Office of International Relations Pukyong National University 599- Daeyeon-dong, Nam-gu, Pusan 608-737, Korea Phone: (+82 5) 629 6903~9 Fax: (+82 5) 629 690 e-mail: oir@pknu.ac.kr Photo International Student Exchange Application Form Please fill out the followings completely and submit your application through your home institution.. Personal Details Title Mr Mrs Miss Ms Other Gender Female Male Name Last Name(Family Name) First(Surname) Middle(If you have one) Date of Birth / / in, Month Day Year City Country Country of Citizenship Mailing Address: No. and Street Suburb/City State/Country Zipcode Phone Fax Mobile Email 2. Application Details Please indicate your length of stay. Semester Semester 2 Both Name of Home University Major Minor Name of University Representative/Agent: Mailing Address: No. and Street Suburb/City State/Country Zipcode Phone Fax Email
3. Korean Language Proficiency Please indicate your proficiency in Korean language. Excellent Good Fair Poor None If you have undertaken Korean studies in a non-korean speaking country you must provide a letter attesting that instruction was undertaken in Korean. This must be on official institution letterhead. Have you taken a Korean test in the past? Yes No Korean Test Name 4. SIGNATURE I declare that to the best of my knowledge the information given in this application is correct and complete in every particular. I recognize that it is my responsibility to provide all necessary documentary evidence of my qualifications and studies and hereby authorize PKNU reserves the right to withdraw my offer or enrollment at any stage during my course where false or misleading information has been provided. Applicant's signature Date / / 2
PUKYONG NATIONAL UNIVERSITY 599- DAEYEON-3DONG NAM-GU, BUSAN 608-737, KOREA FINANCIAL CERTIFICATION FOR ADMISSION ⅠⅨⅧⅦⅥⅤⅣⅢ. Name in Full Vernacular: English: ⅠⅨⅧⅦⅥⅤⅣⅢ. Gender: Male ( ) Female ( ) ⅠⅨⅧⅦⅥⅤⅣⅢ. Marital Status: Single ( ) Married ( ) ⅠⅨⅧⅦⅥⅤⅣⅢ. Nationality: ⅠⅨⅧⅦⅥⅤⅣⅢ. Date of Birth: ⅠⅨⅧⅦⅥⅤⅣⅢ.Place of Birth: ⅠⅨⅧⅦⅥⅤⅣⅢ. Permanent Address: ⅠⅨⅧⅦⅥⅤⅣⅢ. Mailing Address: ⅠⅨⅧⅦⅥⅤⅣⅢ. Present Occupation: You and your sponsor must provide for your educational and living expenses for the duration of your entire educational program at Pukyong National University. If you are not paying for your own educational and living expenses, please indicate the person or organization who is paying for you: ⅠⅨⅧⅦⅥⅤⅣⅢ. Name ⅠⅨⅧⅦⅥⅤⅣⅢ. Relation to Applicant : ⅠⅨⅧⅦⅥⅤⅣⅢ. Occupation ⅠⅨⅧⅦⅥⅤⅣⅢ. Address : ⅠⅨⅧⅦⅥⅤⅣⅢ. Telephone : ⅠⅨⅧⅦⅥⅤⅣⅢ. Fax: ⅠⅨⅧⅦⅥⅤⅣⅢ. E-mail : I guarantee that the amount of US$ 8,000 entire duration of this program. will be available for the above named applicant for the Signature Date
PUKYONG NATIONAL UNIVERSITY 599- DAEYEON-3DONG NAM-GU, BUSAN 608-737, KOREA FINANCIAL CERTIFICATION FOR ADMISSION Ⅰ. Name in Full Vernacular: English: Ⅱ. Gender: Male ( ) Female ( ) Ⅲ. Marital Status: Single ( ) Married ( ) Ⅳ. Nationality: Ⅴ. Date of Birth: Ⅵ.Place of Birth: Ⅶ. Permanent Address: Ⅷ. Mailing Address: Ⅸ. Present Occupation: You and your sponsor must provide for your educational and living expenses for the duration of your entire educational program at Pukyong National University. If you are not paying for your own educational and living expenses, please indicate the person or organization who is paying for you: Ⅰ. Name Ⅱ. Relation to Applicant : Ⅲ. Occupation Ⅳ. Address : Ⅴ. Telephone : Ⅵ. Fax: Ⅶ. E-mail : I guarantee that the amount of US$ 4,000 will be available for the above named applicant for the entire duration of this program. Signature Date
PUKYONG NATIONAL UNIVERSITY 599- DAEYEON-DONG, NAM-GU, BUSAN 608-737, KOREA A WRITTEN PLEDGE Date :. Name in Full : 2. Date of Birth : 3. Permanent Address : 4. Address (Home) : 5. Address (in Korea) : 6. Course : The above mentioned person, shall keep the laws of Republic of Korea and school regulations admitted to the Division/Department of, and I will not take any illegal job with a student visa during my staying in Korea. And I am sure that all documents submitted by me are true. When I violate them, I shall have no complaint to be put in any disadvantages on my personal affairs. (Signature)
ESSAY (Approximately 500 English words in total.) Full name : Major field of study at your home university :. Please summarize your motivation for applying for International Student Exchange Program at Pukyong National University. 2. Please describe your plan of study if you are accepted by Pukyong National University to join the program. 3. Please describe your plan after returning to your home university upon the completion on International Exchange Student Program at Pukyong National University.