internationales

PHOTO
Programme de bourses internationales / International Scholarship Programme
Formulaire de candidature / Application Form
Anne universitaire / Academic Year: 2012 - 2013
IDENTIT DE LTUDIANT POSTULANT / APPLICANT INFORMATION
Nom / Last Name: GETACHEW
Prnom / First Name: YOHANNES
Genre / Gender: M

Date et lieu de naissance / Date and Place of Birth: 07 July- 1989 Addis Ababa
................................................................................................................................................................................................
Nationalit / Nationality: ETHIOPIAN
Pays de rsidence actuel / Present residential country: ETHIOPIAN
Adresse pour la correspondance / Mailing Address for correspondence: .............................................................................
N et rue / House number and street: 741/+
................................................................................................................................................................................................
Localit / City: Addis Ababa
Code postal / Postcode: 1176
Pays / Country: ETHIOPIA
Tlphone: +251114400577.....................................
E-mail: .....................................................................
Adresse de votre lieu de rsidence permanent, si diffrente (sinon, ne rien crire) / Permanent residential address if
different (if not, do not use):
N et rue/House number and street: ......................................................................................................................................
................................................................................................................................................................................................
Localit / Suburb or town: .....................................................................................................................................................
Code / Postcode: ......................................................
Pays / Country: ........................................................
Tlphone: ............................................................... Fax: ......................................................................
Etat civil / Marital Status:

Clibataire / Single

Avez-vous des enfants ? / Do you have children?

Mari(e) / Married

Oui / Yes

Non / No

Nbr denfants / Number of children: .....................................................................................................................................

Serez-vous accompagn(e) par des membres de votre famille pendant votre sjour lENS Cachan ? Si oui, indiquez
leurs noms, ge et la relation de dpendance. Will you be accompanied by members of your family during your stay at
ENS Cachan? If yes, please indicate their name, ages and the relation of dependence:
1 .............................................................................................................................................................................................
2 .............................................................................................................................................................................................
3 .............................................................................................................................................................................................

Programme de bourses internationales International Scholarship Programme

COLENORMALESUPRIEUREDECACHAN
Relations internationales
ETABLISSEMENT DORIGINE / HOME INSTITUTION
Nom de linstitution / Institution Name: Addis Ababa university
Adresse complte / Complete Address: Addis Ababa, Ethiopia
...............................................................................................................................................................................................
Dpartement ou Laboratoire / Department or Laboratory: Physics
Adresse / Address: P.O.Box 1176 Addis Ababa, Ethiopia
................................................................................................................................................................................................
Tel.:+251111223931 ................................................ Fax: +251111223931...........................................
E-mail: info@phys.aau.edu.et................................ Website: www.aau.et

PARCOURS UNIVERSITAIRE / ACADEMIC RECORD

Discipline tudie / Field of Study: Applied Physics............................................................................................................
Diplme en cours dobtention (si cest le cas) / Current Degree (if applicable): BSc in Physics.......................................
................................................................................................................................................................................................
Date dobtention du diplme prpar (prvision) / Expected date for final degre : ..............................................................
Nombre dannes universitaires ou semestres valids ce jour / Number of years or terms fully completed at university
prior to this application: ........................................................................................................................................................
Dernier diplme universitaire obtenu, institution et date / Last higher education degree obtained, institution and date:
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
Date du diplme de fin dtudes secondaires / Graduation date from high school: .............................................................
Indiquez votre parcours des 6 dernires annes, diplmes obtenus ou en cours dobtention / Detail your education
during the last 6 years. Include details of qualifications to be awarded:
Etablissement
denseignement / Organisme/
Pays / Ville/
College / University /
Awarding body/Country/City

Nom du dpartment/
Name of unit

Domaine dtudes
principal / Main
subject(s) studied

Diplme obtenu /
date dobtention /
Degree/Diploma
obtained/date of
award

Notes /
Marks
(ex:
17/20)

Rang /
Rank
(ex :
5/54)

2011-2012

...

...

...

...

2010-2011

...

...

...

...

2009-2010

...

...

...

...

2008-2009

...

...

...

...

2007-2008

...

...

...

...

2006-2007

...

...

...

...

Programme de bourses internationales International Scholarship Programme

COLENORMALESUPRIEUREDECACHAN
Relations internationales

Indiquez, si cest le cas, les prix, mentions, rsultats particuliers que vous avez obtenus / Please indicate if you received
exceptionally high grades, prizes, etc.:
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
Indiquez les tablissements denseignement suprieur auxquels vous avez postul la fin de vos tudes secondaires /
List the institutions of higher education you applied to at the end of your secondary education:
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
Quels tablissements ont accept votre candidature ? / At which institutions was your application successful?
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
Quel tablissement avez-vous choisi ? / Which did you choose? ..........................................................................................
................................................................................................................................................................................................
Indiquez les raisons de votre choix / Why? ...........................................................................................................................
................................................................................................................................................................................................
Avez-vous reu des bourses pendant vos tudes universitaires ? / Were you awarded a grant during your university
studies?

Oui / Yes

Non / No

Type ou nom de la bourse et organisme de financement / Type or name of grant and financing institution:
................................................................................................................................................................................................
................................................................................................................................................................................................
Critres dattribution / According to what criteria where the grants awarded?
Mrite / Merit

Situation financire / Financial situation

Autres / Other: .......................................................................................................................................................................

Pour lanne universitaire 2012-2013 / For the academic year 2012-2013 :
a) candidatez-vous une autre universit en France ou ltranger ? are you applying to other institutions in France or
in another country?

Oui / Yes

Non / No

b) demandez-vous une bourse auprs dune autre institution ? / are you applying for another scholarship?
Oui / Yes

Non / No

REFERENCES / REFEREES
Indiquez minimum deux personnes de contact (enseignants ou chercheurs) qui peuvent fournir des rfrences sur votre
candidature / Please indicate at least two persons within your home institution that may provide references for your
application.
1. Nom et qualit / Name and position: .................................................................................................................................
................................................................................................................................................................................................
Dpartement ou Laboratoire / Department or Laboratory: ...................................................................................................
................................................................................................................................................................................................
Programme de bourses internationales International Scholarship Programme

COLENORMALESUPRIEUREDECACHAN
Relations internationales

Adresse / Address: .................................................................................................................................................................

................................................................................................................................................................................................
Tel.: .......................................................................... Fax: ......................................................................
E-mail: ..................................................................... Website: ...............................................................
2. Nom et qualit / Name and position: .................................................................................................................................
................................................................................................................................................................................................
Dpartement ou Laboratoire / Department or Laboratory: ...................................................................................................
................................................................................................................................................................................................
Adresse / Address: .................................................................................................................................................................
................................................................................................................................................................................................
Tel.: .......................................................................... Fax: ......................................................................
E-mail: ..................................................................... Website: ...............................................................
3. Nom et qualit / Name and position: .................................................................................................................................
................................................................................................................................................................................................
Dpartement ou Laboratoire / Department or Laboratory: ...................................................................................................
................................................................................................................................................................................................
Adresse / Address: .................................................................................................................................................................
................................................................................................................................................................................................
Tel.: .......................................................................... Fax: ......................................................................
E-mail: ..................................................................... Website: ...............................................................

SEJOUR ENVISAGE A LENSC / EXPECTED LENGTH OF STAY AT ENSC

NB : Avant de nous transmettre le dossier de candidature, les candidat(e)s sont pri(e)s de prsenter leur projet
dtudes et/ou de recherche au directeur du dpartement ou du laboratoire quils souhaitent intgrer
lENS Cachan et obtenir leur accord de principe sur leur projet / Interested applicants should first contact
the academic department or research laboratory director in their respective fields to present their research
and/or study project and consequently to obtain affiliation.
Objectif du sjour / Purpose of your stay at ENS Cachan:
Master

Doctorat en cotutelle / Joint PhD

Dure totale en mois / Total duration in months: ..................................................................................................................

Priode du sjour lENS Cachan / Time frame for studies / research training at ENS Cachan:
de (jj/mm/aa) / from (dd/mm/yy) ......................................... (jj/mm/aa) / to dd/mm/yy) .....................................
Laboratoire ou dpartement daccueil / Host Department or Laboratory: ............................................................................
................................................................................................................................................................................................
Personne(s) de contact dans le laboratoire ou le dpartement daccueil lENS Cachan / Contact person in the host
research laboratory or academic department at the ENS Cachan: ......................................................................................
................................................................................................................................................................................................

Programme de bourses internationales International Scholarship Programme

COLENORMALESUPRIEUREDECACHAN
Relations internationales
Si vous tes candidat(e) pour le niveau master, envisagez-vous de faire ensuite une thse de doctorat ? / Do you plan
eventually to undertake a doctoral thesis after you Masters degree? Oui / Yes

Non / No

Si oui, dans quel domaine ? / If yes, in which field? Space physics or computational physics...........................................
Sinon, quels sont vos projets professionnels ?/ If not, what are your future career plans? .................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
Candidats pour niveau Master
/ Master candidates

Candidats pour stage de recherche ou thse

/ Research training or PhD candidates

Indiquez ci-aprs les cours choisis et les sujets de recherche qui

Sjour de recherche - dcrivez votre projet /
vous intressent / Academic Courses Selected and Research
Research Training - Please describe below your project
topics of interest - maximum 2 pages
3 6 pages maximum
Rajouter des pages sur papier libre si ncessaire / Add necessary pages

Programme de bourses internationales International Scholarship Programme

COLENORMALESUPRIEUREDECACHAN
Relations internationales

COMPETENCES LINGUISTIQUES / LANGUAGE EVALUATION

NB : Une bonne matrise de la langue (franais ou anglais) utilise dans le programme choisi est imprative. / A
good knowledge of the language (French or English) used in the chosen programme is compulsory.
Votre apprciation personnelle sur votre niveau de franais et anglais / Your level of competence in French and English:
Franais

English

Franais

English

Franais

English

Parl / Spoken ability:

Dbutant

Beginner

Bon

Good

Trs bon

Very good

Ecrit / Written ability:

Dbutant

Beginner

Bon

Good

Trs bon

Very good

Seriez-vous capable de suivre des cours en franais, de participer aux discussions, de prendre des notes et de
comprendre des documents crits en franais ? Plus prcisment, que faites-vous en ce moment pour arriver au niveau
requis ? Would you be able to follow university lectures in French, participate in seminar discussion, take notes and
understand written material in your field? Specifically, what are you doing now and what are your plans to bring your
language abilities up to this level?
................................................................................................................................................................................................
................................................................................................................................................................................................
................................................................................................................................................................................................
Souhaitez-vous suivre des cours de franais lENS Cachan ? / Do you plan on taking French language courses at
ENS Cachan?
OUI

YES

NON

NO

Source de linformation sur le Programme de bourses internationales de lENS Cachan / Source of information
about ENS Cachans International scholarship programme
Comment avez-vous entendu parler du programme de bourses internationales de lENS Cachan ? / How did you get to
know the ENS Cachans international scholarship programme?
Brochure / Leaflet Prospectus

Salon / Recruitment exhibition / Fair

quipe enseignante ENS Cachan / ENS

CampusFrance

Cachan Academic staff

Autre quipe enseignante / Other Academic
staff

Journal / Magazine, lequel ?

Newspaper/Magazine advertisement. Which one?
Autre - Prcisez / Other - Please specify:

Employeur / Employer

web serch...............................................................

Etudiant ENS Cachan / ENS Cachan student

Programme de bourses internationales International Scholarship Programme

COLENORMALESUPRIEUREDECACHAN
Relations internationales

Le dossier de candidature doit comporter les pices suivantes :

The application file is composed of the following documents:

ce formulaire de candidature en 2 exemplaires avec photo didentit / this application form with passeport size
photograph in 2 copies,
un CV complet jusqu ce jour / your complete and up to date curriculum vitae,

une lettre de motivation expliquant en dtail lobjectif du sjour lENS Cachan et les raisons pour lesquelles
vous avez choisi lENS Cachan. Dtaillez vos objectifs professionnels. Prsentez tous les lments, dordre
acadmique ou autres, qui vous semblent appuyer votre candidature. Indiquez la liste des publications ventuelles /
a cover letter detailing the purpose of your studies or research at ENS Cachan and your reasons for applying
here. Detail your career objectives. Present any relevant academic or non-academic achievements as well as any
publications,

la liste des cours suivis et les notes sur les deux dernires annes de scolarit / courses attended and
transcripts for the past two years of higher education,

copie et traduction certifie officiellement de vos diplmes NB : les candidats retenus pour la bourse
internationale doivent prsenter les originaux leur arrive / copies and officially certified translation of your
diplomas NB: selected students will be asked to bring the original diplomas on arrival,

attestation dinscription pour lanne universitaire 2011-2012 (si scolarit en cours) / registration certificate
for 2011-2012 (if presently enrolled in a higher education institution),

deux lettres de recommandation denseignants ou chercheurs, dont au moins un appartenant votre universit
dorigine, avec leurs coordonnes exactes et compltes / two letters of reference from academic or research staff,
of which at least one belongs to your home university, with their exact and complete contact details,

copie du passeport / a photocopy of your passport.

attestation soit de niveau du franais, pour les candidats aux programmes dlivrs en franais, soit de niveau
danglais, pour les autres candidats ; language certificate for French or English language, according to the
language of the academic or research programme you apply for.
Les candidatures incompltes ne seront pas prises en compte.
Incomplete applications will not be considered.
Dclaration des candidat(e)s / Applicants declaration
Je dclare sur lhonneur que :

I certify that:

o Jai suivi des tudes suprieures hors de France,

o je serais titulaire du diplme requis par le
programme de bourses de lENS Cachan avant
mon ventuelle inscription lENS Cachan,
o les informations contenues dans mon dossier de
candidature sont correctes et compltes.
LENS Cachan se rserve le droit de refuser ou de
mettre un terme linscription dun tudiant si les
informations dclares savraient fausses ou
sil/elle avait omis de dclarer des informations
importantes.
Si votre candidature est retenue, il vous sera
demand de prsenter les preuves de vos
qualifications.

o I have undertaken my higher education outside

France,

o I shall obtain the required qualifications before

starting research or studies at ENS Cachan, in

case I am admitted,
o the information contained in this application is
accurate and complete.
Please note that ENS Cachan reserves the right to
refuse admission or to terminate a students
attendance should it be discovered that he/she has
made a false statement or has omitted significant
information.
If your application is selected, you will be
required to provide evidence proof of your
qualifications.
Lieu, date et signature de ltudiant / Place, date and applicants signature:
Programme de bourses internationales International Scholarship Programme

COLENORMALESUPRIEUREDECACHAN
Relations internationales

................................................................................................................................................................................................

Les dossiers de candidature seront transmis / Application files are to be sent :

1) par e-mail dans un fichier unique : / by e-mail in a single file to : boursi12@ens-cachan.fr
ET / AND
2) Version papier envoyer : / Paper application to be sent to :
Ecole normale suprieure de Cachan
Relations internationales
61, Avenue du Prsident Wilson
94235 Cachan Cedex France
***

Date limite de rception des dossiers lectroniques et papier lENS Cachan :

15 mars 2012
Deadline for reception of e-mail and paper applications at the ENS Cachan :
15 March, 2012

Programme de bourses internationales International Scholarship Programme