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Form PROPE-S2
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This program is considered as one of TOTAL E&P Indonesies commitment to develop human resources
in their core business by giving a financial support to outstanding Indonesian students and also further
developing the institutes of higher learning by encouraging international cooperation.
English proficiency of 500 TOEFL or follow the TOEFL test arranged by ITB and obtain the
passing mark of 500.
Pass the Academic Potency Test conducted by OTO BAPPENAS at ITB with a minimum score of
500.
Total E&P Indonesie will conduct the selection process together with ITB. The grantees will be entitled to
have their tuition fees paid. The fee for the Professional Master PE has been fixed at Rp 39.000.000,
payable Rp 13.000.000,/semester.
A certain number of the successful Scholarship holders will be offered pre-employment agreements with
TOTAL E&P INDONESIE where in addition to the Tuition Fees, a competitive living allowance will be
offered to cover lodging, books and other expenses during the period of the course.
An obligation to work with TOTAL E&P INDONESIE will be required for a period of 2n+1 in which n is the
number of years of the pre-employment agreement between the Scholarship holder and TOTAL E&P
INDONESIE.
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Full Name
Present Address
Permanent Address
Telephone
081330367621
Email Address
Account Number
Bank Address
Photo
3x4 cm
Iif_udin@yahoo.co.id
Gresik, 21 November 1990
FAMILY DATA
Name
Age
Education
Occupation
Father
Mother
Siblin
g:
1
2
3
4
5
EDUCATION BACKGROUND
School
From - To
Elementar
y
Jr. High
Sr. High
University
UNIVERSITY CONTACT NUMBER
University
Faculty/ Major
University Address
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Major Course
Graduated/ Degree
Received
GPA
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Telephone & Fax. Number
(with area code)
ORGANIZATIONAL ACTIVITIES
Name of Organization/ Activities
From - To
Position
Organized By
Location
The facts stated in this Scholarship Form are true and complete to the best of my knowledge and belief.
I understand and agree to follow all the procedures, regulations, and requirements that related to Total E&P Indonesies Scholarship
Program.
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Date:
Applicants Signature:
N.B: Please supply all of this documents, along with this form:
; Copy of academic transcripts, from 1st semester until the last semester.
;
;
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Date : _____________________________
Name : _____________________________
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3. What is your plan after graduated from ITB Professional Masters in Petroleum Engineering?
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