POLISH NATIONAL FILM, TELEVISION AND THEATRESCHOOL

Targowa 61/63, 90-323 Łódź

INTERNATIONAL STUDENT APPLICATION FORM

FOR FULL TIME STUDIES,
or ONE YEAR TRAINING

in the academic year 2018/2019

I. INTENDED TUITION FORM[1]:

1. Courses available:

 Direction – consolidated MA studies (5 years)

 Editing – consolidated MA studies (5 years)

 Cinematography – consolidated MA studies (5 years)

 Animation & special effects – consolidated MA studies (5 years)

 Photography – consolidated MA studies (5 years)

 Acting – consolidated MA studies (4,5 years)

 Film & TV production management – BA studies (3 years)

 Film & TV production management – MA studies (2 years)

2. One year training in:

 Cinematography

 Animation & special effects

 Direction

 Editing

II. PERSONAL DATA

1. Surname: ______

2. First name: ______

3. Place of birth (town, country): ______

4. Date of birth: ______

5. Sex (M/F): ______

6. Parents: names, surnames and citizenship:

a) Mother: ______

b) Father: ______

7. Nationality: ______

8. Citizenship[2]:

citizenship / passport number / valid until / country of issue

I hereby certify that I do not hold Polish citizenship.

______

(signature)

9. Present address: ______

Tel.: ______E-mail: ______

10. Person to be notified in case of an emergency: ______

Tel.: ______E-mail: ______

II. EDUCATION

1. High school:

school(s) / duration / place / certificates/diplomas

2. Universities and academies:

University / department / duration / diploma

3. Financial conditions on which the candidate intends to study in Poland[3]:

 full tuition payment

 no tuition payment, no social benefits[4]

 Polish Government scholarship, or other scholarships

4. Command of foreign languages:

Mother tongue: ______

Foreign languages[5]:

Foreign language / Level of competence
Polish
English
others

ATTENTION!

This application form has to be accompanied by documents specified at the school’s website ( in the section devoted to a given faculty.

………………………………………………………………………….

Place and date Candidate’s signature

[1]Tick the right box

[2]Declare each citizenship held

[3] Tick the right box

[4]Enclose documents which entitle you to free studies

[5] write: very good, good, satisfactory, none