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King Mongkuts University of Technology Thonburi

Application Form of 2B-KMUTT CAMP 2017

**Please ensure correct and complete data are filled in to the application form**

1. Personal Background

Passport Number/ Student ID. ..

Schools Name........................................................................................................................
Full Name (English) .................................................................................................................
Nickname(English)................................. Date of Birth (D/M/Y)................................ Age...........Years Old
Weight........Kg. Height..........................................Cm. Blood Type.................................
Nationality..................................... Race......................................... Religion..........
Please identifying types of food sensitivity (Food Allergy and Food Intolerance)
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Congenital Disease...................................................................................................................................
Hobby.......
Address No....................... Road.............................................Sub-District................................................
District.................................................................. Province.......................................................................
Zip Code................................ Telephone No. ............................................................................................
Mobile Phone No. .............................................................E-mail.....
Fathers Name.............. Status Alive Died
Occupation Civil Servant State Enterprise Officer Employee
Business Owner Farmer/Fisherman Government Officer
Government Employee Freelance None of Occupation
Other (Identify)...........................................................................
Position...............................................................................................................
Mothers Name.............. Status Alive Died
Occupation Civil Servant State Enterprise Officer Employee
Business Owner Farmer/Fisherman Government Officer
Government Employee Freelance None of Occupation
Other (Identify)...........................................................................
Position...............................................................................................................
Family Status Together Separate Divorce
Scholarship Ever Never
Total Amount of the Previous Scholarship...
Received Date/Month/Year................................................................................................
Scholarships Name.............................................................................................................

2. Education Background
Level of currently studying Grade 10 Grade 11
Vocational Certificate 1 Vocational Certificate 2
Major..................................................................................
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Schools Address Sub-District................................... District........................................

Province............................................................................
Zip Code.............................................. GPA..................................................

3. Science Field of Interesting (Research Group)

3.1 Which research study are you interested in? (Choose one field of research study)
Group 1 Power, Electrical and Electronic Engineering
Group 2 Robotic, Automation, Mechanical and Manufacturing
Group 3 Information Technology and Computer Engineering
Group 4 Multimedia, Art and Architecture
Group 5 General Science and Food Technology
Group 6 Civil and Transportation

Reason:
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3.2 When you have joined this camp, which topic are you interested in? (Please describe in detail)
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4. Comments toward this camp

4.1 The reason you want to participate this camp:

(Please sorted the reason: 1=Most, 2=Moderate , 3=Lowest)
want to have experience in research work.
want to improve my potential.
want to be researcher/ scientist
want to know more about KMUTT
want to have further study in KMUTT
want to use the free time to take advantage in the summer vacation.
4.2 Where do you receive this camp information? (Choose more than 1)
Teacher Father/Mother Parent Senior Classmate
Website...................................................... Newspaper/Television
Other (Identify)..................................................
4.3 Who has the most importance to you deciding to join this camp?
Myself Father/Mother Teacher Friends
Other (Identify) ..................................................
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5. Other special talent

Athletes
Used to be National Team Athletes / District / School / Other (Specify)
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Leadership
Used to be the Student President / Club President / Chairman the project / Other (specify)
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Innovation
Used to create inventions / create other project words/ submitted inventions (Specify the project
works name and project)
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Art and Culture
Specify the music instruments you can play.
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Games
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6. Project or Craft
Write a brief summary of what project or craft you have done and why you are interested in. (It is
inessential that you submitted to the contest. It might be a hobby at home or at school. If you have
many project works, please choose one of your favorite.
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Required Documents
Documents to apply this camp. Sorted as follow:
1. Curriculum Vitae (CV)
2. A letter of recommendation from guardian
3. A letter of recommendation from teacher/ lecturer
4. Application form with picture 1*1 inch at the top right corner.
5. Transcript
6. Portfolio
7. Personal statement of motivation (Max. one A4 paper)
Why do you want to attend 2B-KMUTT camp 2017
What are your special characteristics, attitudes and talents?

Applicants Signature..................................................................
Date.................../...................../.........................

I certify that the information I have provided in this application form is true and
complete. If the university has found that the information is untrue, I agree to
withdrawal of the application form and others.

Admissions and Recruitment Office

E-Mail: admission@kmutt.ac.th