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Gredlt-Transfer-Form of Tha i -ASEAN Student Exchange Program
1. STUDENT'S PERSONAL DATA (To be completed by the student. The Information provided in this form will be treated in-confidence by the home and host institutions. Data from the form may be used for staiistical purposes, but only in an aggregated and non-identiflable manner.)
Last name: First name:
Home institution:_
Date of birth:
Country:
Sex:
Student Identification Number:
2. DETAiLS OF THE PROPOSED THAI-ASEAN STUDENT EXCHANGE PROGRAM (To be completed and signed by student and counter-signed by the academic staff members of both Institutions.)
Host institution: Country:
Host Institution
Home institution
Host InstitutJon Home Institution Host
Institution' Home
Institution
(If necessary, continue the list on a separate sheet, including any changes to be approved program, which must be signed and counter-signed)
Student's signature: Date:
We confirm that the proposed program of study is approved.
(Home institution staff member) INSTITUTION S T A M P
Date:
(Host institution staff member) INSTITUTION S T A M P
Date:
3. TRANSCRJPT OF THAI-ASEAN STUDENT EXCHANGE PROGRAM RESULTS
-iome ir
Code Title Duration Grade Credits Grade Credits
4.- CERTIFICATION OF THAI-ASEAN STUDENT EXCHANGE PROGRAM RESULTS
Host institution
Signed:
(Signature of registrar/dean/administration officer)
Date:
INSTITUTION STAMP
NOTE: This document is not valid without the signatures of the registrars/deans/ administration officers and stamps of the host and home institutions.
