< Form 1 >

Application Form

General Information

Personal Data (Please type or print neatly)

PHILBERT Photo (3.5cm X 4.5cm)
Full Name
(as in your passport)

(Last/Family)
BAHATI

(First/Given)
(Middle)

Gender
 Male  Female

__08________ /___24_______ /____1985_____

Date of Birth RWANDA
Month Day Year Country of Birth

RWANDAN PC306881
Citizenship Passport Number

Email bahatiphi@gmail.com

Home Phone ( +250788663560 ) Cell Phone

Number Number +250783240165
Country / Area Code

Permanent Home Address NG 34 NYARUGENGE

(Number and Street) (City or Town)

KIGALI CITY RWANDA

(Province or State) (Country) (Zip/Postal Code)

Emergency Contact INGELI CONTANTINE CHRISTIAN PUBLIC SERVANT

in Korea (if any) (Name) (Relation) (Occupation)

KIGALI/GITEGA +250788665084
(Address) (Phone No.)
Family Information

Father BARIHUNGE Emmanuel Mother KABUKEHA Alphonsine

Last/Family) (First/Given) (Last/Family) (First/Given) (Middle)
Middle)
Date of_01/__01___ /__1958____ /_____ ____01__ /__01____ /__1961___
Birth Date of Birth
Month Day Year Month Day Year
Living?  Yes  No (Date deceased Living?  Yes  No (Date deceased )
April 1994 )
Citizenship RWANDAN/ EATERN
PROVINCE . rCitizenship RWANDAN/ EATERN PROVINCE .

Home address if different from yours Home address if different from yours
RWANDA EASTEN PROVINCE RWANDA EASTEN PROVINCE
NGOMA DITRICT NGOMA DITRICT

Cell Phone NONE Cell Phone +250727347265

Email NONE Email NONE

By signing here, I certify that the information that I have provided on this form is true and accurate to the best of my knowledge and I fully understand that knowingly and
willfully falsifying or concealing a material fact or using any false document in the submission of this form may result in the withdrawal of my admission and entrance to
Yonsei University and may even lead to severe penalties.

Applicant’s Name (Print or Type) __Philbert BAHATI________________________________________________________________

Applicant’s Signature ___________________________________________ Date ___01 March 2018_________________________

Educational History

1. Undergraduate School Name: _UNIVERSITY _OF__RWANDA (College of Education)_________

2. Province/Country of Undergraduate School indicated above: _KIGALI CITY/ RWANDA________
3. (Expected) Graduation Date of Undergraduate School (mm/dd/yy): __09__/_24___/__2012___

Academics
Average Grade (as written on the transcript):

Class Rank / Class Size LOWER SECOND CLASS HONORS /

GPA / Scale 64,74 / 100 Weighted?  Yes  No

Test Information
If you are submitting any official exam results, please fill in the exam scores below.

□ I have taken the TOEFL: □ I will take the TOEFL: Date / .

(Recommended for applicants whose native language is not English.) (yyyy /mm)
Composite Score Date / .
(yyyy / mm)

□ I have taken the SAT 1 Test: □ I will take the SAT 1 Test: Date
/ .
(yyyy / mm)
Critical Reading Writing Math .

□ I have taken the AP/IB/SAT Subject Test: □ I will take the AP/IB/SAT Subject Test:
Date / .

(yyyy / mm)

Type & Subject Score

Date / .

(yyyy / mm)

Type & Subject Score

Date / .

(yyyy / mm)

Type & Subject Score

Date / .

(yyyy / mm)

Type & Subject Score

Date / .
(yyyy / mm)
□ I have taken the ACT: □ I will take the ACT: Date
/ .

(yyyy / mm)

Eng Math Read Sci Composite

Eng/Wr Date / .
((yyyy / mm)

□ I have taken other standardized exams. Name of

exam .

Subject Score
// Subject
Score .

Subject Score
// Subject
Score .

□ I have taken other standardized exams. Name of

exam .

Subject Score
// Subject
Score .

Subject Score
// Subject
Score .