2+1 Industry-Academia Collaboration Program, 2019 (PENS Students)
program list: tick ONE program ONLY
Name
Your answer
Identification No
Your answer
Passport No. (if already have)
Your answer
Birthday
MM
/
DD
/
YYYY
Sex
Telephone
Your answer
Marital Status
Home Address
Your answer
Email
Your answer
Whatsapp Number
Your answer
Parent's name/Relationship
Your answer
Mobile of Parents
Your answer
Previous Education
Your answer
School Name
Your answer
Major
Your answer
Graduate Date
MM
/
DD
/
YYYY
School's City
Your answer
TOEFL Score
Your answer
IELTS Score
Your answer
TOEIC Score
Your answer
Else
Your answer
Upload Files Requirement:
1. ID card scan file
2. 2+i program application form with signature
3. Diploma certificate scan file
4. Academic transcript scan file
5. Certificate of English Proficiency Examination
6. Autobiography
7. Study plan

For further information please visit:
http://pico.pens.ac.id/2019/08/29/2i-industry-academia-collaboration-program-2019/
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