This form should be typewritten or hand-written in Roman letters..docVIP

This form should be typewritten or hand-written in Roman letters. Please select the program you are applying for and check the appropriate box. All date is used for internal purpose and will be regarded as confidential. Graduate School of International Relations ? International Development Program (IDP) Master of Arts in International Development or Master of Arts in Economics ? Public Management and Policy Analysis Program (PMPP) Master of Arts in Public Management ? International Relations Program (IRP) Master of Arts in International Relations Sponsorship Is your graduate study at IUJ being funded by any institution? Yes No If yes, please provide the following in English and, if applicable, in Chinese characters: Institution Name: Contact Person: Position/Title: Address Street 1: Street 2: City: Country: Telephone Fax: E-mail: Personal Information Name in Full Last Name (Write as appears on your passport in Roman block CAPITALS) □ Male First Name Middle Name □ Female 2. Date and Place of birth (state age as of 1st October 2015) 19 (Year) (Month) (Day) (Age) (Place of Birth) 3. Marital Status Single □ Married 4. 5. a Nationality Name of Institution (Please write in English) b Work Unit/Department/Division (Please write in English) City: Province: (Title of Position)  6. Work Address City: Province: Phone/Fax: Email: 7. Home Address City: E-mail address: Phone/Fax: Mobile phone: 8. Preferred Address for Correspondence