Application for Admission

Tsinghua-INSEAD EMBA Programme

A programme is as good as the quality of its participants. This is why the programme selects a limited
number of talented professionals who have demonstrated high potential to succeed in an international
business career.

Selection is based on a combination of an individuals managerial performance, leadership potential,

personal characteristics and international motivation, as well as willingness to learn and contribute to
the exchange of ideas at INSEAD and Tsinghua SEM.

This document contains all the material and information you need to apply to the TsinghuaINSEAD Dual
Degree EMBA Programme (TIEMBA) including application forms with five essays, two recommendation
letters, degree/diploma and transcripts of grades, GMAT score report. If you do not have GMAT score,
you may take the Tsinghua Management Admission Test (in English) as an alternative.

For the application forms with essays and the two recommendation letters, please kindly follow this
online application instructions.

For degree/diploma and transcripts of grades (with certified translation in English where applicable)
and GMAT score report, please mail to:

TIEMBA Office
Room 311, Shunde Building
School of Economics and Management
Tsinghua University
Beijing, China 100084
Tel:+86 10 6279 5799/+86 10 6279 6317
E-mail: tiemba@sem.tsinghua.edu.cn

You can also use Tsinghua GMAT Code for submitting GMAT: Tsinghua-INSEAD EMBA Programme
VHO-JJ-56, School of Economics & Management, Tsinghua University.
Please complete all sections of the application form in the spaces
provided by typing directly into the form. You may work on it offline.
Save your application as often as you wish.

PERSONAL INFORMATION

FAMILY NAME

FIRST NAME

PREFERRED FIRST NAME

MAILING ADDRESS

STREET

TOWN POSTAL CODE STATE

COUNTRY

HOME PHONE MOBILE PHONE

BUSINESS PHONE FAX

PERSONAL EMAIL

BUSINESS EMAIL

PREFERRED EMAIL

MALE FEMALE DATE OF BIRTH / /

PLACE OF BIRTH: TOWN COUNTRY

SINGLE MARRIED CHILDREN

PASSPORT NUMBER NATIONALITY

OTHER CITIZENSHIP NATIVE LANGUAGE

ID NUMBER(FOR CHINESE NATIONALITY)

GMAT RESULTS
How many times have you taken the GMAT test in the last 5 years?
Please make sure to have ALL your official scores sent to us.

TOTAL VERBAL% QUANTITATIVE% DATE TEST TAKEN/TO BE TAKE(LATEST FIRST)

If you do not have GMAT score, you may take the Tsinghua written test (in English) as an alternative.
Are you willing to take the Tsinghua Written Test?

ACADEMIC BACKGROUND
Starting with the most recent, please list all colleges and universities attended.

INSTITUTION DEGREE START END FINAL MAJOR FULL TIME/

AND COUNTRY RECEIVED DATE DATE GRADE SUBJECT PART TIME

In which language(s) was your university degree taught?

What language(s) do you use at work?
Please list academic distinctions, honors and awards.

When and how did you first hear about Tsinghua-INSEAD Dual Degree Executive MBA programme?
Year
TIEMBA Alumnus Name: Tsinghua Event
Tsinghua Alumnus Name: INSEAD Event
INSEAD Alumnus Name: World EMBA Tour
Professor Name: Press
Relative On the Web
Colleague at work (other than Tsinghua/INSEAD Alumnus) Other (please specify)
Please indicate the name of any Tsinghua/INSEAD programme you have attended in the past.
PROFESSIONAL BACKGROUND
Please list all full-time positions starting with your most recent/current position.

COMPANY START DATE END DATE JOB CITY/COUNTRY GROSS ANNUAL SALARY
NAME IN FULL (Month&Year) (Month&Year) TITLE OF WORK (In US$)

Total duration in years of full-time positions held

Current Employer
Company/Organization Name:
Address: City:
Country: Postal Code:
Number of employees in your location:
Number of employees worldwide: Annual sales (in US dollars):

COMPANY SECTOR (Please check)

Advertising Environment/Utilities Pharmaceuticals

Aeronautics Executive Search Plastics&Rubber
Agriculture Fabricated Metal Products Primary Metal Industries
Automobiles Food&Drink Printing-Publishing
Business Associate Holdings Public Administration
Chemicals Insurance Real Estate
Commercial Banking Internet Services/Multimedia Research Institute
Communications Investment Banking Retail Trade
Computers/Computer Services Media/Entertainment Social-Health Services
Conglomerates Mining Sports/Leisure
Construction Msc Manufactured Products Stone, Clay&Glass
Consulting Non-electric Machines Telecommunications
Cosmetics-Toiletries Non-profit/NGOs Textile
Education Optical&Scientific Equipment Tobacco
Electric Machines Other Financial Services Transportation-Travel
Electronic Equipment Other Products&Services Venture Capital/Private Equity
Energy Paper-Allied Products Wholesale Trade
Engineering Services Petroleum Wood

Your current job title:

Job Function: (Please check)

Business Development Consulting(Audit/Accounting)

Consulting General Management
Finance Legal
Human Resources Management Medical
Marketing/Sales Project Management
Product Dev/Technology Mgt Strategy/Corporate Planning
R&D Other (Please specify)
System Analysis

Managerial Responsibilities (if needed, do add an organization chart and job description)

Number of people managed Assets under your management

Sales managed Average yearly sales growth
P&L responsibilities YES NO , If yes, last years amount (specify currency)

Who is your direct superior? (Please give title). Who does he/she in turn report to?

May we contact your current employer? Yes No

If yes, whom may we contact?
Full Name: Email:

Title: Direct Tel:

Is your employer willing to support you by:

Time Commitment Partial Tuition Full Tuition

Is your employer prepared to provide you with facilities/access to undertake an in-company project
during the final months of the programme?

Yes No To be confirmed
Please give details of how you propose to pay for the Tsinghua-INSEAD Dual Degree EMBA Programme:

Fully Sponsored By Employer Own Funds

Partially Sponsored by Employer Bank Loan

Applying to Employer For Sponsorship Other (Please Specify)

INTERNATIONAL EXPOSURE
Please list your most significant experiences grouping up, living, studying, working or travelling outside
your own country.

DURATION
ACTIVITY COUNTRY/REGION
From ( Month&Year ) To ( Month&Year )

ACTIVITIES AND INTERESTS

Please list, in order of importance to you, any extra-curricular activities in which you are/have been
involved (i.e. sports, politics, performing arts, associations, club memberships, hobbies, community
activities, etc.)

DURATION
POSITION/LEVEL/
ACTIVITY
OFFICE HELD
From ( Month&Year ) To ( Month&Year )

List any distinctions, honours and awards achieved in your extra-curricular activities.

If you have any disability or illness that we should be aware of, please explain.
ESSAYS
Each essay topic listed below and in the subsequent pages must be answered.
1. Please give your objectives of attending the TIEMBA Programme. What would you like to achieve
over the next 5 years, and how could TIEMBA contribute to achieving these plans? What are your
alternatives to this programme? ( 500 words approx.)
2. Give a candid description of yourself, stressing the personal characteristics you feel to be your
strengths and weaknesses. (500 words approx.)
3. Please describe one of your most enjoyable experiences in life, preferably from your business
context.Where did it originate? In retrospect, what did you learn about yourself and about others?
(500 words approx.)
4. Please describe a situation, either work or personal, where you faced particular frustration or
difficulty. What was the outcome and what did you learn from the experience? (500 words
approx.)
5. Tell us about someone who has especially influenced your choices in life. (500 words approx)
PERSONAL RECOMMENDATIONS
Please make sure to first enter your personal details in the profile section, or at least in the box below,
before providing the corresponding Internet links to your recommenders.

FULL NAME: FIRST NAME:

DATE OF BIRTH: / /

You are responsible for securing two reference letters from qualified individuals able to comment about
your professional achievements and your career potential. One of the letters should come from a direct
supervisor in the company you are currently employed in. The second letter is at your discretion.

STATEMENT OF INTEGRITY

I hereby certify that I have provided accurate information in this application.

I am the sole author of the essays that follow. I authorise Tsinghua / the
Admissions Office to verify my credentials. I understand that any
misrepresentation or omission of facts in my application may justify denial
of admission, cancellation of admission or withdrawal from the EMBA
Programme. This is my honest statement to Tsinghua.

SIGNATURE
DATE: / /