Attachment 1>

SUN MOON UNIVERSITY

STUDENT EXCHANGE PROGRAM APPLICATION FORM

PLEASE TYPE CLEARLY AND PRINT (DO NOT WRITE IN HAND)

PERSONAL INFORMATION
Name:
(First) (Middle) (Family)
Attach
a Photo
Passport No.: Here
Nationality:
Date of Birth (day/month/year):
Gender: □ Male □Female
Marital Status: □ Married □ Single
Blood Type: □A □B □O □AB +/-
Staying period: □ one semester □ two semesters (one year)
Program: □ Intercultural Studies □ Korean Study Program □ Both Intercultural Studies & Korean Program
*Please check the relevant box above.

EDUCATIONAL BACKGROUND
University:
Faculty: Department: Major:
Year / Semester: /
Language Proficiency: (TOEFL: PBT/CBT/IBT), (TOPIK: ), (Other: )
Academic Achievements (GPA): (4.5 scale) (100 scale)

CONTACT INFORMATION FOR STUDENT

Home Address:
Mailing Address:
Telephone: E-mail address:

PARENTS OR GUARDIAN
Name: Relationship:
Telephone: Fax or E-mail:
Job (title/company):
Attachment 2>
XXXXXXXXXXXXXXXX UNIVERSITY
Address: XXXXX, XXXXXXXXXXXXXXXX
Tel: XXXXXXXX Fax: XXXXXXXX

LETTER OF RECOMMENDATION
To: President,
Sun Moon University

Re: Name:
Gender:
Nationality:
Date of Birth:
Department / Faculty:
School Year:

In view of the above student’s exemplary conduct and superior academic achievements,
and on the recommendation of the respective faculty members, we hereby recommend the
above student as a candidate for the □ Intercultural Studies □ Korean Study Program
□ Both (Intercultural Studies & Korean Program)
of the Sun Moon University during □ One Semester
□ Two Semesters
*Please check the relevant box above.

Academic Advisor
Name: Signature:
Date:

Director, International Affairs or Student Affairs

Name: Signature:
XXXXXXXXXX University Date:
Attachment 3>

Study Plan
Name
Nationality
Major

Personal Statement
Attachment 4>

Certificate of Health
1. Personal Information                                                      
Full Name:                                                                              
Age:                                         Sex:                                    
Date of Birth:                                                                           
Nationality:                                                                             

2. Physical Examination 
Weight           kg Height            cm
    Blood Pressure: Systolic              Diastolic             mmHg
Vision: Right 20/                Left 20/               Color Vision                   
   Corrected: Right             /15  Left             /15
    Dental Evaluation: Good (    )  Fair (    )  Poor (    ) Needs Attention (     )
    Clinical Evaluation:
Classification Normal Abnormal Classification Normal Abnormal

Skin     Heart    
Head & Face     Abdomen    
Eyes     Rectum    
 Ears     Genitalia    
Mouth & Throat     Extremities    
Nose & Sinuses     Back & Spine    
Neck     Neurological    
Chest & Lungs     Mental    
      Other    
If Abnormal:
3. Chest X‐ray Examination
   Date taken:
   Findings:

4. Laboratory Examination
   Hemoglobin:                Gm/dl
Urine: S.G.                  Sugar               Micro                
Hepatitis B:
Stool for Parasite Oval:
Serological Test for Syphilis & AIDS :                                                   
   Other:  

                                                        

This is to certify that the above named applicant has gone through a general medical examination and the findings
indicated here are true to the best of my knowledge. In my opinion his/her health condition is;
Excellent (   )  Good (    )   Fair (    )   Poor (    )

Date     Hospital or Institute

M.D  
 
Signature