Application Form

APPLICATION FORM

SAWASDEE THAILAND SUMMER PROGRAM 2024 (BATCH B 27 AUG - 9 SEP 2024)
HOW TO APPLY

Please complete all sections of this form and submit it with other required documents to International Relations Division, Mahidol University by 10 JUL 2024.
Please indicate below the interested module*

CultureSustainable Life and Society
Would you like us to arrange housing for you?*

Yes, shared room (250 USD) *Students from partner universities can apply for accommodation scholarship at USD 250 max. The scholarships are limited.Yes, single room (550 USD)No
PERSONAL INFORMATION
Full Name*

Given NameFamily Name
Calling Name*
Gender*

MaleFemale
Date of Birth*

MonthDayYear
Date
Nationality*
Passport Number*
Telephone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Food Restriction / Food Allergies / Other Allergies *
Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Upload Your Photo (Portrait)*
EDUCATIONAL INFORMATION
University / Faculty / Department *
Year of Study / Major*
Field of Interest *
EMERGENCY CONTACT PERSON
Name *
Relationship *
Contact Number *
Please enter a valid phone number.
Contact Address *
STATEMENT OF INTENT
Why are you interested in this program?*
What do you expect to learn from this program?*
REQUIRED DOCUMENTS
Transcript

Cancelof
Curriculum Vitae / Resume

Cancelof
A Copy of Passport

Cancelof

APPLICATION FORM

SAWASDEE THAILAND SUMMER PROGRAM 2024 (BATCH B 27 AUG - 9 SEP 2024)
DECLARATION

I declare that the information on this application is complete and correct. I will provide original documentation as requiredand acknowledge that the provision of incorrect information or documentation or the withholding of relevant information or documentation relating to this application may result in cancellation of any arrangement by Mahidol University. I agree and consent to Mahidol University collecting, using, and disclosing personal information such as full name(s), address (es), contact details, and name of institution. I agree and consent to Mahidol University recording pictures/videos which shall be used by Mahidol University for academic-related purposes only.
Term and Conditions*

I have read and agree to Mahidol University's Terms and Privacy Policy
Date*

MonthDayYear
Date
Remarks:

1. Pick up service from the airport will be provided.

2. Program can not be conducted if there are less than 10 participants.

3. All applicants are requested to make the payment. Please also send a copy of the transferslip to the International Relations Division, Mahidol University.
Bank Details

A/C Name: Global Special Projects

Bank Name: Siam Commercial Bank (SCB)

Branch: Mahidol University, Salaya Campus

Address: 25/25 Mu 5 Phutthamondon Sai 4 Road Sub District Nakhorn Pathom, Salaya, Phutthamonthon District, Nakhon Pathom 73170

Bank A/C: 333 - 271161 - 8

Swift Code: SICOTHBK

Note: Please do not make any payments until you receive an acceptance email from us.
Payment*

Will be paid by myselfWill be paid by home university
For more information

International Relations Division Mahidol University

Tel: +66 2 849 6235 Fax: + 66 2 849 6237

Email: sawasdee.mahidol@gmail.com

Facebook: http://www.facebook.com/OPINTER.mahidol
Should be Empty:

APPLICATION FORM

PERSONAL INFORMATION

EDUCATIONAL INFORMATION

EMERGENCY CONTACT PERSON

STATEMENT OF INTENT

REQUIRED DOCUMENTS

APPLICATION FORM

DECLARATION