MEDITERRANEAN INSTITUTE OF MANAGEMENT

Kallipoleos Ave. 77, 2100 Nicosia, P.O. Box 20536, 1679 Nicosia, Cyprus, Tel.: (+357)22806000, Fax: (+357)22376872,
Ε-mail: , Website: www.mlsi.gov.cy/kepa
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POSTGRADUATE MANAGEMENT DIPLOMA PROGRAMME

(Academic Year 2014-2015)

APPLICATION FORM

1. PERSONAL DETAILS

Mr/Ms ______/ ______
(please circle) Surname / First Name / Date of Birth
______/ ______
City and Country of Birth / Identity Card No.
(Cypriot Applicants) / Passport No.
(Foreign Applicants)

Home Address:

Street: ______City: ______

Post Code: ______Country: ______Email: ______

Mobile No: ______Home Phone No: ______Fax: ______

(include country code)

2. ACADEMIC QUALIFICATIONS

List all Institutes and Universities attended, starting from the most recent first.

Please supply an official copy of diploma/degree from each institution listed.

Name of Institution / Country

/ From (mm/yy) / To (mm/yy) / Degree/Diploma

3. ENGLISH LANGUAGE QUALIFICATION

If English is not your first language or/and you are not a graduate of an english speaking university, please state the highest qualification (GCE, TOEFL, IELTS, etc,) you hold, the score or grade achieved and the date taken. Please submit supporting documentation.

Qualification

/ Score or Grade / Date (year) taken
______/ ______/ ______

4. FINANCIAL DETAILS (for Overseas Applicants)

Overseas applicants who wish to attend the Programme on their own expenses must also submit a Certificate of Financial Resources indicating the source of funds to be used during their studies at the MIM.

5. DECLARATION

I confirm that the information given in this form is correct and complete

Signature of Applicant:……………………………………………………………………..Date:…………………………………

6. FOR USE BY THE MIM SECRETARIAT

Please indicate how you found out/were informed about the Postgraduate Programme of the MIM. Please tick as appropriate.

(a)  Newspapers (b) Magazines (c) Radio

(d) CPC/MIM Website (e) Other Websites (f) SMS received

(g) MIM student or graduate (h) Other, please specify ______

The application form and all supporting documents should be sent:

By email to: OR

By post to:

Secretary, MEDITERRANEAN INSTITUTE OF MANAGEMENT, P.O.BOX 20536, CY-1679 Nicosia, CYPRUS

OR

By fax to: +357-22376872

WHEN TO APPLY: The application deadline is 8th September 2014.

Early submission of application is recommended

CHECKLIST FOR APPLICATION

Before submitting your application, please make sure you have included the following:

1.  A recent passport size photograph

2.  An official copy of diploma/degree from each academic institution attended

3.  Evidence of knowledge of English (if not a graduate of an english speaking university)

4.  A Certificate of Financial Resources (for overseas applicants only)