Application for Students_CIEP________

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Application for Admission

Faculty of Engineering
application for admission
King Mongkut’s University of Technology North Bangkok
Student information Apply without
Scholarship
Apply for Tuition-fee
waived Scholarship
Semester Year
Program of Interest 1.
2.
3.
Last name (family name)

First name (given name) Middle name


Please attach a
recent
passport size

4.5cm
Date of birth (day / month / year) Male Female

4.5cm
photograph of
yourself
Place of birth (city & country)
3.5c
Citizenship (on passport) Religion (optional)

Passport number (non-Thais) or Thai national ID number (Thai citizens) Current country of residence

Contact and residence information


number and street Town or city
Address
in home State or province Postal code Country
country
Mobile Telephone number (please include country code) Email address

Number and street Town or city


Mailing
address State or province Postal code Country
(if different
from home
country Mobile Telephone number
address)

English proficiency test score (for non-native speakers)


TOEFL score Date tested Other English language test (name of test)
Most recent
English
proficiency IELTS score Date tested Score Date tested
test score
Please rate your Reading comprehension Writing Listening Comprehension Speaking
English ability Excellent Excellent Excellent Excellent
in the following Good Good Good Good
areas:
Fair Fair Fair Fair

Standardized test score as required by the program


SAT score Date tested A Level score Date tested

IB score Date tested Other Standardized tests (name of test)

GSAT score Date tested Score Date tested


Academic data
Educational background (beginning with most recently attended institution to high school or vocational school level)
Institution Country Degree earned Program and level of study Dates of attendance GPA
(eg, Inter program – Grade 12) (from month/year to month/year)

Financial data
Father Profession/Position
jgh
Mother Profession/Position
Guardian
f Profession/Position
( if different )
Address

Estimated household income per year

Applicant Certification
I hereby certify that the information I have given is true and correct to the best of my knowledge.
I understand that the concealment of information may result in rejection of my enrollment or disciplinary action if discovered after enrollment.

Signature of Applicant Date / Month / Year

Application checklist (the following items are required for admission procedure)
Submit soft copy of completed form and required documents to
Completed application form (this sheet) ciep@eng.kmutnb.ac.th and mail the hard copy to:
Certified academic transcripts Center for International Engineering Programs
Copy of any diplomas received Faculty of Engineering
(from high school, vocational school, or university level) King Mongkut’s University of Technology North Bangkok
1518 Pracharat 1 Rd., Wongsawang, Bangsue
Copy of standardized test score report (if available)
Bangkok, 10800, Thailand
Copy of official English proficiency test score report
Copy of passport data pages (for non-Thais)
For more information please contact:
A motivation letter (if available)
Center for International Engineering Programs
A letter of recommendation from sending institution stated purpose ciep@eng.kmutnb.ac.th
and duration of study at KMUTNB (for exchange student)
Tel: +66 2 555 2000 ext. 8146
One passport-size photograph
Fax: +66 2 585 6149

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