MEDEG

Erasmus Mundus Master Course in Economic Development and Growth Application Form
Edition 2012/2014

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MOBILITY OPTION
I CHOOSE TO SPEND THE FIRST YEAR OF MEDEG AT: OPTION A: University of Warwick OPTION B: Universidad Carlos III Madrid

I am aware that Ill have to spend the second year of MEDEG mandatorily at Lund University

PERSONAL DATA
Family name ................................... Date of birth Place of Birth (dd/mm/yyyy) ......................

First name Nationality ...........................

Middle name .................................. Country of Gender residence ..................... Contact Mail Address

.................................. ID Document

Document (ID, Passport etc.) ..................................... Nr. ................................. Contact Fax Telephone +... ........................... ........ 1 .....................

................................................................................... ................................................................................... E-mail

....................................................................................

ACADEMIC DATA
EDUCATION/TRAINING RECEIVED IN THE FOLLOWING DISCIPLINES Economics Economic History 1=Excellent 2=Good Business Administration Finance

Other. Please specify : ________________ 3=Fair 4=Weak or none

BACHELOR DEGREE * Degree Obtained ................................... University Month/Year ...............................

... *A scanned copy and an official English translation of your BA degree and transcript must be attached to the application for full consideration. If you expect to obtain a degree at the end of the academic year 2011-12, please indicate the expected date of graduation and enclose an official certificate issued by your University stating explicitly the expected date of graduation.

OTHER DEGREES/MASTER/TRAINING COURSES* Degree Obtained ................................... Degree Obtained ................................... University/Institution University Year ............................... ... Year ...............................

... *A scanned copy and an official English translation of any additional degree/course must be attached to the application for full consideration

LANGUAGES* ENGLIS H 1=Excellent ENGLISH CERTIFICATE*: TOEFL please specify ............................... SPANISH CERTIFICATE**: specify ............................... 2=Good 3=Fair 4=Weak or none ESOL FCE OTHER: please OTHER: SPANISH OTHER: please specify ........................................

ESOL IELTS

DELE/Inst.Cervantes

*A certificate of knowledge of English as a foreign language is mandatory for all students from nonEnglish speaking countries/universities ** A certificate of knowledge of Spanish as a foreign language is mandatory for students from nonSpanish speaking countries wanting to spend their first year at Universidad Carlos III Madrid

PROFESSIONAL EXPERIENCES
CURRENT EMPLOYMENT (ONLY IF APPLICABLE) Position/Title ........................................... Sector Public Employer ............................................... Private Mixed Since
(dd/mm/yyy y)

Name of Supervisor .................................. NGO Internation al

............

Other (please specify): . Describe the main functions of your organisation: ............................................................................................................................ Describe your responsibilities: .................................................................................................................................. How does the topic of the Masters programme relate to your current job responsibilities? .................................................................................................................................. Which impact do you foresee this training will have on your career? ...................................................................................................................................

EMPLOYMENT HISTORY (IF ANY) Employer ....................... Employer ....................... Employer ....................... Position ...................... ........ Position ...................... ........ Position ...................... ........ From to ....... - ....... From to ....... - ....... From to ....... - ....... Brief description of your duties ........................................ Brief description of your duties ............................................ Brief description of your duties ...........................................

OBJECTIVES AND MOTIVATIONS

What motivated you to apply for Master MEDEG and what do you expect from this programme? (max 500 words)

ERASMUS MUNDUS SCHOLARSHIPS

APPLICATION FOR AN ERASMUS MUNDUS SCHOLARSHIP I hereby apply for an Erasmus Mundus scholarship: Yes No

If yes, please specify which category of Erasmus Mundus scholarship you apply for: Category A Erasmus Mundus scholarship. *By ticking the Category A box, hereby I declare that I am a citizen of a country qualified as Third-country and that I am not resident nor have carried out my main activity (studies, work, etc.) in any European country for more than a total of 12 months over the last 5 years (ie. from December 1st, 2005, to November 30th, 2010), as per the EACEA criteria specified in the Call for Applications. Category B Erasmus Mundus scholarship. Have you ever received any Erasmus Mundus scholarship in the past? Yes programme: ................................................................................................................. .... Have you applied to other Erasmus Mundus Master Courses for the academic year 2012-13? Yes No If YES, please specify: _______ No If you have ticked the YES box, please specify when and for which

In case you are not selected for an Erasmus Mundus Scholarship, do you want to apply to additional scholarships which may be offered by MEDEG? Yes No

Have you applied to other scholarships offered by national or international institutions? Yes No If YES, please specify: _______

REFERENCES
Please give the names of two Referees Last Name and Name of Referee Position and Organisation Telephone number and e-mail address

*References must be provided using the Letter of Reference Form downloadable from the MEDEG web site.

Do you suffer from any disability that may prevent your regular participation in the Master activities or may require specific support/assistance? Yes No If you have ticked the YES box, please specify: _______________

PRIVACY AND SECURITY ACT (according to Spanish Law) In accordance with article 5 of the Spanish Law 15/1999 on personal data protection, all personal data provided in this application form will be recorded and managed by Universidad Carlos III Madrid only for academic and administrative purposes under the responsibility of the Universitys central administration (Gerencia). Applicants have the right to access, amend and cancel their data, as well as to deny the use of their data by writing to the Excmo. y Magfco. Sr. Rector de la Universidad Carlos III de Madrid, c/ Madrid n 126, 28903 Getafe Madrid.
Accepted and Agreed

Date ________________

Signature ________________________________________

List of documents to enclose to this Application Form: -a photocopy of ID card or passport of the applicant -a short CV of the applicant (use the downloadable CV template) -a scanned copy AND official English translation of a certificate of the Diploma held (Bachelor or equivalent). -a scanned copy AND an official English translation of transcript or similar detailed official record of the applicant's academic achievement (an official report listing exams passed, grades, graduation mark, honours). -a scanned copy of the certificate of language knowledge, if applicable -any other document that may be relevant for the assessment of their education achievement and skillset (e.g. certificates of additional degree obtained, training courses received, participation in research projects and other professional experiences) -two reference letters from academic referees

DEADLINE
The complete application (application form and all required documents) must be submitted online
http://www.uc3m.es/portal/page/portal/admission/master_phd/Admission_MEDEG

by November 30th, 2011 in case of students citizens of Third countries (including Turkey and Western Balkans countries) by January 15, 2012 in case of students citizens of European countries (member states of EU, EEA-EFTA, Switzerland,) Please note that incomplete or late applications will NOT be taken into consideration