APPLICATION For an admission at Communication

photograph
Reserved to the administration
Dossier num.:
Date de réception :
Avis du jury :
Admis
Refusé
APPLICATION
For an admission at Communication Systems Engineering
international Master (2010-2011)
This application form is NOT for students from Grenoble INP and Politecnico
di Torino.
The Communication Systems Engineering (CSE) Master is a joint
training between Grenoble INP (Phelma and Ensimag engineering
schools) and Politecnico di Torino.
Depending on the applicant background, Master CSE student will
receive the diploma of Phelma or Ensimag or Politecnico di Torino.
An admission committee will decide in which engineering school
the student will be registered.
At the end of this international training, Master CSE student will
receive the certificate of joint international training in
Communication Systems Engineering in addition to his diploma.
1. Personal details
Surname
First name
Date and place of birth
Nationality
Permanent address
(such as parent address)
Tel
Email
2. Education
Last degree (obtained or in preparation)
Specialization
Institution
(name & country)
Dates of attendance
Date of award
Nb. years of study in a
College or a University
Knowledge of the
English language
basic
good
fluent
Knowledge of the
Italian language
basic
good
fluent
Knowledge of the
French language
basic
good
fluent
English language test taken
Score/grade
College and University
Secondary /High
school education
Dates (from – to)
Academic year
Status
(student, employee, ...)
part-time / full-time
Institution
(educational institution,
company, ...)
Location (country)
Title of post (duties &
responsabilitties)
Type of study
(bachelor, master, ...)
Rank / Total nb. of
students
Information on completed and ongoing studies /and professional experience
Degree obtained (*)
(write fail in case of
failure)
Award date
or Function
yes
no
(*) Please specify majors, minors.
For degrees composed of several modules, please provide results by module and give the module complete titles.
If you do not have sponsorship or scholarship support, will you still be able to support your proposed studies?
Do you want to apply for a Master CSE grant (grant amount 5400 euros) ?
Date decision expected
Value of award
Details of sponsorship
Name of awarding body
3. Financial support
Company
yes
no
Note for completing the application form
Students who apply must have:
1. a major in computer science, mathematics, electronics or signal processing.
2. a good level in English, all the courses are given in English (at least level B1 at the TOEIC
(650) or 65 TOEFL iBT or equivalent is required)
Compulsory documents
The following documents must be attached or the application will not be considered.
1. A copy of the identity card
2. A photograph
3. Certified transcripts of records for all university studies
4. A description of all your university studies: subjects, hours and contents (2 pages)
5. Copies of all the diplomas and degrees awarded (secondary school examination included)
6. Support letter explaining the reasons for your application
7. 2 assessment letters filled by 2 professors who have known you well in the recent years (one
of them must be filled by the Academic Head of your last degree program)
8. Evidency of competency in English language (TOEIC (650) or 65 TOEFL iBT or equivalent)
9. An envelope with your current address
N.B.
1) The assessment letters must be sent by the signatory directly to the school or by the student
in a sealed envelope.
2) Please have a look at the monthly budget in Grenoble on our website.
3) The application must be sent before the 15th of April.
Join all the most up to date information to the application and send to the school your final
results as soon as possible.
If the final results can’t be sent by this date, a conditional admittance can be pronounced
which will depend on your definitive results.
•
Classify, in order of preference, the universities and the programmes (including Grenoble
INP-Ensimag) to which you are applying.
1. __________________________________________________________________________
2. __________________________________________________________________________
3. __________________________________________________________________________
4. __________________________________________________________________________
5. __________________________________________________________________________
The application form must be sent before April,15 2010 to:
Grenoble INP Ensimag – Elena Leibowitch
681, rue de la Passerelle • Domaine Universitaire • B.P. 72 • 38402 ST MARTIN D’HERES CEDEX
FRANCE
The jury will deliberate on May 30, 2010.
.
ASSESSMENT FORM
Admission based
on records
(applicants should provide this form
to the Professor doing the assessment)
APPLICATION TO MASTER CSE
Surname, first name of the applicant
University or Institution of origin
Surname, first name and status of the assessing person
How did you know the applicant, and for how long?
ASSESSMENT OF THE APPLICANT
(1)
Please rate your assessment
on the global value of the applicant
4
3
2
1
X
on the quality of his recent achievements
4
3
2
1
X
on his capabilities to carry on engineering work
4
3
2
1
X
on his capabilities in computer science
4
3
2
1
X
on his capabilities in applied mathematics
4
3
2
1
X
(1)
In the group of student of the same course of study, would you rank the applicant in the :
5%
10%
25%
above average
below average
Please provide any other comments on the applicant:
Date:
Location:
Signature and institutional stamp
(1)
Circle your choice. Rating: 4: excellent, 3: very good, 2: good, 1: poor, X: cannot be assessed