EXCHANGE STUDENTS APPLICATION FORM 
SUPELEC DOUBLE-DEGREE STUDIES – AY 2015/16
Date réception
Programme
 DD (1A + 2A)
 DD (2A + 3A)
Avis DPI
Campus :
 GIF-SUR-YVETTE
 Voie Intl.
 METZ  RENNES
 Voie Fr.
Avis DE
PERSONAL DETAILS
Last/Family Name (as written on passport):…………………………
First/Second Name (s):…………………………
Gender: ☐ Male
☐ Female
Date of Birth : dd/mm/yyyy
Place of Birth:……………….………..
Nationality:………………………..
Contact address :……………..……………………
ZIP code, Country :…………………………
Town :…………………………
Address valid until: ../../….
Permanent address (if different):…………………………..
Phone :………………..
E-mail:……….@..............
Disability:
☐ No
☐ Yes - please specify : ……………..
(Photograph
500 ko max.)
SENDING INSTITUTION
Institution: …… ………………………… ……………………..
International Exchange Coordinator:………………………….
Address : Cliquez ici pour taper du texte.
Phone : …………………
Fax: ……………….
E-mail: ………….@...................
Coordinator signature
+ Seal of the institution
Exchange programme:
☐ ERASMUS+
☐ BRAFITEC
☐ Double Degree Agreement
☐ Exchange Agreement (other)
Contact for sending the transcripts :
E-mail: ………….@...................
Postal address (if hardcopies are requested):………………………….
- Incoming AppForm / Double Degree Studies / Avril15 / page 1 –
CENTRALESUPELEC - Campus de Gif
Plateau de Moulon - 3 rue Joliot Curie, F-91192 Gif s/Yvette cédex, France
ACADEMIC BACKGROUND
High School Diploma
Name of the High School :………………………..
Awarding date : dd/mm/yyyy Country : ……………..
☐International high school degree ☐International/EU Bac.
Higher Education studies
Number of years (higher education) before arrival at CSupélec: ☐2
☐French Baccalauréat
☐3
☐4
☐5 ☐5+
Highest degree obtained (if any) : ……………………….
Name of the institution :……………………………………
Awarding date : dd/mm/yyyy
Country : …………….
Current studies (diploma/degree): ……………………………….
Total number of credits (ECTS or local - please precise : …………..)
 already obtained when applying: …... ECTS
…... local credits
 expected by the end of this academic year: ….. ECTS …... local credits
Cumulative GPA :………..
Global Average Grade : ………….
LANGUAGE SKILLS
Spoken languages
Native language(s) : …………………..
Other(s) : ………………...
Self-assessment CECR level
French
English
!!! Warning : real beginners may face severe
difficulties during laboratories and elective courses
☐
☐
A1 - Beginner
☐
☐
A2 - Elementary
☐
☐
B1 - Intermediate
☐
☐
B2 - Upper intermediate
☐
☐
C1 - Effective Operational Proficiency
☐
☐
C2 - Mastery
☐
☐
A0 – Real beginner
Basic user
Independent user
Proficient user
NB : Official test or certificate of Language proficiency is requested for the application
- Incoming AppForm / Double Degree Studies / Avril15 / page 2 –
CENTRALESUPELEC - Campus de Gif
Plateau de Moulon - 3 rue Joliot Curie, F-91192 Gif s/Yvette cédex, France
DOUBLE DEGREE PROGRAMME (DD)
The DD programme is open to students applying within the framework of a special
agreement between their home university and Supélec. Please contact your institutional
coordinator to define the appropriate programme (1A+2A or 2A+3A) before filling the form.
Please thick the chosen programme and pathway for your first year of DD:
☐
DD (1A+2A) : 1st & 2nd Year of Supélec Engineering programme
.
☐ International pathway
/
Gif campus only (DD students will automatically be directed to
a French pathway for their second year of studies).
☐ French pathway
☐ Gif campus
☐ Metz campus
☐ Rennes campus
☐ No preference
☐
DD (2A+3A) : 2nd & 3rd Year of Supélec Engineering programme
.
NB: Assignments in 3rd year are made by the end of the 2nd year of engineering studies
for ALL student according to students’ requests, and depending of applicants results
before selection and the number of available places.
☐ International pathway
Gif campus
/
☐ French pathway
☐ Gif campus
☐ Metz campus
☐ Rennes campus
☐ No preference
Courses content :
1st and 2nd Year of Supélec Engineering programme (all campuses): in-depth overall engineering
training in electronics, telecommunications, computer science and signal processing > Common core
courses, laboratory work, projects, elective courses.
3rd year of Supélec Engineering programme: specialization year > Major and minor courses,
seminar, projects.
Languages :
/
International Pathway (1st and 2nd year of engineering programme, Gif campus only):
most of the core courses are taught in English. Exercises can be attended in French or English
upon request. Laboratory studies and elective courses are usually held in French.
Free French courses (as Foreign Language) are offered to foreign students for the duration of
their stay in our school. NB : B2 level in French is requested by the end of the double-degree
programme to graduate the engineering diploma.
- Incoming AppForm / Double Degree Studies / Avril15 / page 3 –
CENTRALESUPELEC - Campus de Gif
Plateau de Moulon - 3 rue Joliot Curie, F-91192 Gif s/Yvette cédex, France
APPLICATION DEADLINES
 SUPPORT MATERIALS TO ATTACH TO THE APPLICATION:
 Curriculum Vitae (preferably in French)
 Personal Statement (preferably in French - describe your academic interests and
reasons for applying)
 Official certificate of French Language Proficiency as TCE or DELF test
 Official transcript of records from each institution of higher education attended (with
official French or English translation)
 Photocopy of secondary school diploma + certified translation
 Photocopy of identity card/passport or birth certificate + certified translation
 TIMETABLE FOR APPLICATION (FALL SEMESTER, FULL ACADEMIC YEAR)
Please note that students must first be officially nominated by the home university
exchange office by e-mail, specifying:
 Name, Surname and email of the student
 Exchange programme
 Period of stay
Closing date for receiving the application
May 15, 2015
Decision on admission
July 10, 2015
Communication of decision to students
July 15, 2015
Students acceptance due
August 24, 2015
 PLEASE SEND YOUR APPLICATION BY EMAIL (NO HARD COPY REQUESTED) TO:
Xavière MARCY (Ms.)
International Affairs & Partnerships
Xaviere.Marcy@centralesupelec.fr
Any further question ? Feel free to contact us !...
I certify that all information in this application is true and complete. I understand that misrepresentation may be
cause for cancelling my admission. I understand that all credentials and documents I submit are subject to a
treatment designed to manage the processing of my application and my arrival in the host university.
The recipients of these data are the Direction of Studies of CentraleSupélec, and “Cercle Europe” (non-profit
association which is part of the Board of European Students of Technology, “BEST” and get involved in the
CentraleSupélec student life by organizing some activities such as the reception of the foreign students).
According to the Data Protection French law, I has a right to access and correct information about me. I can
also, for legitimate reasons, oppose to the communication of my data to the group “Cercle Europe”.
If I wish to exercise this right and obtain information about me, I may ask to Xaviere Marcy (Ms.) –
International Affairs & Partnerships Xaviere.Marcy@centralesupelec.fr.
Date:
Signature of Applicant:
- Incoming AppForm / Double Degree Studies / Avril15 / page 4 –
CENTRALESUPELEC - Campus de Gif
Plateau de Moulon - 3 rue Joliot Curie, F-91192 Gif s/Yvette cédex, France