(ASEAN University Network / Southeast Asia Engineering Education Development Network)

APPLICATION FORM for AUN/SEED-Net Scholarship

Master’s Degree Program 2011
Application form can be downloaded from http://www.seed-net.org/ and can be
photocopied as needed. Please print or type all entries. The original and all
required documents should be submitted by post, through Member Institutions Photo
where the applicant belong, at the below address: (Taken within
the past 6 months)
AUN/SEED-Net Project
(Master’s Degree Program) Tel: (66 2) 2186419, 2186420,
Faculty of Engineering Bld 2, Rm 109-110 2186421
Chulalongkorn University Fax: (66 2) 2186418
Bangkok 10330, THAILAND E-mail: grad@aun-seed.net

Program Guidelines
Applicants should carefully study the Implementation Guidelines of the Master’s Degree Program 2011. It is
advisable to provide detailed information and description for each item below, and attach supporting documents
when necessary.

1 Personal Information (I)

1.1 Family Name
Given Name(s)
1.2 Full Name (as appeared
in passport)
1.3 Nationality
1.4 Date of Birth Date Month Year
1.5 Age (at the time of application)
1.6 Gender (please mark √) Male Female
1.7 Current Status/Position
1.8 Department/Faculty
1.9 University/Organization

2 Personal Information (II)

2.1 Marital Status Single Married
2.2 Office Address

Tel / Fax / Mobile

E-mail Address
2.3 Home Address

Tel / Fax
When communication with applicants is needed, AUN/SEED-Net will contact mainly to your Sending Institution
and/or to your e-mail address. Please make sure you keep regular contact with your institution and/or access to
your given e-mail address. In case you do not have an e-mail address, please specify your preferred contact
address below.
2.4 E-mail Office Home

AUN/SEED-Net Master’s Degree Program 2011;

 Preferred Contact Other
Address (please mark √ (Please give full details)
at your preference)

3 Academic Qualifications
A certified official certificate and transcript (with grade points) issued by the university and a certified letter of
class rank signed by Dean or Registrar must be submitted with this application form. For graduating students, an
official transcript with academic record up to the time of application must be submitted as an alternative.
3.1 Bachelors’ Degree
3.2 Program/Faculty
3.3 University
3.4 Date of Completion (or expected to) Month Year
3.5 Grade Point Average of all semesters taken (Honors, if any)
3.6 Class Rank Placed at the rank of
(Please submit a Out of the total number of students of
certified letter) In the Department/Program of

4 Relevant Qualifications
Any honors, distinction, or certificate obtained in your academic career that is not indicated in the official
statement should be mentioned in a separate statement. Relevant document should be attached to support your
information stated below.
4.1 English Language TOEFL Date taken
GRE Date taken
Others (Please specify)
4.2 Other Awards, Honors,
Certificates
(Please give details)

5 Employment Record
Please summarize (in separate sheet) any employment experience, including name of employer, your position, job
responsibility and period of work

6 Proposed Graduate Program

6.1 Proposed Place of Applicants can apply to the maximum of two Host Institutions, but cannot apply
Study to any institution within their own country. If you wish to apply to two
universities, please ensure you attach the applications of both universities.
(1) First Priority University
Department
Field of Study
Preferred advisor (if any)
Semester Month Year
University
Department
(2) Second Priority
Field of Study
Preferred advisor (if any)
Semester Month Year
6.2 Propose Research Area AUN/SEED-Net Graduate Program covers 9 fundamental fields, from which you
or Topic can choose at the time of application to study at the Host Institution responsible
for the respective field. However, in terms of research, apart from research topics

AUN/SEED-Net Master’s Degree Program 2011; p.2/13

 under fundamental fields, student can also choose to do research across fields.

Please check (√) if you are interested in any of the following research areas listed
below;
Fundamental Fields

Interdisciplinary research areas:

Biotechnology
Disaster Mitigation
Global Environment
Natural Resources/Materials
New/Renewable Energy

(For further details regarding each interdisciplinary research area, please feel
free to visit http://www.seed-net.org/research_umbrella.php)

7 Medical Record
Please acquire a medical certificate from a licensed doctor and submit it with this application. The certificate must
cover your health condition showing that you have sufficient ability to complete a graduate study abroad.

8 Document Checklist : Compulsory

Please check (√) that your application is complete and that you have enclosed all documents listed below. These
documents are compulsory and please note that AUN/SEED-Net Project reserves its right NOT to consider any
application with incomplete documents.
A. Application of AUN/SEED-Net (for scholarship)
8.1 This application form, completed with photo & signature
8.2 Official Bachelor’s Degree certificate (original or certified copy)
8.3 Official Bachelor’s transcript with grade points (original or certified copy)
8.4 Certified letter of Class Rank of the Bachelor’s study from the Dean or Registrar Office of your
graduated institution (Form in Attachment 4)
8.5 Medical check-up certificate by a licensed doctor
8.6 At least one Letter of Recommendation from the Dean or Head of the Department to which you
belong or from which you graduated. (Form in Attachment 5)
8.7 Letter of Endorsement from the Rector or Dean of Member Institution to which you belong (with
current status or position in case you are a faculty staff.)
B. Application of Host Institution(s) (for university admission)
8.8 Two sets of completed application(s) of the Host Institution(s) with photo & signature, and all
documents required by the Host Institution(s) for which you want to apply (Please note that each host
may have different requirements.)

9 Document Checklist : Optional

Please check (√) if you have enclosed the documents listed below. These documents are not compulsory but may
help support your qualifications.
9. Notifying letter of admission from Host Institution(s) from which you want to apply (only in case you
1 have earlier applied to a Host Institution and already been admitted)
9. Certificate of English proficiency, e.g. TOEFL official score
2
9. Others (please specify):
3

AUN/SEED-Net Master’s Degree Program 2011; p.3/13

10 Declaration
I declare that all information supplied in this application as well as the attached documents are true and correct to
the best of my knowledge. I acknowledge that the provision of incorrect information or supporting documents
may result in termination of scholarship, and that I will have to be responsible for all expenses incurred from my
misinformation.
If awarded the scholarship, I agree:
(a) to abide by the rules and regulations of the Host Institution, AUN/SEED-Net Project, and JICA;
(b) to follow course regulations and instructions and abide by such conditions as may be stipulated by both the
host institution and the AUN/SEED-Net in respect of this course of study;
(c) to refrain from engaging in political activities, or any form of employment for profit;
(d) to submit any progress reports or evaluation questionnaire which may be prescribed;
(e) to return to my home country at the end of my course of study.
I also fully understand that, the scholarship, if awarded, may be subsequently withdrawn for failure of making
adequate progress, or for other sufficient cause including health condition as determined by AUN/SEED-Net.

Signature: Date:

11 Declaration for Graduating students or younger graduates only

I strongly wish to become a teaching staff or researcher at the Member Institution after my Master’s study under
the AUN/SEED-Net Project.

Signature: Date:

AUN/SEED-Net Master’s Degree Program 2011; p.4/13

 ATTACHMENT 1

List of Host Fields, Host Institutions

and
Japanese Supporting Universities

Host Field Host Institution Host Country

1 Chemical Engineering (ChE) De La Salle University (DLSU) The Philippines

2 Environmental Engineering University of the Philippines- The Philippines

(EnvE) Diliman (UP)
3 Manufacturing Engineering University of Malaya (UM) Malaysia
(ManuE)
4 Materials Engineering (MatE) Universiti Sains Malaysia (USM) Malaysia
5 Civil Engineering (CE) Chulalongkorn University (CU) Thailand

6 Electrical & Electronics Chulalongkorn University (CU) Thailand

Engineering (EEE)
7 Information & Communication King Mongkut’s Institute of Thailand
Technology (ICT) Technology, Ladkrabang (KMITL)
8 Mechanical & Aeronautical Institut Teknologi Bandung Indonesia
Engineering (ME/AE) (ITB(INA))
9 Geological Engineering (GeoE) Gadjah Mada University (UGM) Indonesia

Applicants who are interested in any of the interdisciplinary areas i.e., Biotechnology,
Disaster Mitigation, Global Environment, Natural Resources/Materials, and
New/Renewable Energy can apply to any of the above Host Institution, depending on
research focus.

For the applicants’ convenience, the web-sites of the Host Institutions can be accessed from
the AUN/SEED-Net’s web-site (www.seed-net.org), where application forms of most
universities can be downloaded.

The following is the list of 11 Japanese Supporting Universities.

1. Hokkaido University
2. Keio University
3. Kyoto University
4. Kyushu University
5. National Graduate Institute for Policy Science
6. Tokai University
7. Tokyo Institute of Technology
8. Toyohashi University of Technology
9. University of Tokyo
10. Shibaura Institute of Technology
11. Waseda University

AUN/SEED-Net Master’s Degree Program 2011; p.5/13

 ATTACHMENT 2

Application and Screening Procedure of AUN /SEED-Ne t M aster's D egree Program 2011

Host
Institution
(HI)
HI
(3) (4)
application
SEED-Net checks HI conducts adm is s ion
eligibility of applicants s creening and s ends HI
and forwards HI adm is s ion res ult to admission
result
applications to SEED-Net in priority
res pective HIs order

AUN/SEED-Net
(SEED-Net)
HI
application (2) (5)
SE ED-Net
Contact pers on at SI SEED-Net conducts
application checks application s cholars hip s creening
docum ents and of thos e adm itted by HI SE E D-Net
E ndorsement scholarship
from SI forwards them (in bulk) and announces the result
to SEED-Net with s cholars hip res ult to
endors em ent from SI res pective SIs
Sending
Institution
(SI)
HI
(1)
application (6)
Each applicant s ubm its
SI inform s the res ult to
SEE D-Net SEED-Net application
each s ucces s ful
application and 2 s ets of HI SE E D-Net
applicant and endors es
application(s ) to scholarship
the Reply Form result
Contact Pers on at SI

Applicant

AUN/SEED-Net Master’s Degree Program 2011; p.6/13

 ATTACHMENT 3

List of Contact Persons at Member Institutions

for AUN/SEED-Net Graduate Degree Study Program 2011

No. MI. As Contact Person Position Email Address

Dr. Thavarith Chunhieng Deputy-Director fc@itc.edu.kh
General thavarit@itc.edu.kh
1 ITC Sending
(cc. to Dr. Romny OM ) Director General (cc: romny@itc.edu.kh)
Prof. Dr. Boualinh Dean, Faculty of
boualins@fe-nuol.edu.la
Soysouvanh Engineering

Assoc. Prof. Dr.

kphoui@etllao.com
2 NUOL Sending Khamphoui Vice Dean, Faculty of
Southisombath Engineering

Ms. Pipong Coordinator

ppipongp@yahoo.com
Phimphachanh
uycontact.mm@gmail.com
Prof. Dr. Tin Tun Rector uylibrary@gmail.com
Tel: (95-01) 514908
Fax: (95-01) 510721

(c.c.: Dr. Aye Aye Thant) Associate Professor, uycontact.mm@gmail.com

3 UY Sending Physics Department

(cc. to Ms. Mi Mi Cho) JICA Myanmar Office (cc: MiMiCho.MY@jica.go.jp

,
jicamy12@yangon.net.mm
Tel: (95-1) 255473-6
Fax: (95-1) 255477
ytu.rector@gmail.com
Prof. Dr. Mya Mya Oo Rector Tel: (95-01) 651717, 650762,
660720
Fax: (95-01) 642564

(cc. to Mr. Khin Maung Department of Foreign (cc: ukmzaw@gmail.com )

4 YTU Sending
Zaw) Relations Tel: (95-1) 642557
Yangon Technological Fax: (95-1) 642564
University
(cc:jicamy12@yangon.net.mm
(cc. to Ms. Mi Mi Cho) JICA Myanmar Office Tel: (95-1) 255473-6
Fax: (95-1) 255477
Ms. Doan Thi Thu Trang International doantrang@mail.hut.edu.vn
Cooperation Tel: (84-4)868 3197
Department Fax: (84-4)869 6720
5 HUST Sending
(cc. (cc:
Mr. Hoang Xuan Lan) HXLAN@mail.hut.edu.vn)
External Relations nvphuc@hcmut.edu.vn
Mr.Nguyen Van Phuc
Office Tel: (84-8)38652442
6 HCMUT Sending
(cc. Prof. Dr. Phan Dinh
(cc: pdtuan@hcmut.edu.vn
Tuan –Vice Rector)
phantuan23bhht@gmail.com)
Dean, Faculty of anat@eng.buu.ac.th
Dr. Anat Deepatana
7 BUU Sending Engineering Tel: (66-81) 983 6300

AUN/SEED-Net Master’s Degree Program 2011; p.7/13

 Assoc. Prof. Dr. Dean, International kkananta@kmitl.ac.th
Anantawat Kunakorn College, KMITL
Sending (cc: Assistant to Dean ktchinar@kmitl.ac.th
8 KMITL & Assoc. Prof. Dr.Chinaruk
Hosting Thianpong)
(cc. International Relations (cc: ksarunee@kmitl.ac.th)
Ms.Arunee Suvarnatarn ) Office Tel: (66-2) 326 4729
Assoc. Prof. Dr. Boonsom Dean, Faculty of boonsom.L@chula.ac.th
Sending Lerdhirunwong Engineering
9 CU &
Hosting (cc: Ms.Kanasom) International School of ise@eng.chula.ac.th
Engineering Office
Ms. Elizabeth L. Salazar Graduate Office of elsalazar@up.edu.ph
Sending Engineering
10 UP &
Hosting (cc:Dr.Aura C. Matias) Dean, College of (cc: aura.matias@up.edu.ph )
Engineering
Dean, Collage of pag-asa-gaspillo@dlsu.edu.ph
Prof. Dr. Pag-asa D.
Engineering
Sending Gaspillo
11 DLSU &
Director of the (cc:
Hosting (cc. to Prof. Dr. Leonila
Engineering Graduate leonila.abella@dlsu.edu.ph)
C. Abella)
Studies
sasongko@fti.itb.ac.id;
Assoc. Prof. Dr. Dean, Faculty of
Sending sasongko@che.itb.ac.id
Dwiwahju Sasongko Industrial Technology

Dean, Faculty of
12 ITB Assoc. Prof. Dr. Andi aim@ms.itb.ac.id
Mechanical and
Isra Mahyuddin
Aerospace Engineering
Hosting
Faculty of Mechanical tdirgantara@ae.itb.ac.id
Dr. Ir. Tatacipta
& Aerospace
Dirgantara
Engineering
International
uphi_ft@yahoo.com
Sending Ms. Aci Prima Sari Cooperation Office,
Faculty of Engineering
Prof. Dr. Dwikorita Geological Engineering dwiko2007@yahoo.co.id
Karnawati Department
13 UGM
Dr. Sugeng Sapto sugengssurjono@gmail.com
Hosting
Surjono

(cc: Ms. Fransisca (cc:

N.Herdrastomo fnehendrastomo@gmail.com )
Academic and
Ms. Norpisah Mat Isa norpisah@notes.usm.my
Sending International Affair

14 USM Dean, School of

Prof. Dr. Ahmad Fauzi Materials & Mineral
Hosting afauzi@eng.usm.my
Mohd Noor Resources Engineering

Department of
Sending Ms. Suhana Mohd Said Electrical Engineering smsaid@um.edu.my

15 UM Department of
Mr. Aznijar Bin Ahmad aznijar@um.edu.my
Engineering Design
Hosting Yazid
and Manufacture

AUN/SEED-Net Master’s Degree Program 2011; p.8/13

 ATTACHMENT 4

Certified letter on academic standing

To Whom It May Concern:

This is to certify that ………………………………………….. is / was placed at the rank of

…………. out of the class of …………… students in the department / program of
…………………………………………., Faculty of …………………………………….. at
……………………………………………..

Signature ...........................................................

Name in print ....................................................

Position .............................................................

Institution ..........................................................

Date ...................................................................

AUN/SEED-Net Master’s Degree Program 2011; p.9/13

 ATTACHMENT 5

LETTER OF RECOMMENDATION
This form must be completed, put into a separate envelop, sealed, and signed right on the seal by the
referee him/herself, otherwise the recommendation will be invalid.)

This part is to be completed by applicant.

Full Name: __________________________________________________________________________
Proposed Program of Study
1. Place of Study ______________________________________________________________
Program applying ______________________________________________________________
2. Place of Study ______________________________________________________________
Program applying ______________________________________________________________

TO THE PERSON EVALUATING THE APPLICANT:

The person whose name appears above is applying for the Graduate Degree Program of the AUN/SEED-
Net. AUN/SEED-Net requires your submission of the completed Letter of Recommendation as part of
our appraisal of the above-named applicant. We realize that considerable time and effort are needed to
respond to this request. Your assistance is therefore greatly appreciated.

This part is to be completed by the person completing this Letter of Recommendation Form.

Full Name: ________________________________________________________________________

Position / Title: _____________________________________________________________________
Organization: ______________________________________________________________________
Contact Address: ___________________________________________________________________
___________________________________________________________________
Tel: ____________________________________ Fax: _____________________________________
Mobile: _________________________________ E-mail: ___________________________________

1. What is your candid opinion of the applicant’s potential to complete the program applied
for considering his/her:
(a) intellectual capacity, promise of productive scholarship, and ability to carry out
independent research;
(b) creativity and originality;
(c) relative standing among contemporary graduates;
(d) ability to pursue higher education for which the medium of instruction is English

AUN/SEED-Net Master’s Degree Program 2011; p.10/13

______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

2. Please cite outstanding qualities concerning his/her:

(a) personality (maturity and ability to work with others);
(b) communication skills
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
3. Based on the above, how would you recommend the application for the Graduate Degree
Program of the AUN/SEED-Net? (Please mark √ below where appropriate)

Strongly Recommend
Recommend without reservation
Recommend with some reservation
Do not recommend

Additional Comments:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________

Signature_____________________________________

Date_________________________________________

AUN/SEED-Net Master’s Degree Program 2011; p.11/13

 APPLICATION CHECKLIST
Please remember to include the following documents in your application:

(Mark X in front of the documents submitted)

For AUN/SEED-Net

One set of completed AUN/SEED-Net application form with recent photo and
signature(s)

Required supporting documents (in English)

Endorsement letter from your Sending Institution
Official Bachelor’s Degree certificate
Official Bachelor’s transcript with grade points
Certified letter of Class Rank of the Bachelor’s study
Medical check-up certificate
Letter of Recommendation (if more than one, specify how many:………………)
Letter of Endorsement from Rector or Dean

Additional supporting documents (in English)

Notifying letter of admission from Host Institution(s)
Certificate of English proficiency
Other(s), please specify
……………………………………….
……………………………………….
……………………………………….

For Host Institution 1 (please fill in the name):______________________

Two sets of completed application form of the Host Institution with recent photo &
signature(s)

Supporting documents (Please specify)

……………………………………….
……………………………………….
……………………………………….
……………………………………….
……………………………………….
……………………………………….

For Host Institution 2 (please fill in the name):______________________

Two sets of completed application form of the Host Institution with recent photo &
signature(s)

Supporting documents (Please specify)

……………………………………….
……………………………………….
……………………………………….
……………………………………….

AUN/SEED-Net Master’s Degree Program 2011; p.12/13

……………………………………….

AUN/SEED-Net Master’s Degree Program 2011; p.13/13