Imprimer le formulaire APPLICATION FORM 2013 – 2014 MAN-IMAL Master’s degree “Man-Animal-Food Health: Transdisciplinary Management of Global Health and Nutritional Safety” Please mark the interview session you wish to apply for: Interview session #1 (June 3rd – 7th, 2013) Application must be sent by May 27th Interview session #2 (Sept 23rd – 27th, 2013) Application must be sent by September 20th (date as per postmark) What is your goal after completing the MAN-IMAL Master? Employment Further research Not defined Depending upon various criteria, a MAN-IMAL scholarship is available (please see the Scholarship Application form for details) Would you like to request financial aid for your MAN-IMAL studies? YES NO (If yes, please complete the MAN-IMAL Entraide or International Scholarship form, according to your situation, and send along with your complete file) ELIGIBILITY CHECKLIST (Reserved for administration - Please do not fill)  Applications dated and signed  Legible copy of national identity card or passport  Copy of the minimum required diploma (with certified translation)  Recommendation letter  Detailed curriculum vitae 1 Last Name: ________________________ First Name:______________ (for married women, please indicate your maiden name followed by « married ») Address: N° _________ Street _____________________________________________________________ Postal Code: ________________________ Attach ID photo City: ___________________________________________ Country: ____________________________ E-mail address (obligatory): _____________________________________________________ Telephone: ________________________________ Mobile: ________________________________ Birthdate: ________________________ in _____________________ day month year Country: ___________________ Gender: __________________________ Age: _________________ Nationality: __________________________________ Family Status: _________________________________ Permanent address in country of origin: ____________________________________________________________ INE number (Identifiant National Etudiant, 11 characters): _________________ (non obligatory for students who have never studied in France before) Have you passed a language test? YES If yes, please indicate which test: TOEIC NO TOEFL IELTS OTHER (please specify: ___________) (please attach a copy of test results and certificate) Test date: ________________________ Test score: ______________ Current situation: Student Employed Unemployed Other Please describe in further detail your current situation (type of ongoing studies, education level, position held …) 2 Prior University Education, in chronological order (beginning with the most recent diploma) Dates From - To Academic institution Fields of Study City, Country Diploma Title Distinction, Ranking (if any) Other studies, Ongoing studies, Participation in international university exchange programmes Dates From - To Academic institution Fields of Study City, Country Diploma Title Distinction, Ranking (if any) 3 Professional experience (internships included) in France and abroad Dates From - To Company Name Reason for abroad stay / Tasks carried out Language used (if abroad) Type of contract (work contract, internship, voluntary work…) Reports, dissertations or publications on subjects related to MAN-IMAL Type of report/dissertation/publication Date Bibliographic references 4 Other activities Please indicate any other activities that you are involved in (sports, associations…). Describe the responsibilities you have assumed, or currently assume. Please state the projects you have undertaken. Other degree programmes which you are applying for Please detail the other programmes you are applying for (Master and other diplomas in Nantes, or elsewhere) by order of preference, including the MAN-IMAL Master program: 1) …………………………………………………………………………………………………………… 2) …………………………………………………………………………………………………………… 3) …………………………………………………………………………………………………………… 4) …………………………………………………………………………………………………………… References Please complete the information below, of two references that we may contact, so as to better study your application: Reference: Last Name: First Name: Profession: Professional Address: E-mail Address: Telephone: What brought you in contact with this reference? Reference: Last Name: First Name: Profession: Professional Address: E-mail Address: Telephone: What brought you in contact with this reference? 5 EVALUATION CHART Candidate Name: Degree/Internship: Situation during the current academic year (e.g. studies, work, unemployment, etc.) Excellent Strong Average Weak Not acceptable No opinion Knowledge of basic scientific principles Application of knowledge Motivation Curiosity Ease in communication Professional ethics Maturity Judgement Cooperative spirit Organization Evaluator’s name: ____________________________________ Evaluator’s signature: ____________________________________ Date: ____________________________________ This document replaces the letter of recommandation. Please send along with the complete application file to the following e-mail address: contact.manimal@oniris-nantes.fr or by mail to Formation MAN-IMAL, 6 Oniris - Site de la chantrerie - Route de Gâchet - CS 40706 - 44307 Nantes cedex 3, FRANCE. Reminder: In the event of dispute, the French version of the MAN-IMAL documents and their texts shall prevail. French is the official administrative language for all MAN-IMAL procedures. Any supporting document in another language other than French or English must be accompanied by a certified translation (either in French or in English). I hereby certify that the above information is correct, and am aware that any false statement or omission written on the application form, even if involuntary, might lead to the discarding of my application. Date: Signature: 7 Supporting documents to include in the application Mandatory documents  The MAN-IMAL application form (7 pages),  Photocopy of valid ID (National Identity Card or Passport),  Photocopy and translation into French or English of all University diplomas completed* mentioned on page 3 of this form, including the transcript of records in English or French of all completed higher education degrees. (Specify the averages and ranks, if possible),  The Evaluation Chart (page 6) or a letter of recommendation from the Head of the diploma programme (Professor, Program Director…),  …and/or the Evaluation Chart (page 6) or a letter of recommandation from last employer or internship Director,  A Cover letter written in English (please describe the reasons for which you are applying to this programme - personal motivation, career goals...),  Detailed Curriculum Vitae (maximum 2 pages) Optional documents  Official certificates for all short training courses and seminars, of participation in university exchange programmes, and of the ongoing studies mentioned on page 3  Certificates for professional experiences mentioned on page 3  If you have one, English language certificate: TOEFL IBT 75, IELTS 5.5, Cambridge: First Certificate in English, TOEIC “listening and reading”: 750/990  If you have one, French language certificate: TCF, with a valid complementary/optional exam of written skills, DALF or DELF B2 PLEASE NOTE: Any written documents sent in any language other than English or French must be accompanied by their official translation (in English or French). All translations must be completed by a certified translator. * a certificate of achievement must be included if you are not yet in possession of your last diploma. Complete application must be sent latest on: - May 27th, 2013 (June 2013 session) - September 20th, 2013 (September 2013 session) preferably by e-mail to contact.manimal@oniris-nantes.fr or by mail to Oniris - Site de la Chantrerie MAN-IMAL Route de Gachet CS 40706 – 44307 Nantes cedex 3 8 IMPORTANT OBSERVATIONS: a) In order to ensure that the students accepted into the MAN-IMAL programme are welcomed under the best conditions, much attention is given to the scientific level of each candidate, which must enable the student to follow all courses with serious chances of completion and success. b) All applications will be examined by a pedagogical committee and all final decisions will be sent to the candidates by week 24 or 40, depending upon the session applied for. An acceptance form and registration procedures will be sent to the candidates whose applications are accepted to the programme. c) There does not exist within French territory any valid, uniform equivalency with regards to diplomas. A foreign degree may be accepted by a French Higher Education establishment and refused by another. All replies to all candidatures depend exclusively upon the Director of the school which is supported by the propositions of the pedagogical committee. This committee places important emphasis on past degree content and the requirements of the degree to which the student is applying. Language capacities will also be considered. The educational establishment to which the candidate is applying has sovereign power over all validations. The French Ministry of Higher Education and Research does not grant either any waivers or equivalences in the pursuit of higher education. d) Incomplete applications will not be considered. e) All documents sent for the application of the MAN-IMAL programme remain property of the French administration, even upon entry refusal. No application document will be sent back to the candidate. f) Candidates whose applications have been accepted must present, at the time of registration, the original copies of all diplomas and their certified translations. Scholarships: In addition to the MAN-IMAL scholarship you may apply for, the French government offers various types of scholarships that you may qualify for. If you would like further information, please consult the Cultural and Cooperation Department of the French embassy in your country of residence. You may also consult the website of the Ministry of Foreign and European Affairs at: http://www.diplomatie.gouv.fr > Espace étudiants> Etudier en France > Financer le projet/bourses Optional question: How did you hear about the programme? (please tick one box only) [ ] Internet [ ] Youth information and counselling centre [ ] Students registered in the programme [ ] Training/education fair or forum [ ] Current institution [ ] Other (please specify) [ ] Parents or other family member 9 Acknowledgment of application receipt If you would like official acknowledgement that your application has been received by Oniris, please complete the form below and attach it to your application file.  ------------------------------------------------------------------------------------------------------------------We acknowledge receipt of the application file for the Master “Man-Animal-Food Health: Transdisciplinary Management of Global Health and Nutritional Safety” from: Last name: ………………………………… First Name: ………………………………………… Date: ………………………………… Oniris - Site de la Chantrerie MAN-IMAL Route de Gachet CS 40706 – 44307 Nantes cedex 3 1 0