[Form #3] 6. Work/Research Experience

Please list your main work experience and paid jobs related to your study and research. '

present

----- ' - --- ------- -------- . - ... -- ---------- ----- - ---r-------

- ----'--- ---- - - - --------------- .. . .. ... .. -- ------------ .... ------- . ---L ____ ..... .. ----------- .. -- . I

I I

- !---- --------- ---------.. -----

* Write in chronological order

7. Family Background

PUSAT KOMUNIKASI - KEMLU

[Form #3] 8. Academic Reference

This application requires two Letters of Recommendation from your universities you have attended or are attending. Please provide the following information of the two teachers who will write recommendation letters for you.

Name

Affiliation

Position

Postal Address

E-mail Telephone Address number

Name

Affiliation

Position

Postal Address

E-mail I Telephone Address I number

9. Interested Areas of Study

. .

[Form #3] 10. Study Background

Knowledge of o your knowledge, education and work experience, etc in relation to major field

Major Field

Reason for Studying in Korea

Key Achievements o important books, thesis, report, patent, R&D achievement, prize-winning & scholarship record, etc

PUSAT KOMUNIKASI - KEMLU

[Form #3] 11. Study Plan

Goal of study & o goal of study, title or subject of the research and detailed study plan

Study Plan

Action Plan o Describe how to contribute to the development of the country or the

after Study region you belong to through collaboration with Korean entities.

(Specified proposal showing your commitment is preferred)

PUSAT KOMUNIKASI - KEMLU

[Form #3] 12 Self Introduction

I certify that the information provided in my application is accurate, complete, and honestly presented. I understand that any omission, intentionally Inaccurate information or misrepresentation herein may resuit in cancellation of my admission to KAIST.

Applicant's Signature Date (yyyylmmldd)

I PUSAT KOMUNIKASI - KEMLU