Attachment 1>
SUN MOON UNIVERSITY
STUDENT EXCHANGE PROGRAM APPLICATION FORM
PLEASE TYPE CLEARLY AND PRINT (DO NOT WRITE IN HAND)
PERSONAL INFORMATION
Name:
(First) (Middle) (Family)
Attach
a Photo
Passport No.: Here
Nationality:
Date of Birth (day/month/year):
Gender: □ Male □Female
Marital Status: □ Married □ Single
Blood Type: □A □B □O □AB +/-
Staying period: □ one semester □ two semesters (one year)
Program: □ Intercultural Studies □ Korean Study Program □ Both Intercultural Studies & Korean Program
*Please check the relevant box above.
EDUCATIONAL BACKGROUND
University:
Faculty: Department: Major:
Year / Semester: /
Language Proficiency: (TOEFL: PBT/CBT/IBT), (TOPIK: ), (Other: )
Academic Achievements (GPA): (4.5 scale) (100 scale)
CONTACT INFORMATION FOR STUDENT
Home Address:
Mailing Address:
Telephone: E-mail address:
PARENTS OR GUARDIAN
Name: Relationship:
Telephone: Fax or E-mail:
Job (title/company):
Attachment 2>
XXXXXXXXXXXXXXXX UNIVERSITY
Address: XXXXX, XXXXXXXXXXXXXXXX
Tel: XXXXXXXX Fax: XXXXXXXX
LETTER OF RECOMMENDATION
To: President,
Sun Moon University
Re: Name:
Gender:
Nationality:
Date of Birth:
Department / Faculty:
School Year:
In view of the above student’s exemplary conduct and superior academic achievements,
and on the recommendation of the respective faculty members, we hereby recommend the
above student as a candidate for the □ Intercultural Studies □ Korean Study Program
□ Both (Intercultural Studies & Korean Program)
of the Sun Moon University during □ One Semester
□ Two Semesters
*Please check the relevant box above.
Academic Advisor
Name: Signature:
Date:
Director, International Affairs or Student Affairs
Name: Signature:
XXXXXXXXXX University Date:
Attachment 3>
Study Plan
Name
Nationality
Major
Personal Statement
Attachment 4>
Certificate of Health
1. Personal Information
Full Name:
Age: Sex:
Date of Birth:
Nationality:
2. Physical Examination
Weight kg Height cm
Blood Pressure: Systolic Diastolic mmHg
Vision: Right 20/ Left 20/ Color Vision
Corrected: Right /15 Left /15
Dental Evaluation: Good ( ) Fair ( ) Poor ( ) Needs Attention ( )
Clinical Evaluation:
Classification Normal Abnormal Classification Normal Abnormal
Skin Heart
Head & Face Abdomen
Eyes Rectum
Ears Genitalia
Mouth & Throat Extremities
Nose & Sinuses Back & Spine
Neck Neurological
Chest & Lungs Mental
Other
If Abnormal:
3. Chest X‐ray Examination
Date taken:
Findings:
4. Laboratory Examination
Hemoglobin: Gm/dl
Urine: S.G. Sugar Micro
Hepatitis B:
Stool for Parasite Oval:
Serological Test for Syphilis & AIDS :
Other:
This is to certify that the above named applicant has gone through a general medical examination and the findings
indicated here are true to the best of my knowledge. In my opinion his/her health condition is;
Excellent ( ) Good ( ) Fair ( ) Poor ( )
Date Hospital or Institute
M.D
Signature