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					                                      The Graduate Institute
                      Executive Master in International Oil and Gas Leadership
                                     May 2011 – January 2012


                                                     Application Form
                                  Rolling admission from 1 November 2010 until 1 April 2011

Please complete this form and return it to the address below, preferably by e-mail. If you would like help completing the
form, please do not hesitate to contact us.

Postal address:
Graduate Institute of International and Development Studies
Executive Master in International Oil and Gas Leadership
P.O. Box 136, 1211 Geneva 21
Switzerland
Email: iog@graduateinstitute.ch
Phone: +41 22 908 57 16

All fields marked with an asterisk (*) must be completed.


PERSONAL DETAILS

Family name (*)                                                        First name (*)

Date of birth (*)
                                   Day         Month            Year
                                                                       Gender (*)                Male          Female

Nationality



ADDRESS

Correspondence Address
(Must be valid at least until May 2011)

                                                                  Telephone number
Street (*)
                                                                  (Home)
                                                                  Telephone number
NPA (*)
                                                                  (Work)

City (*)                                                          Mobile

Country (*)                                                       Email (*)



ENGLISH AS A SECOND LANGUAGE

Applicants are expected to be proficient in the use of English, although no certificate is required.




The Graduate Institute of International and Development Studies                                                          1/5
P.O. Box 136, 1211 Geneva 21 Tel. +41 22 908 57 16 · Fax. +41 22 908 57 10 · http://graduateinstitute.ch/executive/iog
GENERAL EDUCATIONAL BACKGROUND

Please list the academic institutions you are attending or have attended and the degrees which you are on your way to
completing or have already completed.

1

Degree Type

Subject

Year commenced

Year completed (or year of
planned completion if studies under way)

University name

Country


2

Degree Type

Subject

Year commenced

Year completed (or year of
planned completion if studies under way)

University name

Country


3

Degree Type

Subject

Year commenced

Year completed (or year of
planned completion if studies under way)

University name

Country



     >>>           Please send us copies (electronic or paper) of your last diplomas.




The Graduate Institute of International and Development Studies                                                          2/5
P.O. Box 136, 1211 Geneva 21 Tel. +41 22 908 57 16 · Fax. +41 22 908 57 10 · http://graduateinstitute.ch/executive/iog
QUALIFICATION BACKGROUND

Please list the organizations you have worked for and the positions held.

                   Type of                                        Location
Position held                        Name of organisation                                Starting year          Duration (months)
                   activity                                       (country)




YOUR CURRENT JOB

Please give a detailed description of your current job, including nature of work, major responsibilities and where relevant,
employees under your supervision, size of budget, number of clients / products and results. (15 lines maxi)




REFEREES

Please give details of the two referees who will provide you with letters of recommendations. We may contact them
concerning your application. These can be professional or academic references.

First referee

Name (*)                                                          Institution (*)

Position (*)                                                      Relationship to you (*)

E-mail (*)                                                        Telephone


Second referee

Name (*)                                                          Institution (*)

Position (*)                                                      Relationship to you (*)

E-mail (*)                                                        Telephone




     >>> Please send us two recommendation letters from your referees (electronic or paper).




The Graduate Institute of International and Development Studies                                                              3/5
P.O. Box 136, 1211 Geneva 21 Tel. +41 22 908 57 16 · Fax. +41 22 908 57 10 · http://graduateinstitute.ch/executive/iog
FINANCING YOUR STUDIES

Applicants are responsible to secure the funding for their studies at the Graduate Institute as the Executive
Education is unable to provide any financial assistance to candidates

How do you intend to finance your studies?

     1.   Are you financing your studies yourself?                                                                Yes    No


     2.   Is your current employer willing to sponsor your participation to the Executive Master IOG?             Yes    No

          If yes, please give contact person and address of your employer




Employer’s sponsorship will need to be supported by an official letter of your institution once admitted to the
programme.



MOTIVATIONS

Have you attended a course at the Graduate Institute in previous years?                       Yes        No

If yes, please give details




What is your motivation to attend the Executive Master in International Oil and Gas Leadership? What competencies do
you expect to obtain from studying with IOG and how will it contribute to your professional life?
(one A4 paper max.)




The Graduate Institute of International and Development Studies                                                               4/5
P.O. Box 136, 1211 Geneva 21 Tel. +41 22 908 57 16 · Fax. +41 22 908 57 10 · http://graduateinstitute.ch/executive/iog
BACKGROUND INFORMATION

Indicate how you learned about the Graduate Institute’s IOG Programme.


Media                 Recommendation             Documentation                 Fairs                      Internet

    Advertisement
                         Alumni                     Alumni association            APSIA Fair                  Google ads
in newspaper

   Article               Family                     Flyer                         APSIA Website               Search engine

                                                                                                             The Graduate
   Conference            Professor                  Poster                        QS Fair
                                                                                                          Institute website
   Faculty
                         Student                    Student’s guide               QS Website                  Other website
Presentation

   Other                 Other                     Other                          Other fairs




Other



CHECK LIST

Please remember to send along:

     >>>            The two referees’ letters of recommendation
     >>>            Copies of your last diplomas




                                   THANK YOU FOR YOUR APPLICATION!

                              Once complete, your application will be processed within a month.

                           Only fully completed applications will be taken into consideration.




   For questions regarding the application procedures or any other aspect of the Programme, please visit our website
                                         http://graduateinstitute.ch/executive/iog
                 or contact us by email iog@graduateinstitue.ch or by phone, Tel: +41 (0) 22 908 57 16




The Graduate Institute of International and Development Studies                                                               5/5
P.O. Box 136, 1211 Geneva 21 Tel. +41 22 908 57 16 · Fax. +41 22 908 57 10 · http://graduateinstitute.ch/executive/iog

				
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