GRADUATE SERVICES DIVISION

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GRADUATE STUDY APPLICATION FORM

PROCESS:
Please forward the original and one copy of this application form to SIU International, along with all supporting
documentation as indicated in the admissions guidance. Applications with missing information will not be processed.
PROGRAM OF STUDY:
I am applying for the Degree :

Master of Business Administration in Management (MBA) Master of Science in Information Technology (MSIT)
Master of Science in Management Technology (MSMT)
Master of Education in Teaching English as an International Language MEd (TEIL)
Doctor of Philosophy in Management Science (PhD Management Science)
Doctor of Philosophy in Information Technology (PhD Information Technology)
Doctor of Philosophy in Management Technology (PhD Management Technology)
PERSONAL INFORMATION :
Title:

Mr.

Ms.

Mrs.

Others.

First name: _________________________Middle name: ____________________ Last name: ___________________

Date of birth: ____________________ ___Country of birth: __________________ Nationality:
Citizen ID number: _______________________________ Native language:

____________________________

CONTACT ADDRESS:
Company: _________________________________________________ Position: ______________________________
Business Address: ________________________________________________________________________________
Country:

Province/State:

Postal Code:

_____ Ext: ____________ Business fax number:

Business telephone number:

Home Address: __________________________________________________________________________________

Country:

Province/State:
Home telephone number:

Postal Code:

_____________________ Home fax number:

Mobile number: ___________________________ Preferred email address: ___________________________________

The Channel of Knowing Shinawatra University
ACADEMIC BACKGROUND:
Starting with the most recent, please list all academic institutions attended and degree awarded. Please include original
or certified copies of your transcript with this application.
Institution

Country

Dates of Attendance

Degree

Major

Lanuguage

Awarded

or Specialization

of Instruction

GPA.

ENGLISH PROFICIENCY TEST SCORE:

__date taken:

________

TOEFL of

Others [Specify] _______________date taken __________

IELTS of

___date taken: ______________

Have not taken any test.

FAMILY INFORMATION
Name

Age

Occupation

Place of Work

Relationship

1
2
3

EMPLOYMENT HISTORY:
Beginning with your current or most recent position, please list your employment history below or attach a resume or
curriculum vitae in the same format.
1. Employer: _______________________________________________ Position: _______________________________
Employed from: _____ / _____ / _____ to: _____ / ______ / _______ Location: _______________________________
Responsibilities: _________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Reason for leaving: _______________________________________________________________________________
2. Employer: _______________________________________________ Position: _______________________________
Employed from: _____ / _____ / _____ to: _____ / ______ / _______ Location: _______________________________
Responsibilities: _________________________________________________________________________________
_______________________________________________________________________________________________
_______________________________________________________________________________________________
Reason for leaving: _______________________________________________________________________________
INTERNATIONAL EXPERIENCE:
Please list the most significant experience you have had in terms of living, working, studying or traveling outside your
own culture or country.
Activity

Duration (From/To)

Country/Region

REFEREES:
Please list the names and contact information of three individuals who can comment on your personal and professional
characteristics. Also indicate in what capacity you have known them.
Name

Address, Telephone Number, E-Mail

Relationship to applicant

CERTIFICATION OF TRUE STATEMENT:

I certify that I have read all the instructions and that the information I have provided on this application form and on any
additional materials that I submit related to the admission process is true and complete. I understand the
misrepresentation may be cause for canceling my admission. I understand that all credentials and documents I submit
become the property of the Shinawatra University.
Applicants Signature:

Date:

Please send application materials to:

Graduate Services, Shinawatra University
Graduate Building, 197 BBD Building Viphavadi-Rangsit Road,
Samsennai, Phayathai, Bangkok 10400 THAILAND
Phone : +66 (0) 2650 6011, +66 (0) 2650 6012, +66 (0) 2650 6022
Fax : +66 (0) 2650 6033, +66 (0) 2650 6017
E-mail : grad@siu.ac.th, http://www.siu.ac.th