University Admissions Application FormRegistration Number:
Bachelor – 1st level
Or combined – 1st and 2nd level in one unit1
Stamp of university, Department:
Academic Year:20/20
Citizenship:Date of delivery:
First name:Academic Title:
Surname:
Maiden Name:Marital Status:
Date of Birth: daymonthyearGender1:malefemale
Place of Birth:Country:
Personal ID Number:Nationality:
ID Card Number (Passport Number):
Tel. No.:E-mail address:
Permanent residence:
Street and House Number:
City (town):Zip Code:
District/ Region:Country:
Mailing address (if different than permanent residence):
Street and House Number:
City (town):Zip Code:
District/ Region:Country:
University:
Department:
Faculty:
Study Programme3:
Form of Study2:Method of Study3:
Study Programme3:
Form of Study2:Method of Study3:
Study Programme3:
Form of Study2:Method of Study3:
I will be taking an entry exam in a foreign language6:
Year of secondary school leaving exam (matura):Code of secondary school:
Finished secondary school2:
Grammar schoolSecondary vocational schoolApprentice training collegeSecondary school Other
Name:
Street and House Number:
City (town):Zip Code Country
Field of study:Field of study code:
Level of achieved education:
COMPLETE LEGIBLY IN CAPITAL LETTERS.
Instructions are on Page 3.
The Ministry of Education of the Slovak Republic, November 20061st Page
Applicants should indicate their secondary school results upon request of the university/ faculty.Applicants taking school leaving exams in the current year should not fill in results from the last year.I In the 'Classification of school leaving exam' section they should only fill in the 'Subject of school leaving exam' and the 'Level' portions.In the 'Classification of school leaving exam' section, applicants who passed their school leaving exam before 2004 should fill in the 'Subject of school leaving exam' portion, the 'Oral exam (mark)' portion of the internal section, the 'date of school leaving exam' and the 'Average mark of school leaving exam' sections.
Attendance and success in Olympiads, Competitions, Student Scientific Vocational Activity, Invention or Industrial Design Authorship will be stated on a separate attachment, as requested by the university or department in the admission conditions.
Results according to end of year report in the individual years of secondary school
(Do not submit classification for behaviour)
year
I.II.III.IV.V.VI.
Subject
Average mark (two decimal places)
Classification of school leaving exam
Subject of school leaving examLevelExternal partInternal part
%PercentWritten formOral form (%) (mark)
Date of school leaving exam:Average of school leaving exam:
Confirmation of accuracy of data:
Date:Signature:School stamp:
Medical statement confirming the required level of health to study and work in the chosen field of study (following the university/department's request):
Date:Physician’s signature:Physician’s stamp:
The Ministry of Education of the Slovak Republic, November 20062nd Page
Overview of further (including not completed) university studies7:
University:
Department:
Faculty:
Study programme:
Field of study:
Level of achieved education:
Commencement of studies:Completion of studies:Academic Title:
Instructions and notes for the completion of application:Confirmation ofadmission process payment
1 Cross out unsuitable alternatives. The study combining the 1st and 2nd level into
one unit is a PhD or master’s degree.
2 In the 'Gender and finished secondary school' section, indicate with a cross.
3 The applicant should enter one title of a study programme.The titles of several
study programmes shall be completed according to university instructions.
4 In the Form of Study section, specify daily or distance learning according to
study options information.
5 In the Method of Study section, fill in attendance or distance, or combined according to
study option information.
6If the admission exam includes a foreign language exam, the applicant should
choose one foreign language according to study option information.
7If you cannot fit all your information in the pre-printed form please use a separate attachment.
Please specify completed studies, current studies or unfinished studies (e.g.
terms attended).
8Applicants with disabilities can request an exam method that takes the
9disability into account.
Applicant’s Declaration and Agreement
I hereby confirm that all information I have provided is true and no information has been withheld. According to provisions of Art. 7 Act No. 363/2005, Coll. on the Protection of Personal Data, I hereby grant with my signature permission to process my personal data for the purposes of the application for study until the date of enrolment on a first year Masters or Engineering university degree course. This permission refers to the personal data in the application and attachments that the university is entitled to request according to the provisions of Art. 58 item 5 of Act No. 131/2002, Coll. on universities and Colleges as amended (“the Act”).I am aware that I may cancel my permission only with substantial justification in written form with the relevant university or department.I am also aware that this data can only be processed by authorised persons, who are obliged to adhere to Act No. 363/2005 Coll. on the Protection of Personal Data, and the processed data will be archived and disposed of with in accordance with valid legislation of the Slovak Republic.
Notes to Applicant’s Declaration and Agreement:
This permission refers to specific data regarding further conditions of university admissions that cannot be specified in detail by the legislation due to the diversity of university requirements (e.g. health information) – see Art. 58 item 5 of the Act.
This permission does not refer to first name, surname, ID Number, date of birth, marital status, nationality and other, therefore a permission to process the data is not requested – see Art. 58 item 3 Of the Act, where this data is listed.The permission refers to all other data.
Attachments:
1.CV
2.Confirmation of admission process payment
Date:Applicant’s signature:
The Ministry of Education of the Slovak Republic, November 20063rd Page
Admission process Record:
Admission exams:
SubjectDateForm of examResult
Overall assessment of applicant:
Number of points achieved:
Order Number:
Fulfilment of Admission Process Conditions:
Recommendation of Admissions Board:
Date:Signature of Admissions Board Chairman:
Recommendation of Admissions Board:
Date:Signature of Admissions Board Chairman:
Dean’s (Rector’s) Decision:
Date:Signature of the Faculty Dean (University Rector):
Rector’s decision (academic senate) on the application to review the decision of non-admission to university or faculty (Art. 58 (9) Act No. 131/2002 Coll.):
Date:Rector’s signature (Chairman of the academic senate):
Dean’s decision (rector’s decision) on admission according to provisions of Art. 58 item 10 of Act No. 131/2002, Coll.:
Date:Signature of the faculty Dean (University Rector):
The Ministry of Education of the Slovak Republic, November 20064th Page