APPLICATION FORM
ACADEMIC YEAR 2014/2015 
Cnam engineering school, international master degree
Software and systems architecture and engineering - Computer science -  

1. Home University
University/School  name	 	 	 	
					
Field of Study 			 	
Town			
Country		

2. Legal informations
Family name 	 	 	
First name	 			
Date of birth			
Place of birth		
Gender		
Nationality		
Personal cell phone  		
Home Town adress  		

		
Email adress		

3. Education
Current status at home university	
Level	Major’s heading 	List of courses	

			

			
Diplomas obtained	
Year	Grade	Heading of diploma	University name	

				

4. Professional experience and/or internship
Start date	Duration	Lab or company name	Mission completed	

				

5. Langage proficiency
Mother tongue: .................. 		
Hours of classes taken already	0 - 100	100 - 200	200 - 300	Over 300 : specify	Specify the learning context 	level reached 	
French							
Hours of classes taken already	0 – 300 : specify 	300 - 400	400 - 500	Over 600 	Specify the learning context	Certified level reached 	
English							

6. Statement of purpose
Briefly state the reasons why you wish to study abroad :	

	

	Date :
		Signature 
preceded by the handwritten words:  I hereby certify that the statements and information in this application form are true and correct to the best of my knowledge

Documents to be joined
1. Copy of bachelor original diploma
2. Certified french translation of original diploma. 
3. Marks and ranking of all courses attended at master program 
4. Certified English level
5. Curriculum vitae (résumé)  
6. Reference letters from teachers and/or tutors will be considered (page 5)
Beware 
1) Never send original documents
2) Copies will not be returned
3) Incomplete application forms will not be considered
Return application form both by post and email to :
Conservatoire Nationale des Arts et Métiers
Mme Maryse Kovalevitch
Ecole d’Ingénieurs
Case courrier 2ASP10
2 Rue Conté
75003 PARIS
France
maryse.kovalevitch@cnam.fr

You may find more information (in French) at : http://portail-formation.cnam.fr/ecole-sciences-industrielles-technologies-de-l-information/informatique/architecture-et-integration-des-systemes-logiciels/master-international-de-l-ecole-d-ingenieurs-du-cnam-mention-informatique-specialite-architecture-et-integration-des-systemes-et-du-logiciel--511064.kjsp?RH=205

Reference letter 

Family name and first name : 
Position : 
Scientific department :  
Email adress : 
University or company’s name : 
Town : 
Country :
 
Candidate’s family name and first name : 
Candidate’s date of birth :
Title of master program followed by the candidate : 

Assessment of the candidate’s qualities :  

 

 

Done at  : ……………………..      
Date : …………………………     Signature and university’s stamp