application eng 2009

							                                                 Check List

1. Application Form including the Statement of Purpose, Personal Interview Form, Questionnaire for
International Students and Student Health History.

2. Two Recommendation Letters (PLS use the GV Interview Form)
(One from the academic advisor, the other from the director of International Programs or Study Abroad Office)

3. An Official Transcript of Academic Records

4. A Letter from a Physician Showing Your Medical Condition

5. A Copy of Medical Insurance

6. A Copy of Accident Insurance

7. A Copy of the fist page of a passport

8. The Two Additional Photos sized (3.5cm(width)*4.5cm(height)

PLS TYPE OR WRITE IN CAPITAL WHEN YOU FILL OUT THESE FORMS.
                              GLOBAL VILLAGE PROGRAM
                                 APPLICATION FORM
                                                                                         photo

                                       Study Abroad in Korea
                                    Yonsei University at Wonju


Applicant is applying for admission for (check one)

 Spring semester, 09 □                             Spring semester, 10 □

 Fall semester, 09        □                               Fall semester, 10   □

 Spring & Fall semester, 09 □                             Spring & Fall semester, 10 □


I. PERSONAL INFORMATION

1. Name in Full (               )

                   (Ms. Mrs. Mr.)     Family         First Name          Middle Name

2. Sex             Male   □     Female □


3. Date of Birth

                     Month, Day, Year

4. Nationality


5. Permanent Address

  Tel.                                                    Fax
                                               .
  E-mail

6. Mailing Address

  Tel.                                             Fax.

7. Emergency contact person
  Name in full                                    Relationship to you

  Address

  Tel                                                E-mail




II. ACADEMIC INFORMATION


1. Institution you are currently attending:

2. Present year of study:                            Major:

3. Degree sought:                                    G.P.A.:

                    (Bachelor’s □ , Master’s        □)

III. STATEMENT OF PURPOSE
In the space provided, write a brief self-introduction and a statement on why you want to study abroad in Korea.
(Limit to one page double-spaced.)


Date:                                         Signature:
STATEMENT OF THE PURPOSE
                                                                             Global Village Program
                                                                          Yonsei University at Wonju
                                                                            Personal Interview Form



Student’s Name ___________________________________Partner campus______________________Cum.GPA ______

Check term of study: Spring 200___ Fall 200 ___ Major ___________________________________________________

*************************************************************************************************
*
                                                    Excellent Good Average Poor Unknown

      Consideration for and interest in others and their views.   ____     ____    ____      ____      ____
      Ability to adjust to and cope with new situations           ____     ____    ____      ____      ____
       (food, inconveniences, language, etc.) and a new culture
      Intellectual curiosity and imagination                      ____     ____    ____      ____      ____
      Common sense and good judgment                              ____     ____    ____      ____      ____
      Emotional stability                                         ____     ____    ____      ____      ____
      Sense of responsibility                                     ____     ____    ____      ____      ____
      Willingness to contribute to group activities               ____     ____    ____      ____      ____
      Personal time management                                    ____     ____    ____      ____      ____

Comment briefly on your impression of the student’s suitability for participation in Yonsei University’s Global Village
Program. Consider such matters as motivation, understanding of program academic and community living expectations,
ability to make a positive contribution to the Global Village community, previous contact with international students,
leadership and volunteer/work experience, and ability to adapt to new situations and cultures. Please continue on a
separate page, if more space is needed.

Comments:




Recommendation for study abroad: ___ Highly Recommended ___Recommended ___ Not Recommended

Signatures of interview team members:


Name/Position
Name/Position                                                                                    Date




                     QUESTIONNAIRE FOR INTERNATIONAL STUDENTS
                                 Global Village Entry for Spring 2007


Name                                          Home University
Major                                         Dorm Room Number
This questionnaire is to help you to stay more comfortably and safely. Your response does not affect your status
as an exchange student. Please respond to the following questions frankly. We will not reveal your personal
matters to others.

1. Are there any types of food you do not eat? (pork, chicken, dairy product, etc.)

2. Do you have any allergy or illness we should know?

3. Do you have any medicine you should take while staying in Korea?

4. Do you have any valuable belongings that you must ask us to keep safe for you?

5. Do you have any relatives or friends in Korea?
 (If yes, please provide the person's information.)
  Name:
  Phone Number: (Home)                          (Work)
  Address:



  Name:
 Phone Number: (Home)                          (Work)
 Address:




6. Is there anything that we should know about you?
                                                   STUDENT HEALTH HISTORY
                                    Global Village Program – Yonsei University at Wonju, Korea
Confidential for Health Service Staff
Name                                                  Last                First   Middle




Permanent Address City                     State      Zip



Emergency Contact Name                     Telephone




Gender:              M                     F


Have you had or do you have any of the following:
                                                No               Yes
1.        Eye disorders                                          ___
2.        Ears/Nose/Throat disorder                               ___
3.        Migraine headaches                                     ___
4.        Seizures/Epilepsy                                      ___
5.        Thyroid disease                                        ___
6.        Heart disease/murmur/
          rheumatic fever                                        ___
7.        High blood pressure                                    ___
8.        Asthma/chronic respiratory
           disorders                                             ___
9.        Hayfever/Sinus disorder                                ___
10.       Stomach/intestinal disorder                            ___
11.       Anorexia/bulimia/other
           eating disorder                                       ___
12.       Kidney/bladder disorder                                ___
13.       Liver/gallbladder/spleen                               ___
14.       Diabetes                                               ___
15.       Joint/muscle disorder                                  ___
16.       Skin disorder                                          ___
17.       Reproductive organs disorders                          ___
18.       Blood disorder/Mono                                    ___
19.       Cancer/other malignancies                              ___
20.       Emotional problem/depression                           ___
21.       Childhood/communicable
           diseases/Chicken Pox
22.       Other                                                  ___

Have you ever had surgery?
No        Yes       Why? ______________________________
Have you ever been hospitalized?
No        Yes      Why?______________________________
Are you taking any medications, vitamins, etc.?
No        Yes    (include birth control pills & over the counter drugs)
Name of drug(s)_____________________________________



Rev 4/4/2001
Social Security #                     SID#


Date of Birth


Weight                          Height

Do you have a physical, learning or emotional disability that you want the Health Service to be aware of?

No        Yes        Explain:


Please list all the dates of the following immunizations:
1. DPT or DT and tetanus booster (Td)




2. Oral polio vaccine (OPV) or polio injection




3. Measles, mumps, rubella (MMR) and boosters




4. Hepatitis B




5. Date of last tuberculosis skin test or x-ray and result
________________________________________________
6. BCG _______________
7. Others _______________
Family Health History (any person related by blood)
No        Yes                                        Member
                     Cancer                         ________
          __         Diabetes/ Thyroid               ________
                     Heart Disease                   ________
                     Respiratory Disorders           ________
                     Stomach Disorders
                     Stroke                          ________
                     Tuberculosis (Active)           ________
                     Alcohol/Drug abuse              ________
                     Sudden, Unexpected
                     Death, before age 60            ________

                     Other                                      .

Any known allergies or adverse reaction to any drugs, antibiotic, food, etc.?

No        Yes       List allergies:




________________________________________________
Student Signature, Date