CPHS Graduate Checklist Form (Doctor Degree)

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CPHS Graduate Checklist Form (Doctor Degree)

Please submit this form, you will receive the form via email, and send to CPHS Librarian for their signature. After that, send the form and documents via email or print out to the Academic Administration Office (12th FL)

Name *

*** Example : Mr./Mrs./Ms. A ***

ชื่อ-นามสกุล ภาษาไทย *

*** นาย/นาง/นางสาว ...... ***

***For international student applicants, please provide your name in English again, even if initially entered in Thai***

Student ID *

*** Example : 67 12345 6XX ***

E-mail *

Phone *

Address *

***Current Mailing Address in your country (สำหรับคนไทยให้เขียนที่อยู่เป็นภาษาไทยให้ชัดเจน)***

Examination & Result

Program *

Please choose only one answer.

Public Health

Public Health Science

Date of Thesis Examination
*

YYYY

Result
*

*** Pass/Good/Very Good ***

GPAX
*

*** Example 3.33 ***

Publication

First Journal's name
*

First Volume, Number, Year or Article DOI
*

First Index
*

Second Journal's name

Second Volume, Number, Year or Article DOI

Second Index

Conference Certificate (If any)

First Conference Title

First Hosting Organization

Second Conference Title

Second Hosting Organization

Submit

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