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APPEL AC ANDIDATURES by tLGoNhJ

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									                                         QUAI D’ORSAY / ENTREPRISES
              PROGRAMME DE BOURSES COFINANCEES AIR LIQUIDE/ MAEE 2012/2013
                      AIR LIQUIDE INTERNATIONAL SCHOLARSHIP (ALIS)


                                      APPLICATION FORM
Important: please submit your application electronically in Word format to the Cooperation and Cultural Action
Service (SCAC) of the French Embassy in your country of residence, together with the required documents
listed in the “Mandatory application documents” section.
Incomplete or post-mailed applications will not be considered.


         Last Name (as shown on passport)                               First Name (as shown on passport)

                           Nationality                                                                    Sex
   (specify if you have dual nationality – bi-national applicants          Date of birth       (click on the appropriate
            holding French nationality are not eligible)                                                  box)
                                                                                                      M      F
                                     Permanent address in your home country

        Telephone                          Fax                                 E-mail (IMPORTANT)

                                   Address en France if you have already arrived
                                                                      Telephone

                          Current course of higher education and/or training courses
           Higher education institution or company                                     Area of study


                          Degree title                                  Dates of training courses (month and year)
                                                                             Begins               Ends

 Details of your academic achievements, such as marks obtained, commendations, class rankings, etc., should
                               appear on the CV submitted with this application

Courses for which you have applied for the scholarship (if you have applied to several Masters, please state
                             your choice in ascending order of priority)

   Ecole Centrale Paris: Energy, materials and processes

   Ecole Centrale Paris: Industrial Engineering – Optimisation of industrial systems and logistics

   Ecole Polytechnique: Fluid Mechanics

   Ecole Polytechnique: Engineering and Innovation Technologies

   Ecole Polytechnique: Materials Science and Structural Mechanics

   Ecole Polytechnique: Renewable Energy Science and Technology

   University of Paris-Dauphine: Energy, Finance, Carbon

   University of Paris-Dauphine: Technology and innovation management

								
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