POSTGRADUATE STUDENT - APPLICATION FORM

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POSTGRADUATE STUDENT - APPLICATION FORM FOR September 2006 INTAKE

Study period: from 01-09-2006 to 30-06-2009

POSTGRADUATE APPLICATION

Personal Information

Date of Birth:*

Gender (male/female):*

Nationality:*

First Name(s):*

Last Name:*

Permanent address:*

Country:*

Phone:

Fax:

E-mail:*

Full name and phone no. of next of kin:*

Campus: of election*

You are applying for the London, England or the Florida, U.S.A Campus, Explain us why?

Academic Records*

test

Are you presently studying at Republic University :*

List your academic background relevant to the programme(s) you are applying for:

Academic Record 1*

Name of home university (academic institution):*

Address of home university (academic institution):*

Name of contact person at home university (academic institution):*

E-mail of contact person at home university (academic institution):*

Period you attended your home university (academic institution) from/to:*

Actual name of degree/diploma obtained:*

Degree/diploma obtained (dd/mm/yyyy):*

Academic courses attended (please give a short description of the attended academic courses relevant to the programme(s) you are applying for): (max ½ page)*

Academic Record 2*

Name of home university (academic institution):*

Address of home university (academic institution):*

Name of contact person at home university (academic institution):*

E-mail of contact person at home university (academic institution):*

Period you attended your home university (academic institution) from/to:*

Actual name of degree/diploma obtained:*

Degree/diploma obtained (dd/mm/yyyy):*

Academic courses attended (please give a short description of the attended academic courses relevant to the programme(s) you are applying for): (max ½ page)*

Academic Record 3*

Name of home university (academic institution):*

Address of home university (academic institution):*

Name of contact person at home university (academic institution):*

E-mail of contact person at home university (academic institution):*

Period you attended your home university (academic institution) from/to:*

Actual name of degree/diploma obtained:*

Degree/diploma obtained (dd/mm/yyyy):*

Academic courses attended (please give a short description of the attended academic courses relevant to the programme(s) you are applying for): (max ½ page)*

Please include details of paid and voluntary work. You should also state any work-related skills relevant to your proposed studies: for example, report-writing, computer programming, work with statistics or languages, accounting procedures, engineering or scientific experience, etc... Please, feel free to mention any past or present experience that you judge important to communicate and could be relevant to your future studies.

Employment history (If relevant for application purpose)

Name your Employer and list your position in the company as well as your major realizations and sector of activity. Please note that if you are in the military a special recognition for your past accomplishments will be given to you according to your Rank as well as position.

Address of Employer :

Name of contact person at Employer :

E-mail of contact person at employer:

From; To;

Employment history 2

Name your Employer and list your position in the company as well as your major realizations and sector of activity. Please note that if you are in the military a special recognition for your past accomplishments will be given to you according to your Rank as well as position.

Address of Employer :

Name of contact person at Employer :

E-mail of contact person at employer:

From; To;

Life history

Please include details of paid and voluntary work. You should also state any work or research related skills relevant to your proposed studies: for example, report-writing, computer programming, work with statistics or languages, accounting procedures, engineering or scientific experience, etc... Please, feel free to mention any past or present experience that you judge important to communicate and could be relevant to your future studies.

Please note that if you are in the military a special recognition for your past accomplishments will be given to you according to your Rank as well as position..

Need more Space :

English proficiency*

Is English your native language:*

If you answered NO please complete this section ; English proficiency Tests (Please give the date you took or intend to take the test and, if applicable, the score you obtained):

Test

Date

Score(if applicable)

TOEFL(All programs)
(Applicants who are not native speakers)

Have you taken the test?

Which programme would you like to study? *

MBA - Master of Business Administration
MICT - Master of Information and Communication Technology
MScCS - Master of Science
MScM - Master of Science
PHD - Doctor of Philosophy
PHD - Doctor of Sciences

*Note : Details

Research student status

There are no additional documents prescribed by the department.

Examinations

Master's course

The written examination tests mathematics and English language ability. The mathematical part will be taken in English. Everyone can buy past examinations.

Doctoral course

There is no written or oral examination for applicants. Evaluation is done from the submitted documents.

Choose a School or a College: *

Master :

Doctorate :

Other full-time programmes (please give a detailed description of your plan) (IMPORTANT: choose also "Other" under 1st priority)

SUPPORTING STATEMENT

If you are applying to do RESEARCH, please use this space to tell us about your research interests. Outline your research proposal in not more than 250-500 words (continue on a separate sheet if necessary). Please also list your publications/reports, if any, and tell us if you wish to work with a particular member of staff at Republic University.

If you are applying for a TAUGHT COURSE, please tell us about any relevant professional qualifications you have and your reasons for wishing to study this course. You may attach another sheet/CV if necessary. (This box cannot take more then 3.000 letters.)

Finance

How will your studies be financed?

Have own funds:

If you are a sponsored student, please complete the following :

Name of organisation:

Fax:

Name of approving manager:

Tel:

Address of the institution or company:

Have a special grant (awards or others):

If you are the recipient of a Grant/Scholarship; please specify :

Name of Award:

Obtained Applied for, but not yet obtained

References*

Please enclose with your application references from people with direct knowledge of your recent academic

Work: If you are at present in employment a reference from your employer is required.

Names, positions and addresses of your referees 1:

Names, positions and addresses of your referees 2:

Fraudulent statements and omissions

You should be aware that offers of a place are made in good faith by the Republic University and are based on the information you provide at any point during the application process. False statements or omissions of relevant information may lead to the withdrawal of an offer or a place

Anti-discrimination Policy

The Republic University is committed to the fair treatment of its students and applicants, and no individual will be unjustifiably discriminated against on the basis of race, colour, nationality, ethnic origin, gender, sexual orientation, marital or parental status, age, disability, political or religious or socio-economic class. Please contact one of our administrators if you feel victim of discrimination in your dealing with anyone of our admission staff.

Contact Information (Please let us know how you learned about the Republic University and its programs):

Newspaper/Magazine:		Employer/Company:
Staff of:		Television/Radio:
Fair:		Web:
School Visit (name of school, date):		Other:
Student of R.Un		Staff of R.Un
International businesses		Studying Abroad Magazine
Studying Abroad Fair		Search Engines

Declaration by applicant

1. I give my consent to the processing of my data by Republic University.

2. In making this application for admission to the programme, I acknowledge that any offer of admission I may receive is subject to the condition that I fulfil the relevant entrance requirements and that I provide, when asked to do so, original documentary evidence of holding the academic qualifications and of any other information listed above. If, having been admitted, I fail to fulfil that condition; I undertake to withdraw from the College.

3. I undertake not to engage in any course of study concurrently with that to be taken at Republic University.

I certify that the information provided in this application is true and complete. I acknowledge that in the case of incomplete or incorrect information, the Republic University reserves the right to withdraw the offer of admission or financial aid, dismiss me at any time during the programme's duration, and revoke any degree obtained at the Republic University.

Application for year:

2006 to 2010

Application for Semester:


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