APPLICATION FORM
PhD SCHOLARHIP FOR ASEAN CITIZENS THAKSIN UNIVERSITY
HOW TO COMPLETE THIS FORM:
With all required documents
Signed where required
Add pages if needed
(Incomplete applications will not be processed)
1. PERSONAL DETAILS
Title:…………Name as in passport /id: ………
Date of birth (day/month/year):………..Gender:………
Citizenship (list all):……….
Country of birth:………Marital status:.………...
Languages (Main/Other):………..………
Address for correspondence:……….………
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Telephone:………Email:………Fax:………
Permanent address in home country:……….
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Telephone:………Email:………Fax:……….
Affix photo here
2. ACADEMIC DEGREES & WORK EXPERIENCES List all academic degrees, beginning with most recent.
Graduate degree
Qualification:………..………
Institution:………...
Country:………..
Full-time years of study:..…….……… CGPA : ………...
Bachelor degree
Qualification:………..………
Institution:………..
Country:………..
Full-time years of study:..…….……… CGPA : ………...
Other academic degrees
Qualification:………..………
Institution:………...
Country:………..
Full-time years of study:..…….……… CGPA : ………...
Scholarship awarded for any of the above programs/studies:
List all scholarships obtained, beginning with most recent.
Name of scholarship(s):..………
Program/Study:……..……….
Institution:………...
Membership of professional societies:
List all memberships in professional societies.
Memberships of professional societies:………...
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Work Experiences
List all work experiences, beginning with your current position.
Current position (Position, Organization, Address):………..
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Years of professional work experience in this position:……….
Other positions, in chronological order (Position, Organization, Address).:………..
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Years of professional work experience in these positions:………..
Publications
List all academic publications, in chronological order beginning with the most recent, for each of the following categories; please provide full references.
Books:
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Refereed publications:
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Publications with review committee:
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Other publications:
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3. PLAN OF STUDY AND RESEARCH PROPOSAL
Your area or field of expertise:………
The area or field of expertise of your research proposal:……….
Preliminary title of your research proposal:………...
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Objectives of your research work:
Write below, not in a separate sheet, one paragraph (maximum of 200 words) on the objectives of your research work in relationship with the needs of the country/region. Please note that, if the scholarship is awarded, the final research program will be developed with your thesis advisor(s).
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Preliminary research proposal:
In a separate document, please provide a preliminary research proposal for a PhD program, not more than four (4) pages. Please note that, if the scholarship is awarded, the final research program will be developed with your thesis advisor(s).
Letter of motivation:
In a separate document (maximum of one page), please provide a letter stating your motivation for doing a PhD and the reasons of your application to this scholarship.
Preferred date of commencement of the PhD:……….
4. REFERENCES
List name and contact details of two referees who have accepted to provide references for your candidacy. Please assure that the referees send their letter of references, at the latest on May 19, 2017, directly to the following email address: phd@thaksinuni.org
Referee 1:
Position/Title:………
Name:..………..
Relationship with applicant:………..
Institution / Address:………..
………..Country:………...……….
Telephone:………Email:………...
Referee 2:
Position/Title:………
Name:..………..
Relationship with applicant:………..
Institution / Address:………..
………Country:……….
Telephone:………Email:………...
5. ENGLISH PROFICIENCY
List all English proficiency test results, starting with the most recent.
IELTS/TOEFL scores:…...
Date of test:………..
Score of other English proficiency tests:…...
Date of test:………..
6. FINANCIAL GUARANTEE
Please check all that applies, and provide the relevant information.
sufficient funds for living
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The scholarship covers the following:………...
I’m applying for a scholarship from:……….
The scholarship will covers the following:………....
7. SIGNED DECLARATION I declare that:
All information herein is true and complete (failure to disclose relevant information may result in exclusion).
Thaksin University International College may make enquiries about me from any source.
If I am awarded any assistance from Thaksin University on the basis of misleading information, I will repay all fees, allowances, remissions and others.
I must be easily accessible for an application interview.
Thaksin University may inform other tertiary institutions, if any, of the material presented to support my application is found to be false.
All documents submitted become the property of Thaksin University International Graduate Program.
Name of applicant (please print):………
Signature:……….
Date: Day / Month / Year:………
8. ATTACHMENTS
o List of publications.
o A copy of your curriculum vitae summarizing your academic and professional experiences, certified by you as accurate.
o One copy of all information pages of all passport(s), certified as true by a representative of your university or relevant embassy with the name, position and address of the representative clearly signed on the photograph page.
o One English copy of all professional qualifications, certified as true by a designated officer of the granting institution – translations must be signed by the same officer.
o One copy of all academic transcripts that include enrolment dates, subjects, grades and the title of the award conferred, certified as true by a designated officer of the granting institution – translations must be signed by the same officer.
o Certified copies of IELTS or TOEFL results.
o Preliminary research proposal that outlines the anticipated work in a PhD program, not more than four (4 ) pages.
o Letter stating your motivation for doing a PhD and the reasons of your application to this scholarship, not more than one (1 ) page.
Note:
This Application form is the first information document to assess your eligibility as a candidate for the program. If you are found eligible and qualify for the next phase of the selection process, you could be asked to send another set of documents.
You will be contacted only if you qualify for the next phase. No other letter/information will be given to you if you do not qualify for the next phase.
If you feel that any requirement in the form is not relevant to your application, please duly record this in the appropriate section and indicate the reasons.
