National University of Kiev-Mohyla Academy

NationalUniversity of “Kyiv-MohylaAcademy”

APPLICATION for admission to Master’s programs 2013/2014

International Students

Please provide complete information for each item requested. Please type or print clearly.

Please indicate which Master’s Program you are applying for:

Biology

Laboratory Diagnosis of Biological Systems

Chemistry (Membrane and Sorption Processes and Technologies)

Cultural Studies (History and Theory of Culture)

Economic Theory

Finance

History

History (Archaeology and Ancient History of Ukraine)

History.Judaica

Informational Electronic Systems and Technologies

Intellectual Systems of Decision-Making

Journalism

Law

Philology (Theory, History of Literature and Comparative Literature)

Philology (Theory, History of Linguistics and Comparative Linguistics)

Philosophy (History of Philosophy)

Political Science

Physics

Public Health Management

Public Relations Management

Social Work and Social Politics

Sociology

Software for Automated Systems

GENERAL INFORMATION

Last (family) name……………………………………………………………………………
First (given) name …………………………………………………………………………………………….
Middle name …………………………………………………………………………………………………..
Sex: male……….. female……… 5. Marital status: single……… married……… divorced……………
Date of Birth (month/day/year)………………………Place of Birth………………………………………..
Age of Applicant……………………………Citizenship …………………………………………………….
Present Address ………………………………………………………………………………………………..
Permanent Address ……………………………………………………………………………………………
Telephone……………………………..Fax……………………………e-mail………………………………
Purpose of your study at the NationalUniversity of “Kyiv-MohylaAcademy”…………………………..
Proposed period of your stay in Ukraine……………………………………………………………………

ACADEMIC INFORMATION

If applicable, please indicate your proposed field of specialisation within Master’s Program you are applying for:

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

EDUCATION

Institutions attended above high-school level / Dates attended
(month/year)
from to / Degrees received
or expected / Fields of study
Major Minor

If you previously submitted a thesis as part of your degree, please give title and a brief resume:

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..….

LANGUAGES:

Mother tongue: ………………………………………………………………………………………………………………

Others:

Language: / Poor / Fair / Good / Excellent

Please, indicate your level of English and Ukrainian:

English:

Poor / Fair / Good / Excellent
Academic Reading
Academic Writing
Oral Comprehension
Special English
(your specialization)

Have you ever submitted Test of English as a Foreign Language (TOEFL) or other equivalent (e.g. IELTS) (for non-native speakers).

Name of Test…………………………………………………………………………………………………………......

Date…………………………………………………………………………………………………………………….

Location………………………………………………………………………………………………………………….

Score………………………………………………………………………………………………………………………

Ukrainian:

Poor / Fair / Good / Excellent
Academic Reading
Academic Writing
Oral Comprehension
Special English
(your specialization)

When and how did you learn Ukrainian?

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

FELLOWSHIPS, HONORS, PUBLICATIONS, EXHIBITIONS, PERFORMANCES, ETC.

Name and address of the person in your home country to be notified in case of emergency

Professional Experience

type of activity / Date and duration / Employer / Place and country

Do you already have contacts in Ukraine or with Ukrainian citizens?

…………………………………………………………………………………………………………………………………………………………………………………………………………………………

Foreign experience (Country, period of stay and purpose)

Passport Information

Passport Number.......

Indicate the issuing country and the day through which your passport is valid:

Country………………………………………Date of Expiration…………………………………………………….

PERSONAL INFORMATION

Hobbies, interests……………………………………………………………………………………………………….

……………………………………………………………………………………………………………………………………

Any extracurricular activities you would like to participate in…………………………………………………….……..

…………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………

Additional information you would like to share about your stay (health, diet, etc.) ……………………………………………………………………………………………………………………………..……

APPLICATION DEADLINE: POSTMARKED NO LATER THAN May 25, 2013

ATTACHMENTS

In addition to this completed form, your application must include the following:

1. A copy of your official degree/diploma/certificate.

2. A university transcript documenting your academic work ( an official document issued by your university/college which lists courses, course hours and grades received, and an explanation of the grading system).

Documents must be translated into English or Ukrainian. The translated document must be signed and stamped by an officially certified translator. If a translation of your documents is necessary, you must submit both the original language copy and the translated version

3. An essay on the topic proposed by a Master’s Program you are applying for.

4. Abstract from your fist degree thesis/term paper (up to 20 pages).

I certify that I have provided complete and accurate answers to the questions of this application to the best of my knowledge. I further certify that all official documents submitted in support of this application are authentic and unaltered records that pertain to me.

Date …………………………………… Signature ………………………………………..

Please return these completed forms to:

Larysa Chovnyuk

Vice-President for Foreign Cooperation

International Office

NationalUniversity of “Kyiv-MohylaAcademy”

2, Skovoroda St.,

Kyiv04655, Ukraine

Tel/fax: +38 (044) 425-5016

e-mail: