English language proficiency : ☐ Native language
Accreditation test (TOEIC, TOEFL, IELTS…) : _________________ Score : _________________
French language proficiency : ☐ Fluent ☐ Advanced ☐ Intermediate ☐ Beginner ☐ None
Accreditation test if applicable (DELF, DALF, TEF, TCF…): ____________________ Score : __________
⇒ Could you please state briefly what are your motivations and expectations for joining this
programme ? (in a separate document if you prefer) Please precise if you have any previous
experience/courses in formulation and cosmetics science :
⇒ How did you learn about ESCOM Chimie ?
☐ International relations of your university ☐ Your faculty at university
☐ Students from your university ☐ Other students
☐ Website ☐ Internet/ Social networks ☐ Flyer ☐ Other:____________
Documents to be sent with the application
Enrolment certificate from your home university for academic year 2019/2020
Copy of ID/Passport
Transcripts of records for all university studies
Proof of English language proficiency
Proof of French language proficiency if applicable
I hereby certify that the information given above is accurate and complete.
I understand that ESCOM Chimie reserves the right to withdraw any application, should any statement in
this form prove to be false.