Master’s Program for Future Global Leaders in Environmental Policy (MGLEP)

International School of Urban Sciences at University of Seoul

APPLICATION CHECKLIST
Name: Nationality:
E-Mail: Phone Number:

Check if
No. Note Document
submitted
1 Form 1 MGLEP Application Form
Application Form of International School of Urban Sciences,
2 Form 2
University of Seoul
3 From 3 Personal Statement
4 Form 4 Statement of Purpose/Study Plan
5 Form 5 A Letter of Recommendation
Official Letter of Nomination from the Minister of the Ministry or
6 Free Format
the Head of the Organization of the Applicant’s Affiliation
Certificate of Graduation of Undergraduate and Graduate School
7 Copy
* Selected applicants must submit original copies upon arrival in Korea
Official Transcripts of Undergraduate and Graduate School
8 Original
(if applicable)
Official Report of English Proficiency Test or Any Proof of
9 Original Applicant’s English Proficiency
* The test results must be dated later than 15 May 2018.
10 Original Certificate of Employment
11 Free Format Curriculum Vitae
Identification Page(First Page) of the Passport
12 Copy * If the passport has yet to be issued, please send a photocopy of national ID card.
As soon as the passport is issued, please send the photocopy of the passport.
13 Original Two Photos, 3X4 cm (with white-colored background)

※ Every document and certificate not written in English must be accompanied by notarized ones translated into English
or Korean.

This is to certify that I have submitted all the above required documents in order to apply for
2022 MGLEP Program. I declare that all the forms submitted are true and correct. I understand
the offer of admission may be withdrawn at any time if I cannot provide proof of validity or
contains falsified record.

Signature: Date:

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<Form 1>

2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY
Korea Environmental Industry & Technology Institute (KEITI)
215 Jinheungno, Eunpyeong-gu, Seoul, 03367, Rep. of KOREA

PART I: COMPLETED BY APPLICANT

1. TITLE of COURSE
Master’s Program for Future Global Leaders in Environmental Policy

2. PERSONAL INFORMATION
Name (as in the passport)

First name Middle name Family name

Preferred Name (or Nickname) Nationality
Photo
Country of Birth Date of Birth (dd/mm/yy) Size
(3.5cm4.5cm)
Gender Marital Status
 Male  Female  Single  Married
Passport Number Airport of Departure

Home Address

Telephone Fax
Contact Information
(including country code) Mobile E-mail

Name Relation

Emergency Contact
Telephone E-mail

3. EMPLOYMENT
Type of Organization
Name of Organization Government:  Central  Local
Institution:  Public  Private  International
 Others ( )
Department Present Position Employment Duration
From to present
Address

Telephone Fax

What are your main tasks in your current organization?

Job
Description Describe any themes, topics and places of interest you would like to study and visit in the training course related
to your tasks mentioned aforesaid.

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<Form 1>

2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY

4. CARRER

Career History
Position/ Period (dd/mm/yy)
Organization Department
Responsibilities From To

Educational Background (please list from high school information)

Date of
Start Date
Educational Institution Field of Study and Degree Location (City/Country) Graduation
(dd/mm/yy)
(dd/mm/yy)

Previous Attendance
Have you previously attended any course sponsored by Korea or other countries?
 Yes  No
(If yes, please specify below.)

Location Period (dd/mm/yy)

Educational Institution Field of Study / Diploma
(City/Country) From To

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2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY

5. LANGUAGE PROFICIENCY (ENGLISH)

- Excellent Good Fair Basic Remarks

Listening
Speaking
Writing
Reading

Native Language:
Other Languages:
In case you speak English as a foreign language, it is required for you to prove your English proficiency. Please indicate
your English Proficiency Test Scores:
 TOEFL ( IBT,  CBT,  PBT) : ( )
 TOEIC ( )  Others ( )

6. OTHERS

Restriction on Food/Behavior/Medication
Any restriction on food, behavior or medication due to health or religious reasons?
 Yes  No
If yes, please specify below.
 Beef  Pork  Fish  Others ( )

7. TERMS AND CONDITIONS

Participants are committed to read, abide by, and respect the following terms and conditions that KEITI endorses in
implementing the scholarship program:

1. Privacy and Copyright Policy

a. Participants agree that KEITI is able to disclose participant information, including the name, nationality, gender,
contact information, organization and position of participants, to relevant entities within the limit provided by
KEITI Policy, regulations or thereof
b. Participants accept the KEITI’s right of using all the documents or products produced by participant for the
purposes of the scholarship program (e.g. country report, action plan, etc.) including its duplication, translation,
distribution, and/or posting to websites (KEITI program website and/or other Korean government websites).

2. Attendance and Punctuality Policy

a. Participants should submit/present on-time reports that have been requested.
b. Participants should be punctual for any occasion in KEITI scholarship program.
(*) The followings are all monitored and included within the evaluation of the program by KEITI: absence without prior
notice, sufficient reason or proper explanation; and habitual tardiness
c. Participants must leave Korea upon the completion of the scholarship program unless they have obtained prior
approval from KEITI and the government of their country of residence.

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<Form 1>

2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY

3. Policy on Misconduct
a. Any form of harassment or insult, including but not limited to misconduct arising out of racial/ethnic, gender or
class discrimination, whether it be physical or verbal, will not be tolerated and will be dealt with in accordance
with the Korean law and KEITI Policy.
b. Especially, sexual harassment, defined as a form of behavior characterized by sexually connotative words, acts or
gestures that could undermine individual dignity and by which the victim takes offense, is regarded as a serious
misconduct and will be dealt with accordingly.
c. Any kind of disturbance to the efficient operation of the program, such as arbitrary action, including a
breakaway from the scholarship program, immoderate drinking, and any other kind of irresponsible behavior,
will not be tolerated, and the offender may be asked to leave in accordance with KEITI policy.
d. Should damage be caused by any kind of incident of assault or misconduct, all participants are obliged to report
the event to KEITI immediately.

4. Security and Well-being Policy

a. Participants are responsible for their own personal belongings, safety, health and well-being, and are asked to
conduct themselves accordingly.
b. Participants are served with the medical treatment covered by the insurance for accidents or diseases caused
during the length of the participants’ stay up to certain limits. Participants, however, should be solely
responsible for the treatment that exceeds their medical coverage.
(*) The causes of pregnancy or the treatment of any kind of chronic disease are excluded from the insurance coverage.

5. General Rules
a. Participants of the program should carry out instructions given to them and abide by the terms and conditions
of both KEITI and the academic institution, including any subsequent revisions which may be stipulated by KEITI
and the institution in regards to the program.
b. Participants should reside in the accommodation designated by the academic institution for the duration of the
course.
c. Participants should not bring any family members (dependants) to Korea or the country of training.
d. Participants shall refrain from engaging in political activities.
e. Participants are liable for all liabilities, including claims, losses, demands, actions, suits, costs or expenses,
arising in accordance with legal proceedings undertaken during the course of the training course, and of any
damage whatsoever to any property that arises from the carelessness, negligence, omission or default of the
participants during the training course.

I, (name) , of (name of country) have read and fully agree to the

above Terms and Conditions set forth and declare that all the information given above is true
and complete.

Date

Applicant’s Name Signature

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<Form 1>

2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY

8. MEDICAL REPORT 1 (Completed by applicant)

1. Present Status
(a) Do you currently use any drugs for the treatment of a medical condition? (Give name & dosage.)
 No  Yes, Name of medication ( ), Quantity ( )
(b) Are you pregnant? (Female only)
 No  Yes ( months)
(c) Please indicate any needs arising from disabilities that might necessitate additional support or facilities.
( )
(Note) A disability does not lead to dismissal or exclusion from the program. However, upon the situation, you
may be directly inquired by the KEITI official in charge for a more detailed account of your condition.

2. Medical History
(a) Have you had any significant or serious illnesses? (if hospitalized, give place & dates.)
 No  Yes
Past
If yes, Name of illness ( ), Place & dates ( )
Present  No  Yes, Present condition ( )
(b) Have you ever been a patient in a mental hospital or have been treated by a psychiatrist?
 No  Yes
Past
If yes, Name of illness ( ), Place & dates ( )
Present  No  Yes, Present condition ( )
(c) High blood pressure
Past  No  Yes
Present  No  Yes, Present condition ( )mm/Hg to ( )mm/Hg
(d) Diabetes (sugar in the urine)
Past  No  Yes
 No  Yes, Present condition ( )
Present
Are you taking any medicine or insulin?  No  Yes
(e) (Past History) What illness(es) have you had previously?
 Stomach and intestinal Disorder  Liver Disease  Heart Disease  Kidney Disease
 Tuberculosis  Asthma  Thyroid Problem
 Infectious Disease (Specify name of illness: )
 Other (specify: )
(f) Has the above disease been cured?
 Yes  No (Specify name of illness: )
 Yes (Present Condition )

I certify that I have read the above instructions and answered all questions truthfully and
completely to the best of my knowledge.

Date Signature of Applicant

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<Form 1>

2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY

9. MEDICAL REPORT 2 (Completed by Authorized Physician)

Name:
Age: Blood Type:
Basic Information
Gender: Blood Pressure: / mmHG
Height: cm Weight: kg
Test Result
Name Test Result Remarks
EKG  Normal  Abnormal
Chest PA  Normal  Abnormal
Urinalysis  Normal  Abnormal
Diabetes  Positive  Negative
Hepatitis B  Positive  Negative
Syphilis  Positive  Negative
AIDS  Positive  Negative
Infectious disease  Positive  Negative
Endemic disease  Positive  Negative
Pregnancy test  Positive  Negative

1. How long have you known the applicant named above?

 Less than 6 months  More than a year  More than 5 years  More than 10 years

2. Has this person received treatment for the last 5 years or does he/she have any conditions that will require
frequent or long periods of absence, or would otherwise affect his/her ability to carry out role given to him/her
in participating an intensive training course away from home?
 Yes  No
(If you answered yes, please provide details.)

3. Is there anything in the person’s medical history that would make him/her unfit to participate in the training
course?
 Yes  No
(If you answered yes, please provide details.)

I certify that I answered all questions truthfully and completely to the best of my knowledge.

Date:
Name of Clinic:
Address of Clinic:

Name of Physician Signature

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<Form 1>

2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY

PART II: RECOMMENDATION COMPLETED BY SUPERVISOR OF APPLICANT’S

ORGANIZATION

1. The Relevance of the MGLEP Program to the Applicant’s Current Job Duties and Future Career Path at
Your Organization
(*) Please, attach your organization chart and indicate the applicant’s position.

2. Evaluate the Applicant’s Work Performance and Accomplishments

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<Form 1>

2022 APPLICATION OF MASTER’S PROGRAM FOR

FUTURE GLOBAL LEADERS IN ENVIRONMENTAL POLICY

3. The Expected Benefits and Results of this Program to Your Organization

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<Form 2>

Application for Admission

International School of Urban Sciences, University of Seoul

Registration Number

Confirmation

* DO NOT WRITE IN THIS AREA

PLEASE TYPE OR PRINT IN ENGLISH

International Urban Development Program (IUDP), International School of Urban Sciences, University of Seoul
163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Korea Tel) 82-2-6490-5159 Fax) 82-2-6490-5141
E-mail) [email protected] Homepage) http://isus.uos.ac.kr

Ⅰ. TITLE OF COURSE (You are applying for)

MGLEP(Master’s Program for Future Global Leaders in Environmental Policy)

In Cooperation With Korea Environmental Industry & Technology Institute(KEITI)
Photo
(3 x 4cm)

Ⅱ. PERSONAL DATA

Name
First Middle Last
(as in the passport)

Date of Birth Month Day Year

Sex □M □F Marital Status

Nationality Religion

Passport Number Airport of Departure

Home Address

Contact Telephone Fax

Information
(Including country code) Mobile E-mail

Emergency Name Relation

Contact Telephone E-mail

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INTERNATIONAL SCHOOL OF URBAN SCIENCES, UNIVERSITY OF SEOUL
Ⅲ. FAMILY DATA

Name of Father _____________________ Name of Mother _____________________

First Middle Last First Middle Last

Nationality Nationality

Home Address

Contact Information Telephone Fax

(Including country code) Mobile E-mail

Ⅳ. RECOMMENDATION (List names, addresses, phone/fax numbers and e-mail addresses of recommenders.)

Name Organization Department Telephone FAX E-mail

Ⅴ. EMPLOYMENT

Name of
Address
Organization

Present Position
Department Employment
from to present
Duration

Telephone Fax
(Including country code) (Including country code)

Type of Government(□Central, □Local), Institution(□Public, □Private, □International, □NGO)

Organization □Others( )

What are your main tasks with your current employer?

Which technical equipment or facilities do you work on your job with? (if
Job Description applicable)

Describe any themes, topics and places of interest you would like to see in
the training course related to your tasks mentioned aforesaid.

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INTERNATIONAL SCHOOL OF URBAN SCIENCES, UNIVERSITY OF SEOUL
 Career over the past 5 years
Period(dd/mm/yy)
Organization Department Position Responsibilities
From To

Ⅵ. Educational Background

Educational Location Period(dd/mm/yy)

Field of Study and Degree
Institution (City/ Country) From To

Ⅶ. OTHERS

Restriction on Any restrictions on food, behavior or medication due to health or religious

Food/Behavior/ reasons?

Medication □Yes >> □Beef □Pork □Fish □Others( )/ □No

Ⅷ. ENGLISH PROFICIENCY

Excellent Good Fair Basic Remarks

Listening

Speaking

Writing

Reading

Native Language :
Other Languages :

In case you speak English as a foreign language, it is required for you to certify your
English proficiency. Please indicate your English Proficiency Test Scores:

□ TOEFL: □ TOEIC: □Others( ):

(□IBT, □CBT, □PBT) score score score

Ⅸ. APPLICANT’S SIGNATURE/CERTIFICATION OF ACCURACY

I certify that all information in my application is my own work, factually true and honestly presented

Signature Date(mm/dd/yyyy)

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INTERNATIONAL SCHOOL OF URBAN SCIENCES, UNIVERSITY OF SEOUL
<Form 3>

Personal Statement

Name (English) (Korean) (Chinese)

Date of birth (month/day/year) Passport No.

PERSONAL STATEMENT
The personal statement helps the university learn more about you as an individual beyond your grades and
test scores, and other objective data. You should present your thoughts, ideas and views in a focused and
convincing manner. Please write a statement on the listed three topics(100~150 words for each topic)
below in English. Please limit yourself to the space provided.

□ Describe your most important intellectual experience and accomplishment to date or describe some issue
of personal, local, national, or international concern and its importance to you.
□ Describe why you are applying for University of Seoul.
□ Describe your plan after you graduate University of Seoul.

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INTERNATIONAL SCHOOL OF URBAN SCIENCES, UNIVERSITY OF SEOUL
<Form 4>

Study Plan

Name (English) (Korean) (Chinese)

Date of birth (month/day/year) Passport No.

STUDY PLAN

Write a clear and detailed description of your study objectives, and give your reasons for wanting to pursue

them at the University of Seoul in English. Be specific about your major field and your specialized interests

within this field. Describe the programs you expect to undertake, and explain how your study plan fits in

with your previous training and your future objectives. Please limit yourself to the space provided.

Applicant
Signature Date(mm/dd/yyyy)

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INTERNATIONAL SCHOOL OF URBAN SCIENCES, UNIVERSITY OF SEOUL
<Form 5>

Letter of Recommendation
Applicant
Name (English) (Korean) (Chinese)

Date of Birth (month/day/year) Passport No.

Recommender
Name

Institution Position

Telephone E-mail

Address

Signature Date(mm/dd/yyyy)

To
International Urban Development Program (IUDP)
IUDP, #20412, Law School,

International School of Urban Sciences, University of Seoul

163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, KOREA

Email : [email protected]
Homepage : http://isus.uos.ac.kr
Tel : +82-2-6490-5159 Fax : +82-2-6490-5141

With this form, enclose a recommendation letter in a sealed envelope, sign across the seal, and give it to

the applicant.

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INTERNATIONAL SCHOOL OF URBAN SCIENCES, UNIVERSITY OF SEOUL
 Letter of Recommendation
Applicant
Name (English) (Korean) (Chinese)

Recommender
Name (English)

* Use a separate sheet if necessary

Recommender
Signature Date(mm/dd/yyyy)

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INTERNATIONAL SCHOOL OF URBAN SCIENCES, UNIVERSITY OF SEOUL