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APPLICATION FORM

1. PERSONAL DETAILS
Surname ...............................................................
Date of birth (d/m/y) ..............................................
Gender .................................................................

First name (s) ....................................................

Home address:
Street ........................................................................................................................................................
Postal or zip code ................................................
City .....
Country (country code) ............................................................................................................................
Home telephone .................................................... Cell phone .........................................................
E-mail: .....................................................................................................................................................
Have you been to France previously? Yes
No:
If yes, please specify the year and length of your stay ...

2. UNIVERSITY DETAILS
Name .......................................................................................................................................................
Address:
Street ......................................................................................................................................................
Postal or zip code ................................................... City.
Country ...................................................................................................................................................
Telephone (switchboard) ........................................................................................................................
Academic supervisor ...............................................

Telephone ......................................................

E-mail .......................................................................................................................................................

3. FLUENCY IN ENGLISH AND FRENCH

Intermediate:

Level of French (written and spoken)

Fluent:

Intermediate:

Have you taken a TOEFL-type test?

Yes

If yes, which one?

....

beginner:

No:

Grade obtained? ......

4. MAJOR AND GRADES

Program/Field studied ....

Major

......

Year

Grade point average at the end of the 2010-2011 academic year .

Provisional year of final graduation..............................

Do you have a scholarship?

Yes:

No:

If yes, which company is your sponsor? ........................................................................................................

Previous diplomas/qualifications:

Graduation year Field: .....

Graduation year Field: .

5. INTERNSHIPS AND WORK EXPERIENCE

Missions / Achievements
Internships

Work

(yes/no)

Experience
(yes/no)

Company

Field/Area

Year/
Length

6. WHY DO YOU WANT TO ATTEND THE TOTAL SUMMER SCHOOL?

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7. HOW DID YOU KNOW ABOUT THE TOTAL SUMMER SCHOOL (Total affiliate, friend, university)?

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8. YOUR EXPECTATIONS

A) Priority topics (rank according to order of importance, 1 being the most important)

1. Description of an oil and chemical companys main businesses

2. Presentation of the managerial skills and principles applied at Total and its subsidiaries

3. International expansion and geopolitical issues

4. R&D and innovation strategy (oil, gas and chemicals)

5. Environmental issues

6. The future of energy

7. Industrial safety

8. Corporate social responsibility and community relations

9. Ethics

10. Diversity and gender diversity

B) Priority learning experience expectations

1. Work in small groups

2. Interaction with Total senior managers

3. Interaction with experts

4. Interaction with operating managers

5. Interaction with human resources managers (recruiting, training, etc.)

6. Interaction with other cultures

7. An introduction to French culture

8. Other general expectations

9. HEALTH INFORMATION
(Allergies, dietary, current health problems or in the 12 months prior to your trip to France)

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10. PERSONS TO CONTACT IN CASE OF EMERGENCY (names, telephones, e-mails)

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