Palacký Univerzity inOlomoucČ.j. …………………...... ……..

Cyril and Methodius Faculty of Theology

Univerzitní 22, 771 11 OlomoucDošlo dne: ……...... …………..

______

Registrační číslo uchazeče: ......

APPLICATION

For the Doctoral Study Programme

For the academic year ......

Programme of study : / THEOLOGY
Field of study : / SYSTEMATIC THEOLOGY AND CHRISTIAN PHILOSOPHY
Specialization: / DOGMATIC THEOLOGIE
Form of study : / Full-time / Part-time
Degree of study : / Licentiate / Doctorate
Titles, name, surname
Maiden name / Marital status
Date of birth / Place of birth
Nationality / Country Citizenship
Identification number / /
ID number/ Passport number (Foreigners)
Permanent address / Street /Number
Part of the City
City
Zip / Post office
Country
Contact address / Street /Number
Part of the City
City
Zip / Post office
Country
Phone number / E-mail
University Degree Taken at
Faculty
Programme of Study
Date of Graduation
Theme of thesis
Another University Attended
Faculty
Programme of Study
Date of Graduation
Theme of licentiate / dissertation
Applicant applies from / – work
– school
– home
Knowledge of foreign languages: / language: / degree:

I declare that in accordance with Act No. 101/2000 Coll. on the protection of personal data and amendment of certain laws, as amended, I agree with the processing of my personal data for the purposes of admission at Palacký University inOlomouc, statistical reporting, and in the case of admission also for the required evidence of UP students.

In ………...... ……..…… date ……………...... …......

………………………………….....……

Applicant’s signature

Enclosed:

a)Structured CV

b)Notarially certified copy of all diplomas

c)Notarially certified report ofstatefinal exam, or Diploma supplement

d)Documentedsummary of previous theological study (e.g. photocopy of student record book) – Master’s degree, orsummary of exams completed during licentiate

e)Consent of the ordinary or competent ecclesiastical authority for candidates from the clergy and laity, for candidates from the monks and members of societies of apostolic life the consent of higher superiors.[1]

f)List of publications

g)Study project

REPORT ON THE ADMISSIONS

Form of the exam / Date of the exam / Result
Written test on the field of study
Language test
Oral interview
Achieved number of points
Fulfilled – failed conditions of the admissions
PROPOSAL OF THE EXAMINATION AND ADMISSION COMMITTEE:
Recommended for admission at ...... form of study
Not recommended for admission
(complete, cross out the non-applicable) Date:
Composition and signatures of the examination and admission committee:
chairman:
members:
DECISION OF THE DEAN:
I accept for ...... form of doctoral study
I do not accept for doctoral study
Date: Dean’s signature:
DECISION OF THE DEAN issued on the basis of admissions:
Date: Dean’s signature:

[1] Srov. Ordinationes ad Sapientiachristiana art. 24.