Ek 1 TRKYE CUMHURYET HKMET BURSLARI BAVURU FORMU APPLICATION FORM FOR GOVERMENT SCHOLARSHIPS PROVIDED BY THE REPUBLIC OF TURKEY

FORMULE DE DEMANDE DES BOURSES DU GOUVERNEMENT DE LA REPUBLIQUE DE LA TURQUIE I-BURSUN TR / TYPE OF SCHOLARSHIP / TYPE DE LA BOURSE ( Akademik Yl / Academic Year / Anne Scolaire : 2010 2011) Ltfen kutulardan birini iaretleyiniz / Please mark only one of the box / Prire de faire un seul choix Lisans / Undergraduate / Etudes ssuprieures Aratrma / Research / Recherche Yksek Lisans / Master / Master Doktora / Doctorate (Ph.D) / Doctorat

Trk Dili Yaz Kursu / Turkish Summer Course / Cours dt de la langue Turque

II-ADAY BLGLER / PERSONAL INFORMATION / RENSEIGNEMENT PERSONNEL Pasaporta gre doldurunuz / Fill out personal informations as seen on your passport / Remplacez selon votre passeport 1- Ad 2- Doum yeri First name(s) Place of birth Prnom(s) Lieu de naissance 3- Soyad 4- Doum tarihi Family name Date of birth / / 19 Nom de famille Date de naissance 5- Baba ad 6- Anne ad Fathers name Mothers name Nom de pre Nom de mre 7- Meden hli 8- Cinsiyeti Marital status Bekr / Single / Clibataire Gender Bayan / Female / Femme Etat civil Sexe Evli / Married / Marie(e) Erkek / Male / Homme 9- Uyruu 10- lke ad Citizenship Name of country Nationalit Nom de pays 11- Bedensel Engeli Var ise ad nedir? Physical disability Var / Yes / Oui If yes, please specify? : Handicap corporel/le Si vous avez, quest-ce que cest? Yok / No / Non 12- Pasaport no Verili tarihi Passport number Issue date : Numro du passeport Date de validation Tel / Telephone / Tlphone 13- Adres Address Adresse Cep / Mobile phone / Phone de portable E-posta / E-mail / E-poste III-ETM DURUMU / EDUCATIONAL BACKGROUND / ETUDES EFFECTUEES Seviye Blm/Bran Level Okul ad / School name / Nom de l'cole Department/Branch Niveau Section/Branche Lise High school Lyce niversite University Universit Yksek Lisans Master Master Doktora Doctorate (Ph.D) Doctorat : : :

Fotoraf --Attach Recent Passport Photograph --Fixer ici Une phopographie Rcente

Sresi Valid until Priode

lke ad Country name Nom de pays

Balang tarihi Starting date La date de dbut

Mezun olduu tarih Date of graduation La date du diplme

Mezuniyet derecesi Graduation grade Degr du diplme

IV - BLD DLLER / KNOWN LANGUAGES / CONNAISSANCE LINGUISTIQUE (Mkemmel - yi - Orta / Excellent - Good - Fair / Excellente - Bonne - Moyenne) Dil / Languages / Langues Okuma / Reading / Lire Anlama / Comprehension / Comprhension Konuma / Speaking / Parler Yazma / Writing / Ecrire 1 2
TMER diplomas (Trke renim Merkezi) / TMER diploma (Turkish Learning Center) / TMER diplme ( Cours de Turc) : Var / Yes / Oui Yok / No / Non

V- BU KISMI LISANS, YKSEK LSANS, DOKTORA VE ARATIRMA BURSUNA BAVURAN ADAY DOLDURACAKTIR THIS SECTION IS FILLED BY THE UNDERGRADUATE, MASTER, DOCTORATE AND RESEARCH APPLICANTS CETTE SECTION EST RESERVEE AUX CANDIDATS QUI DEMANDENT DES BOURSES POUR LE LICENCE, LE MAITRISE, LE DOCTORAT ET LE RECHERCHE renim Kurumu Tercihi / Education Institution Preference / Cette Section Est Reserve niversite Ad Faklte-Enstit Ad Blm-Ana Bilim Dal The name of University The name of Faculty or Institute Department Main Branch of Science of Faculty or Institute Nom de I Universit Le nom de Facult ou Institut Succursale principale de la Science de la Facult ou Institut 1 2 3 VI- BU KISMI TRK DL YAZ KURSUNA BAVURAN ADAY DOLDURACAKTIR THIS SECTION IS FILLED BY THE TURKISH SUMMER COURSE APPLICANTS CETTE SECTION EST RESERVEE AUX CANDIDATS QUI DEMANDENT DINSCRIPTION POUR LES COURS DE TURQUE EN ETE Ltfen ehir ismi yaznz / Please indicate three cities of your choice / SVP, indiquez trios villes (Ankara, zmir, Burs a, stanbul, Kayseri, Antalya, Samsun) 1 2 3

VII- BU KISMI ARATIRMA BURSUNA BAVURAN ADAY DOLDURACAKTIR THIS SECTION IS FILLED BY THE RESEARCH APPLICANTS CETTE SECTION EST RESERVEE AUX CANDIDATS QUI DEMANDENT DES BOURSES POUR LA RECHERCHE
Trkiyede yapmak istediiniz almay aklaynz / Please explain in detail the studies you are planning to undertake in T urkey / Prire dexposer en dtail les tudes que vous comptez effectuer en Turquie

-T.C. Hkmet burslar artnamesini okudum, bavuru formunu doru ve eksiksiz doldurdum -I have read the terms and conditions for the Turkish Government scholarships. I confirm that information in the application form is right and complete -Jai lu les conditions de bourses du Gouvernement Turc. Jai rempli juste et accompli

Tarih / Date / Date

: / / 20

mza / Signature / Signature :

Adres / Address / Adresse : Mill Eitim Bakanl, Atatrk Bulvar No: 98, 6.Kat, C Blok 06648 - Bakanlklar / ANKARA / TRKYE, Internet / Web / Web : http://digm.meb.gov.tr Telefon / Telephone / Tlphone : + 90 312 413 17 02 (Sn. / Mr. / M. Hasbi ACAR), Faks / Fax / Fax : + 90 312 418 82 89, , e-posta / e-mail / e-poste : digmib@meb.gov.tr