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Contact Details

( Required field ) 
First Name:   
 Middle Name: 
 Last Name:   
First Name (thai) :   
 Last Name (thai) :   
Date of Birth:
/ / 		Nationality:
 
Position (English):
 		 (Thai):
 
Company Name (English):
 		 (Thai):
 
Company Address:
Company website:
Telephone:
 Fax:
Email: 
  		 Mobile: 
Home Address:
Telephone:
 Fax:
List language other than English in which you are fluent:

Personal Information

Please describe any health condition that requires special attention
In case of emergency, contact (Name, Address and Phone Number)

Education
Institution Attended: Major/Degree/Cert. Conferred: Year Received:
Have you previously attended any other university executive education program? If so, please provide details:
Name of University: Program Name: Dates Attended:

Organization Information (Present Employment)
Name of Organization:
Sale per year:
 Net Assets:
Number of Employees:
 Number of Products/Services:
Sector :
Type of Organization:

Areas of Management
Please indicate your proficiency in the following areas. "High" = major job reponsibility and/or formal education, "Some" = working familiarity, and "Little" = unfamiliarity.
Little Some High
Information Technology
Marketing
Organization Behaviour
Finance
Quantitative Skills
Human Resources/Industrial Relations
Strategic Management
Please check your current function (Check one only):

Salary
Monthly salary, including bonus:

Experience
Please describe your career, chronologically, including positions held before working with your current employer.
Organization name Position held Years of experience

Information about Current Position
Describe your present reponsibilities, including the number of employees under your supervision and/or provide a copy of your position description.*


Describe your position as it relates to the total organization, including your reporting responsibilities and the number of levels between your position and that of the organization's top management. Please include an organization chart.*

*please mail or fax to Executive Education Office

Expectations
What do you expect to accomplish by taking the Senior Executive Program? What do you expect to learn and how do you expect to apply it? Do you anticipate any specific benefits? If so, please state them.

Sponsor's Information
Sponsor Name:
Title:
Company:
Address:
City:
Country:
Telephone:
Email:
 
A sponsor may voluntarily add any information deemed appropriate to action this application, but no statement or endorsement is required.

It is understood that during attendance at the Senior Executive Program, the participant will be free of other duties and will not leave except in emergency situations. It is further understood that any cancellation must be received in writing from the applicant's sponsor.
Please tell us how you heard about the Senior Executive Program (check all that apply):
       
       
         
       
       
Sasin reserves the right to change without notice any statement concerning but not limited to rules, policies, tuition fees, curricula and courses.




 
     

This Application Form should be completed and submitted online, with attachments sent via fax or mail to:

Senior Executive Program
Sasin Graduate Institute of Business Administration of Chulalongkorn University
Sasa Patasala Building
Phyathai Road, Bangkok 10330, Thailand.

Tel: (66) 0 2218 4004-8 Ext. 164-167
Fax: (66) 0 2216 1314

E-mail: ExecEd@sasin.edu

Sasin Graduate Institute of Business Administration of Chulalongkorn University
Sasa Patasala Building, Soi Chula 12, Phyathai Road, Bangkok 10330, Thailand
Email: webmaster@sasin.edu