Admission Manual Online

MESSAGE FROM THE RECTOR

UPH Online Admission Manual Academic Year 2016/2017 i

Dr. (Hon) Jonathan L. Parapak, M.Eng.Sc.Chancellor/Rector

Lippo Village, February 24th, 2015

Welcome to UPH Global Campus,

Selamat datang di UPH Global Campus,

This Admission Manual Book has been prepared to provide

you with comprehensive information regarding UPH

Undergraduate Programs and enrollment procedures.

Buku Petunjuk Pendaftaran ini dipersiapkan untuk memberikan

informasi menyeluruh mengenai Program Sarjana Strata 1 dan

prosedur penerimaan mahasiswa baru.

We are eager to have you in the UPH family and introduce you

to the vision of our university, which is: True Knowledge, Faith

in Christ, and Godly Character.

Kami ingin Anda dapat bergabung dengan kami dan

memperkenalkan Anda tentang visi UPH, yaitu: True

Knowledge, Faith in Christ, dan Godly Character.

UPH is committed to serve you in the best possible ways, by

providing a holistic and internationally qualified education, and

world-class facilities, technology, and infrastructure. UPH also

prepares students to be globally respected and appreciated by

modern industries and businesses.

UPH berkomitmen memberi Anda pelayanan terbaik dengan

menyediakan pendidikan holistik dengan kualitas internasional,

fasilitas, teknologi serta infrastruktur kelas dunia.

UPH juga mempersiapkan mahasiswa agar dapat diakui secara

global dan diapresisasi oleh industri dan bisnis modern.

We welcome you to UPH Global Campus in Indonesia

where learning is fun and excellent holistic education

is open to you.

Selamat datang di UPH Global Campus, dimana kami

menyediakan proses pembelajaran yang menyenangkan

melalui pendidikan holistik terbaik di Indonesia.

I pray that God will richly bless you during your study at UPH.

Saya berdoa agar Tuhan selalu memberkati Anda selama

masa kuliah Anda di UPH.

TABLE OF CONTENT

UPH Online Admission Manual Academic Year 2016/2017ii

Message from The Rector i

Table of Content ii

Online Admission Process 1

Important Notes 2

Admission & Scholarship Schedule 3

Undergraduate Program 4

Admission Requirements 5

Additional Requirements for Scholarship 6

Admission Test Regulations 7

Admission Statement 9

Scholarship Application Form 11

Art & Sport Scholarship Recommendation Form 12

Medical School Form 13

Health Declaration Form 14

Conservatory of Music Application Form 15

Conservatory of Music Recommendation Form 16

Full-English Class Application Form 17

Psychology Program Application Form 19

ONLINE ADMISSION PROCESS

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To complete application process please proceed the payment in accordance to Offering Letter.E-payment procedure is available on http://uph.edu/prospective-students.html.

Untuk menyelesaikan proses pendaftaran silahkan lakukan pembayaran sesuai dengan Offering Letter.Prosedur e-payment tersedia di http://uph.edu/prospective-students.html.

FORM NUMBER IS REQUIRED TO PROCEED THE PAYMENT. PLEASE FIND YOUR FORM NUMBER IN YOUR OFFERING LETTER.

NOMOR FORMULIR DIBUTUHKAN UNTUK MELAKUKAN PEMBAYARAN. NOMOR FORMULIR DAPAT DITEMUKAN DALAM OFFERING LETTER ANDA.

FORM NUMBER NOMOR FORMULIR

IMPORTANT NOTES

UPH Online Admission Manual Academic Year 2016/201702

Application will be processed if the data and documents have met the requirementsand been accepted by UPH.Aplikasi akan diproses apabila data dan dokumen sudah diterima lengkap oleh UPH.

Completed application will be processed within 14 working days.Aplikasi yang sudah lengkap akan diproses dalam jangka waktu 14 hari kerja.

Admission result will be announced by 2 (two) methods: Hasil akan diumumkan melalui 2(dua) metode:

Offering Letter posted on Online Admission Website1. Login to the following link: http://online-admission.uph.edu2. Choose Admission Result to see OFFERING LETTER

Offering Letter ditampilkan di website pendaftaran online1. Login ke link berikut ini: http://online-admission.uph.edu2. Pilih hasil pendaftaran untuk melihat OFFERING LETTER

Offering Letter sent to applicants address. Offering Letter dikirimkan ke alamat calon mahasiswa

1ST METHOD | METODE 1

2ND METHOD | METODE 2

If you need more detailed information, please contact us through:Apabila anda memerlukan informasi yang lebih detail, dapat menghubungi kami melalui:

UPH GLOBAL CAMPUSJl. M.H. Thamrin Boulevard 1100 Lippo Village Tangerang 15811 Indonesia

(021) 5470901 (021) 5460910 [email protected] www.uph.edu @uphkonsultasi

ADMISSION & SCHOLARSHIP SCHEDULE

Schedule may be subject to change, latest info please check www.uph.edu


Early Admission 1Early Admission 2

Outside Jabodetabek

Term 1Term 2Term 3Term 4

23 SEPT 201513 NOV 2015

13 NOV 2015

15 JAN 201604 MAR 201629 APR 201601 JUL 2016

10 OCT 201528 NOV 2015

28 NOV 2015

30 JAN 201619 MAR 201613 MAY 201615 JUL 2016

SUBMISSION DEADLINE ADMISSION TEST

Best Student

Term 1Term 2

Term 1Term 2

28 AUG 2015

11 SEPT 201530 0CT 2015

28 AUG 201515 JAN 2016

31 AUG - 11 SEPT 2015

14 SEPT - 02 OCT 201502 - 13 NOV 2015

TBATBA

SUBMISSION DEADLINE INTERVIEW SESSION

-

--

05 SEPT 201530 JAN 2016

ADMISSION TEST

28 SEPT 2015

19 OCT 201530 NOV 2015

12 OCT 201514 MAR 2016

ANNOUNCEMENT

ADMISSION SCHEDULE 2016/2017

SCHOLARSHIP SCHEDULE 2016/2017

Early Admission 1Early Admission 2

Outside Jabodetabek

Term 1Term 3

07 OCT 201525 NOV 2015

25 NOV 2015

27 JAN 201610 MAY 2016

10 OCT 201528 NOV 2015

28 NOV 2015

30 JAN 201613 MAY 2016

SUBMISSION DEADLINE ADMISSION TEST

ALL MAJORS EXCEPT MEDICINE

MEDICINE

ALL MAJORS EXCEPT MEDICINE

MEDICINE

SUBMISSION DEADLINE INTERVIEW SESSIONADMISSION TEST ANNOUNCEMENT

1. Double Degree and Dual Degree Programmes are listed based on information by May 2015. 2. Prospective Students are not required to choose Double Degree or Dual Degree in the first year. These programmes are subject to rules and regulations applied.3. Prospective Students must decide and choose Joint Degree from the first term and complete 2 (two) application package (UPH & RMIT Application).

UNDERGRADUATE PROGRAM


* Available also in Online Learning *** Only for English Education** For admission requirements and further information, please call : Faculty of Nursing : (021) 546 0901 ext. 3437 Teachers College : (021) 546 6057 ext. 2613/2637

-

- -

-

-

Biology Education, Economics Education, English Education,

Mathematics Education, Primary Education

-***

HIGH SCHOOLMAJOR

Management

Accounting

Medicine

Applied Communication Sciences*

Political Science

Law

Architecture

Visual Communication Design

Interior Design

Applied Mathematics

Biotechnology

Electrical Engineering

IndustrialEngineering

Civil Engineering

Food Technology

Information System

Informatics

Computer Technology

Psychology

Music

Hospitality Management

Travel Industry Management

Philosophy

Government andGlobal Affairs

Product Design

-

- -

- --

- -

- --

- --

-

- --

--

- --

- --

- --

--

--

--

--

- --

- --

- --

Nursing -

--

-

-

-

-

-

FACULTY MAJOR FULL ENGLISH CLASSDOUBLEDEGREE

DUAL/JOINTDEGREE

-

- -

IPA & IPS

IPA

IPA

IPA

IPA

IPA

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA & IPS

IPA

Faculty of Education-Teachers College**

Business School

Faculty of Social and Political

Sciences

School of Law

School of Design

Faculty of Science and Technology

Faculty of Computer Science

Faculty of Psychology

Conservatory of Music

Medical School

School of Hospitalityand Tourism

School of Philosophy& Divinity

Faculty of Nursing and Apllied Health Sciences**

Computer TechnologyApplied Mathematics

Information Systems

InformaticsManagement

Accounting

Applied Mathematics

Management

A copy of valid ID Card (KTP/Kartu Pelajar/SIM/Passport)

ADMISSION REQUIREMENTS

DOCUMENTSNO NationalCurriculumIGCSE

O LevelIGCSE

A/AS Level Others

Admission Statement (see page 9)

A copy of TOEFL IBT /IELTS Certificate with minimum score 61 for TOEFL IBT or 5.5 for IELTS (only for non Indonesian passport Holder/WNA)

A legalized copy of Academic Records : Grade 10 and 11

Full-English Classes Application Form (see page 17)

Stamp duty Rp.6000,- (put on Admission Statement page 9)

A legalized copy of O Level/A Level/AS Level IGCSE Report/Certificate (min 5 subject)

A legalized copy of IB Predicted

1

2

3

4

5

6

7

8

9

InternationalBaccalaureate

COMPULSORY REQUIREMENTS FOR ALL MAJORS

A legalized copy of Junior High School National Examination/UN SMP


DOCUMENTSNO

Conservatory of Music Application Form & Conservatory of Music Recommendation Form (see page 17-18)

1 (one) video audition in WMA/MP4/AVI format for each concentration

For procedure and audition requirements (include sample of Theory and Solfeggio Exam), please see http://music.uph.edu/admission/procedure.html

1

2

3

A 500 word English Essay about Why I am Interested in Medicine and How I Will Use It to Provide Good Health Care for the People of Indonesia in the Future.

DOCUMENTSNO

Medical School Application Form & Health Declaration Form (see page 15-16)

Color Blindness Test Certificate by Ophthalmologist / Oculist

1

2

3

ADDITIONAL REQUIREMENTS FOR SCHOOL OF DESIGN

DOCUMENTSNO

One page Essay: Why I Choose X Major Study Program

Color Blindness Test Certificate by Ophthalmologist/Oculist

Architecture: 3 (three) hand drawings/portfolios with Drawing Theme: Free, Interior, and Exterior

DKV: 3 (three) hand drawings/portfolios with Media of Portfolio: Pencil, Paint, and Free Media

Product Design: 2 hand drawings with Media: A3-size Paper & Pencil. Industry Based Design (gadget, home appliances, automotive, furniture, stationary, etc) Handicraft based design (jewelry, furniture, etc). Both preferably an innovation, complete with the uniqueness explanation.

1

2

3

4

5

Interior Design: For portfolio requirements, please see interior.sod.uph.edu6

ADDITIONAL REQUIREMENTS FOR CONSERVATORY OF MUSIC

ADDITIONAL REQUIREMENTS FOR MEDICAL SCHOOL

2 Recent Photo size 3x4 using white collared shirt with blue background4

DOCUMENTSNO

Psychology Program Application Form (see page 19)1

ADDITIONAL REQUIREMENTS FOR FACULTY OF PSYCHOLOGY

AcademicAchievement

Category

LimitedFinancialCategory

ArtAchievement

Category

SportAchievement

Category

Scholarship Application Form (see page 11)

Copy of Family Card/Kartu Keluarga

A-500-word English Essay about:Why I Choose X Major at UPH as a Stepping Stone for My Career(Except School of Design and Faculty of Medicine)

Copy of achievement certificate in any fields

A statement letter of family financial condition, issued by: Church(for Christian/Catholic) or RT/RW/Kelurahan (for other religions)

ADDITIONAL REQUIREMENTSFOR SCHOLARSHIP

DOCUMENTSNO

1

2

3

4

5

6

7

8

9

10

11

12

13

14

Copy of electricity bill for the last 3 months

Copy of water bill for the last 3 months

Copy of landline telephone bill for the last 3 months

Copy of the last Pajak Bumi dan Bangunan (PBB) payment

Copy of Parents payslip of income

Art & Sport Scholarship Recommendation Form (see page 12)

Recent photo (postcard size) using team uniform(write your name, height and weight behind the photo)

Copy of sports certificate of performance(province/national/international level)

Recommendation Letter from Komite Olahraga National Indonesia (KONI)

COMPULSORY REQUIREMENTS FOR ALL MAJORS


ADMISSION TEST REGULATIONS

BEFORE THE TEST

1. Participant is required to wear proper attire and shoes.

2. Participant is required to bring their own stationery (pen, 2B pencil, eraser, and calculator), Admission Test Participant

Card and original ID card (KTP, driving license or other identification which has photograph of participant). Participant who does

not bring the requirements must report to the Admission Test Committee.

3. Participant must be present in the test room 30 minutes before the test begin. Participant who is late is allowed to

participate in the test without additional time.

SEBELUM UJIAN BERLANGSUNG

1. Peserta wajib berpakaian rapi, sopan, dan bersepatu tertutup.

2. Peserta wajib membawa alat tulis (pena, pensil 2B, penghapus, dan kalkulator) milik sendiri, Kartu Tanda Peserta Ujian

Saringan Masuk, dan kartu identitas asli (KTP, SIM atau identitas lainnya yang memuat pasfoto peserta). Peserta yang tidak

membawa perlengkapan tersebut, wajib melapor kepada panitia Ujian Saringan Masuk.

3. Peserta wajib berada di ruang ujian 30 menit sebelum ujian dimulai. Peserta yang terlambat diperbolehkan mengikuti ujian

tanpa ada penambahan waktu.

DURING THE TEST

1. Participant is prohibited to interact with other participants.

2. Participant is not allowed to leave the test room without permission from the supervisor.

3. Participant should stop doing the test when there is a time up notification.

4. Breaking the Admission Test Regulations will cause participants a disqualification from the test and cancellation

on the registration process.

SELAMA UJIAN BERLANGSUNG

1. Peserta dilarang berinteraksi dengan peserta lain.

2. Peserta dilarang meninggalkan tempat ujian tanpa izin dari pengawas.

3. Peserta wajib menghentikan pekerjaannya setelah ada pemberitahuan bahwa waktu ujian telah berakhir.

4. Peserta akan dianggap gugur dan dibatalkan proses pendaftarannya jika melanggar tata tertib Ujian Saringan Masuk.

IMPORTANT

Participants must not cheat during the Admission Test under any conditions. If UPH finds out later that the participant has

cheated on the test, then the participant will be terminated from UPH and no fees will be refunded.

PENTING

Peserta dilarang melakukan kecurangan saat Ujian Saringan Masuk. Apabila di kemudian hari diketahui bahwa mahasiswa aktif

telah melakukan kecurangan saat ujian, mahasiswa yang bersangkutan akan dikeluarkan dari UPH tanpa ada pengembalian

biaya kuliah yang telah dibayarkan.


potong disini


I, the undersigned:Saya yang bertanda tangan di bawah ini:

Form Number :Nomor Formulir

Full Name :Nama Lengkap

Hereby affirm that,dengan ini menegaskan bahwa,

1. I understand that the education program of UPH/STPPH is characterized by the Christian Faith, based on the Pancasila and UUD 1945. Mengetahui bahwa penyelenggaraan pendidikan di UPH/STPPH bercirikan iman Kristiani dan berdasarkan Pancasila dan UUD 19452. I will not engage in any conduct against the law; bring, consume, and/or distribute illegal drugs or alcoholic drinks. The right to be a student of UPH/STPPH will be denied should I fail the health examination/drug examination at any given time by UPH/STPPH. Tidak akan melakukan semua perbuatan yang melanggar hukum; membawa, mengkonsumsi serta mengedarkan obat terlarang (Narkoba)/minuman keras. Hak sebagai mahasiswa UPH/STPPH akan gugur bila tidak lulus dalam tes kesehatan/tes narkoba yang sewaktu- waktu akan dilakukan oleh pihak UPH/STPPH. 3. I am willing to participate in a blood/urine examination at any given time by UPH/STTPH. Bersedia melakukan tes darah/urine yang sewaktu-waktu akan dilakukan oleh pihak UPH/STTPH.4. All documents that I submit are legal. I am fully responsible for any consequences and willing to accept all sanctions for any INCORRECT information. Semua dokumen yang dikumpulkan ke UPH adalah sah. Saya bersedia menanggung segala sanksi apabila informasi yang saya berikan TIDAK BENAR. 5. I am willing to accept sanctions (Drop Out) from UPH/STPPH unless I can submit the copy of High School Certificate or High School Certificate Equivalency before the end of 2nd term, even though the tuition fee has been paid. Bersedia menanggung sanksi (dikeluarkan) dari UPH/STPPH jika tidak dapat menyerahkan fotokopi ijazah SMA Nasional/Surat Penyetaraan Ijazah sebelum term 2 berakhir walaupun sudah diterima dan membayar uang kuliah.6. For Faculty of Psychology: I acknowledge and agree to follow the curriculum in Faculty of Psychology that is enriched with Christian values. I am fully aware that there will be individual counseling as a prerequisite to continue study in the next terms (2nd term). Untuk Fakultas Psikologi: Saya mengetahui dan menyetujui untuk mengikuti pembelajaran di Fakultas Psikologi UPH yang diperkaya dengan nilai-nilai Kristiani. Saya menyadari sepenuhnya bahwa akan ada konseling pribadi sebagai prasyarat untuk melanjutkan pembelajaran pada term berikutnya (term 2).7. I understand that Double Degree and Dual Degree programmes will start after the first year of class. These programmes are subject to the applied rules and regulations . Saya mengerti bahwa program Double Degree dan Dual Degree akan dilaksanakan setelah tahun pertama perkuliahan, sehingga akan ada kemungkinan terjadi perubahan.8. I understand that if the quota of a class is full, UPH has the right not to accept any payment although it is before payment deadline. Saya mengerti bahwa jika batas maksimum kapasitas jumlah mahasiswa yang dapat diterima sudah tercapai, maka UPH berhak menolak pembayaran yang akan dilakukan meskipun belum mencapai batas akhir pembayaran.9. All payments transferred to Pelita Harapan Foundation are declared as the final decision, finalized by the depositor, cant be refunded for any conditions. Semua pembayaran yang telah disetor ke Yayasan Universitas Pelita Harapan dinyatakan sebagai keputusan akhir dari pihak penyetor dan tidak dapat ditarik kembali dengan alasan dan kondisi apapun.10. I along with my parents hereby acknowledged and confirmed our acceptance on the consequences of provisions number 9 as stated above and therefore we will not file any law suit in connection with provision number 9 above. Saya bersama dengan orang tua saya dengan ini menegaskan bahwa kami sudah mengerti dan menerima konsekuensi dari ketentuan point 9 di atas dan oleh karena itu kami tidak akan mengajukan gugatan hukum apapun di kemudian hari sehubungan dengan ketentuan nomor 9 tersebut di atas.11. All documents that I submit fully belong to UPH and UPH will not entertain requests to return the documents for any reason. Semua dokumen yang dikumpulkan sepenuhnya menjadi milik UPH dan tidak dapat dikembalikan dengan alasan apapun.12. I agree to abide by the Regulations stated by the University, both now and in the future. Bersedia mentaati Statuta, Peraturan Tata Tertib Kampus, dan peraturan lain yang telah dan akan diberlakukan.13. I have read, known, and understood the regulations and registration requirements stated in this Admission Manual.

Telah membaca, mengetahui, mengerti ketentuan dan persyaratan pendaftaran dalam Buku Petunjuk Admisi ini.

ADMISSION STATEMENTCopy 1 : Admission Office

Place | Tempat Date | Tanggal

PARENT/GUARDIANS SIGNATURE & FULL NAMETanda Tangan & Nama Lengkap Orang Tua/Wali

PROSPECTIVE STUDENTS SIGNATURE & FULL NAMETanda Tangan & Nama Lengkap Calon Mahasiswa

READ CAREFULLY BEFORE YOU SIGN! Bacalah dengan seksama sebelum Anda menandatangani!

Stamp Duty/MateraiRp. 6000

Please sign on the stamp duty/Harap tanda tangan di atas materai

,

potong disini





I certify that the above information is true and correct.Saya tegaskan informasi di atas adalah benar.

PROSPECTIVE STUDENTS SIGNATURE & FULL NAMETanda Tangan & Nama Lengkap Calon Mahasiswa

SCHOLARSHIP APPLICATION FORM

Social, Organizational or Leadership Activities

Aktivitas sosial, organisasi atau kepimpinan

Achievements (Senior High School Level)Penghargaan yang pernah diperoleh (di tingkat SMA)

(Please attach certificate that support this information)(Lampirkan fotokopi sertifikat sebagai bukti yang mendukung informasi ini)

Student Council Spiritual Activities

Martial Arts

Scout

Flag-raising Squad

Others,

Red Cross Youth Council

Sport

Choir/Vocal Group

Band/Orchestra

Language Club

Religious Activities at ChurchAktivitas keagamaan di gerejaIf you are Christian/Catholic, please fill the following information:Jika Anda beragama Kristen/Katolik, harap isi keterangan berikut ini:

Church :Nama Gereja

Address :Alamat Gereja

Join ministry/activities :Mengikuti kegiatan pelayanan

Academic Achievement | Prestasi Akademik Art Achievement | Prestasi Seni

Limited Finance | Kondisi Ekonomi Terbatas Sport Achievement | Prestasi Olahraga

SCHOLARSHIP APPLICATION FOR ALL CATEGORIES


PARENT/GUARDIANS SIGNATURE & FULL NAMETanda Tangan & Nama Lengkap Orang Tua/Wali

,

Scholarship Category | Kategori Beasiswa Please give tick (v) in your option | Silahkan berikan tanda (v) dalam pilihan Anda



Coach/Teacher Full Name :Nama lengkap Pelatih/Guru

High School/Institution Name :Nama Sekolah/Institusi

Please recommend this prospective student regarding his/her scholarship application:Mohon untuk merekomendasikan Calon Mahasiswa ini pada pendaftaran Program Beasiswa:



Height : cm Weight : kgTinggi Badan Berat Badan

Position in Team : 1. __________________________ 2. __________________________ 3. __________________________Posisi pada Tim

I certify that the above information is true and correct.Saya tegaskan informasi diatas adalah benar.

Coach/Teacher,Pelatih/Guru

ART & SPORT SCHOLARSHIPRECOMMENDATION FORM

Coach/Teacher of:Pelatih/Guru

CoachPelatih

Guitar

Bass

Keyboard

Basketball Volleyball Soccer Swimming Badminton

Drum

Piano

Choir

Modern Dance

Vocal

Traditional Dance

Acting

Photography

Video Editing


Coach/Teachers Signature & Full Name + Stamp (if any)Tanda Tangan & Nama Lengkap Pelatih/Guru + Cap (jika ada)

SCHOLARSHIP APPLICATION FOR ART ACHIEVEMENT OR SPORT ACHIEVEMENT CATEGORY

SPORT

ART

Futsal

,


MEDICAL SCHOOL FORM

potong disini

Form Number : Nomor Formulir Full Name : Nama Lengkap

Place & Date of Birth : Tempat & Tanggal Lahir

Name of Parent : Nama Orang Tua

Name of Family Doctor : Nama Dokter Keluarga

Prospective Student,Calon Mahasiswa

Please provide a brief summary of all volunteering, caring, community leadership, religious services and organizations that you have participated in.Jelaskan secara singkat semua bentuk partisipasi Anda pada kegiatan relawan, kepemimpinan, pelayanan keagamaan dan organisasi.

Please provide a brief summary of your current sports, artistic activities, hobbies, and interests.Jelaskan secara singkat tentang kegiatan olahraga, seni, hobi, dan minat Anda saat ini.

Prospective Students Signature & Full NameTanda Tangan & Nama Lengkap Calon Mahasiswa

PROSPECTIVE STUDENT

COMMUNITY INVOLVEMENT

PERSONAL ACHIEVEMENT

Place | Tempat Date | Tanggal,


HEALTH DECLARATION FORM

If you are accepted as a student of the Medical School, you will be required to complete the Health Declaration Form prior to joining for your classes. The information provided to us is confidential and will not be used for any other purposes except providing support for the student.Jika Anda diterima sebagai mahasiswa Fakultas Kedokteran, Anda wajib melengkapi Formulir Pernyataan Kesehatan sebelum bergabung di dalam kelas. Informasi yang diberikan kepada kami bersifat rahasia dan tidak akan digunakan untuk tujuan lain kecuali memberikan dukungan bagi siswa.



No. HEALTH DECLARATIONPernyataanYESYa

NOTidak

DETAILSKeterangan

1Do you have, or have you ever had, any medical conditions or operations in the past 5 years?Apakah Anda memiliki atau pernah memiliki kondisi medis tertentu atau pernah menjalani operasi dalam 5 tahun terakhir?

2Are you at present attending a doctor for medical care, taking any medication or on a waiting list for hospital assessment or treatment?Apakah Anda saat ini sedang akan menjalani perawatan medis, mengkonsumsi obat-obatan?

3Do you have impairment/disability (physical or metal) or specific learning disability which may affect your ability to study in UPH Medical School?Apakah Anda memilki kekurangan/cacat (fisik atau mental) atau ketidakmampuan belajar yang dapat mempengaruhi proses belajar Anda di Fakultas Kedokteran UPH?

4 Have you ever suffered from tuberculosis (TB) within the past 12 months?Apakah Anda pernah menderita tuberkulosis (TB) dalam 12 bulan terakhir?

5 Has any family member or close contact been treated for TB?Apakah ada anggota keluarga atau orang di sekitar Anda yang pernah dirawat karena TBC?

6 Have you had a cough for more than 3 weeks?Apakah Anda menderita batuk lebih dari 3 minggu?

7 Have you coughed up blood?Apakah Anda pernah batuk berdarah?

8 Have you had any unexplained weight loss?Apakah Anda pernah kehilangan berat badan tanpa sebab yang dapat dijelaskan?

9 Have you suffered from night sweats or fever?Apakah Anda menderita demam atau keringat berlebih saat tidur?

10 Have you ever had any kind of back, joint or muscle problem?Apakah Anda mengalami sakit punggung, sendi atau masalah otot?

11Have you ever had, Dermatitis, Eczema, Psoriasis or any other skin condition?Apakah Anda pernah mengalami: Dermatitis, Eksim, Psoriasis atau penyakit kulit lainnya?

12Have you ever had any mental illness which might affect your ability to study and practice medical science? (including anxiety, depression, self-harm, eating disorders, psychological or emotional problems)Pernahkah Anda punya penyakit mental yang berpotensi mempengaruhi kemampuan Anda dalam belajar dan mempraktekkan ilmu medis?

13 Have you ever had a drug, tobacco, nicotine or alcohol problem?Apakah Anda pernah memiliki masalah yang terkait dengan narkoba, tembakau, nikotin atau alkohol?

14 Do you have any difficulty with your eyesight, including color blindess?Apakah Anda memiliki kesulitan dengan penglihatan Anda, termasuk buta warna?

15 Do you have difficulty in hearing?Apakah Anda memiliki kesulitan pendengaran?

16 Have you ever suffered from any of the following: loss of consciousness including fainting attacks, blackouts or epilepsy?Pernahkah Anda menderita kehilangan kesadaran termasuk pingsan atau pingsan karena epilepsi

17 Have you ever suffered from any of the following: heart disease, diabetes, Hypertension or any other medical illness?Pernahkah Anda pernah mengalami; penyakit jantung, diabetes, Hipertensi atau penyakit medis lainnya?

18Have you ever suffered from chest or lung problems: Asthma, Bronchitis?Apakah Anda pernah mengalami masalah paru-paru: Asma, atau Bronkitis?

19 Have you ever had any allergies, including to drugs, food or latex?Pernahkah Anda punya alergi, termasuk alergi terhadap obat-obatan, makanan atau lateks?

20 Have you ever received treatment for bowel or gastric problems?Apakah Anda menerima perawatan karena masalah usus atau lambung?

21 Do you have any other medical conditions not previously mentioned in questions 1 15 above?Apakah Anda pernah mengalami masalah kesehatan lainnya yang tidak disebutkan pada pertanyaan 1 15?

22 Have you been vaccinated for Hepatitis? If you have, what was the dosage?Apakah Anda pernah mendapat vaksin Hepatitis? Jika ya, berapa dosisnya?

23Have you had any episode of Jaundice/Hepatitis? If yes, please submit the Laboratory Blood Report. If you already committed, you have to submit the Laboratory Blood Report to FK Admission Office, FK Building 2nd fl, on August 1-10, 2016 during weekdays.Apakah Anda pernah menderita Hepatitis? Jika ya, harap mengirimkan Hasil Periksa Darah dari laboratorium ke kantor Administrasi FK, Gedung FK lt.2, pada tanggal 1-10 Agustus 2016 di hari kerja.


Place | Tempat Date | Tanggal Signature & Full NameTanda Tangan & Nama Lengkap

Medical School New Student,Mahasiswa Baru Fakultas Kedokteran


NOTES 1. Complete the Student Information form. 2. Check the admission requirement and procedure at www.music.uph.edu 3. Applicants for all concentrations have to submit a good quality DVD/VCD recording which contains three contrasting pieces. 4. Applicants may be asked to take a Music Placement Test (Music Theory and Solfeggio). 5. The Recommendation form (p.16) must be completed by the referee.

CONSERVATORY OF MUSICAPPLICATION FORM

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Form Number : Nomor Formulir Full Name : Nama Lengkap

High School Name : Nama Sekolah

Preferred Consentration (Put Rank 1st, 2nd, and 3rd based on priority)Konsentrasi Pilihan (Pilih berdasarkan prioritas 1, 2, dan 3)

Preferred major instrument: (Please tick one only)Instrumen Pilihan: (Pilih salah satu)

Arts Management Jazz and Pop Performance

Church Music Music Education

Classical Performance Music Therapy

Composition Sound Design

Why did you choose UPH Conservatory of Music? Describe.Mengapa Anda memilih Conservatory of Music UPH? Jelaskan.

How does music impact your life?Bagaimana musik memberi dampak bagi hidup Anda?

Why did you choose your 1st choice consentration?Mengapa Anda memilih pilihan konsentrasi pertama?

Who is your favorite composer or performer? Why?Siapa komposer/performer favorit Anda? Mengapa?

Ensemble playing experience: Yes/NoApakah Anda pernah memainkan ensemble: Ya/Tidak

Did you apply to a Conservatory of Music other than UPH? Yes/NoApakah Anda mendaftar ke jurusan Musik selain di UPH? Ya/Tidak

Recent teacher name: _______________________________Institution/music schools: ___________________________Music award ever received (if any): ____________________

Why did you choose your 2nd choice consentration?Mengapa Anda memilih pilihan konsentrasi kedua?

Why did you choose your 3rd choice consentration?Mengapa Anda memilih pilihan konsentrasi ketiga?

Mention the repertoire that you have learned!Sebutkan repertoire yang pernah Anda pelajari!

Briefly, describe your goals and what influence you to plan a career in music.Jelaskan secara singkat mengenai tujuan dan dampak yang Anda dapat berikan saat berkarir di bidang musik.

Classical Instrument

Piano

Vocal

Guitar

Violin

Viola

Cello

Contra-Bass

Flute

Clarinet

Bassoon

French-Horn

Trumpet

Trombone

Tuba

Percussion

Harp

Oboe

Non-classical Instrument

Piano

Vocal

Electric Guitar

Electric Bass

Drum

Saxophone


Full Name :Nama Lengkap Institution/School of Music :Nama Sekolah Musik

Phone Number :Nomor Telepon

Mobile Phone : Nomor Handphone

Length of Courses : Year Frequency/week : Hours/Course :Lama Belajar Tahun Frekuensi/minggu Jam/Kelas

Please circle the most appropriate answer based on prospective students music skill.Silahkan lingkari pilihan yang sesuai dengan opini Anda mengenai keterampilan musik Calon Mahasiswa berdasarkan keterampilan musik calon mahasiswa


Referees Signature & Full Name + Stamp (if any)Tanda Tangan & Nama Lengkap Pemberi Rekomendasi + Cap (jika ada)


REFEREE | PEMBERI REKOMENDASI

CONSERVATORY OF MUSICRECOMMENDATION FORM

1. Technical strength in playing the instrument: a. Solid b. Need supervision to be solid c. Difficult to be solid

2. Musical strength in playing the instrument: a. Sensitive and able to perform an outstanding musical showing diligence to do the work b. sensitive yet need guidance c. less sensitive

3. Knowledge of Theory of Music a. Very Good in making harmony using S-A-T-B format b. Know basic format in writing S-A-T-B c. Doesnt have a deep knowledge in theory of music

4. Knowledge about aural training a. Well trained in soffegio/prima vista for example: ritmic dictation, melody, interval, and harmony b. Has sufficient session in aural training but only before the examination period. c. Havent received aural training yet

5. Knowledge about history of music a. Has interest in learning the history of music as well as background of songs that he/she is playing b. Has sufficient guidance c. Never received any guidance

6. Level of diligence a. Show a great enthusiasm to learn his/her musical pieces b. Has ambition to develop his/her musical ability yet less consistent c. Depends on mood, always need support to gain motivation and inspiration

7. Level of speed to grasp knowledge a. Shows rapid development in a short amount of time b. Not too fast in showing diligence to do the work ability by his/her own intitative c. Not too fast and less careful over the given correction not too fast and less careful over the given correction

8. Your opinion about the maturity of your student a. Mature b. Quite mature c. Immature

9. Level of confidence to see your student will be able to succeed studying at UPH Conservatory of Music with his/her chosen rhythmic dictation, melody, interval, and harmony concentration a. Very sure 80%-100% b. Sure 60%-80% c. Unsure 50%-60%

10. Your consideration for the student to get scholarship a. Highly recommended b. Recommended c. Less recommended

REFEREE COMMENTS REGARDING SCHOLARSHIP APPLICANT | KOMENTAR PEMBERI REKOMENDASI MENGENAI PEMOHON

Referee,Pemberi Rekomendasi


Form Number :

Full Name :

Major :

Phone Number :

E-mail Address :

I will submit TOEFL/IELTS score by:

Take TOEFL Test at UPH Language Center. Please check the update schedule at www.uph.edu (Info Center).

Submit a copy of TOEFL/IELTS Certificate (Submission deadline: June 26, 2015) * we accept only TOEFL/IELTS results from LIA, AMINEF, TOEFL/IELTS International

1. This form is required ONLY for Prospective Student who apply to the available Full English Class as listed below: - Management - Accounting - Communication - International Relation - Law - Food Technology - Hospitality Management

2. Prospective Students must submit a copy of valid certificate of TOEFL/IELTS.3. The minimum score to apply Full English Class: TOEFL Paper Based Test : 500 TOEFL Internet Based Test : 59 60 IELTS : 5.0 If the requirement above can not be fulfilled, the Prospective Students could not apply Full English Class.

4. Full English Class has limited seats. All applications will be processed and selected by UPH. The Final decision could be ACCEPTED or NOT, and is an absolute decision.

____________, __________________Place Date

( ___________________________________ )Prospective Students Signature & Full Name

FULL-ENGLISH CLASSESAPPLICATION FORM

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Mobile Number :

Received by,

( ___________________________________ )Admission Staffs Signature & Full Name

Verified by,

( ___________________________________ )UPH Language Centers Signature & Full Name

PROSPECTIVE STUDENT WHO APPLY TO FULL ENGLISH CLASS IS REQUIRED TO FILL THIS FORM

REQUIREMENTS

UPH Admission Manual Academic Year 2015/201616

UPH Admission Manual Academic Year 2016/2017


PSYCHOLOGY PROGRAMAPPLICATION FORM

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Phone/Mobile Number :Nomor Telepon

E-mail address :Alamat E-mail


PSYCHOLOGY PROGRAM

Psychology | Psikologi

Psychology & Entreprenurship | Psikologi & Kewirausahaan

Preferred Concentration | Konsentrasi Pilihan Please give tick (v) in your option | Silahkan berikan tanda (v) dalam pilihan Anda

Prospective Students Signature & Full NameTanda Tangan & Nama Lengkap Calon Mahasiswa


Parent/Guardians Signature & Full NameTanda Tangan & Nama Lengkap Orang Tua/Wali

Admission Manual Online

Documents

Transcript of Admission Manual Online