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passport size photo

in cooperation with Massachusetts Institute of Technology

Application for Graduate Admissions


Please write clearly or type. Applying for the graduate program:

MSc in ________________________________________ for academic year 2010.


(The academic year begins in September each year but students are expected to report in July for
preparatory courses)
Family Name (as in
Passport)
Other Name(s) (as in
Passport)
Date of birth (mm/dd/yy)

Nationality
(and passport number if not UAE national)
Place a √ where appropriate
Sex Male Female

Marital status Married Single


If married number of children

Correspondence address

Daytime phone Evening phone e-mail address

Note: all correspondence will be via e-mail except for a formal letter of admissions, if accepted

List all colleges and universities attended and actual name of degree received/expected
(list most recent first):
Name of college/university Dates attended (mth/yr) Degree received

GRE
Date taken/to be taken:

Verbal: Quantitative: Analytic:

TOEFL or IELTS
Date taken/to be taken Score:

Masdar Institute of Science and Technology, P.O. Box 54224, Abu Dhabi, United Arab Emirates
Tel: +971 2 6988122 Fax: +971 2 6988121
List language of instruction in:
Primary school
Secondary school
University
Graduate school

Names and contact details of three persons (preferably two from academia) whom we can
contact to obtain an evaluation of you
Name Title/Position & Institution/Company e-mail address

Record of courses taken in preparation for graduate study


Course title Year taken Grade
Submit a copy of your undergraduate/graduate transcripts
OR
Type it out on a separate sheet of paper and attach it to this
application

On a separate sheet of paper please write your statement of objectives:


(Please give your reasons for wishing to do graduate work in the field you have chosen.
Include your particular interests and show how you and Masdar will be able to complement
each other in your objectives.)

I certify that all the above information is true and that my admission (if accepted) into the
Institute is conditional subject to verification of the above documents prior to registration.
I understand that admission into the Institute is subject to all relevant immigration laws
and requirements of the United Arab Emirates in securing a valid visa.

Signature Date (mm/dd/yy)

Notes:
 For application, any copies of documents (e.g., transcripts) submitted do not have to be
original or certified true as yet. If you are accepted, it will be conditional subject to
verification of all necessary documents by the first day of classes.

 Incomplete applications will not be processed.

Masdar Institute of Science and Technology, P.O. Box 54224, Abu Dhabi, United Arab Emirates
Tel: +971 2 6988122 Fax: +971 2 6988121

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