Application form

I apply for acceptance in the English language program in Physics for the academic year beginning in September 201_.

  (cross the appropriate square below)

 BSc program

Year of acquiring the certificate of secondary education:...... ……………………………….

 MSc program (for applicants with BSc degree)

Year of acquiring the BSc degree:...... ……………………………………………………….

 PhD program (for applicants with MSc degree)

Year of acquiring the MSc degree:...... ………………………………………………………

  Other

...... (title of the PhD programme from the list)

......

(family name) (first and other names)

......

(date of birth: year, month, day) (place of birth: town, country)

......

(mother’s family name) (mother’s first and other names)

...... …………………

. (sex) (marital status, number and age of children)

......

(permanent address: street, town, postal code, country)

......

(mailing address, if different from the permanent address)

......

(passport code and number
...... and date of validity) (citizenship) (telephone number) (e-mail address)

Hereby I declare that all the information I provide in this sheet is reliable and accurate

......

(place: town, country; date: year, month, day) (original, non-copied handwritten signature)

application form page 1 See the following page for the list of necessary documents!

Enclosed I send the following documents (cross the appropriate square):

original officially attested copy simple copy

Secondary school
certificate (year:_____)

Record of studies of secondary

education (year:_____)

BSc diploma (year:_____)

Record of
BSc studies (year:_____)

MSc diploma (year:_____).

Record of
MSc studies (year:_____).

Document on competency

in English

Curriculum vitae Medical certificate

Four photographs with signature on the back

If the applicant sends only simple copies of documents where original, or officially attested copies are needed he/she has to present the original or officially attested copy at the entrance examination or at registration the latest.

Notes and remarks of the applicant

...... ………….

(place:town, country date: year, month, day) (original, non-copied handwritten signature of the applicant)

Notes, stamp and signature of the authorised representative of organizing partner

Name of the partner…………………………………………………………………………………………… (stamp)

………………………………………. …………………………………………….

(place:town, country; date: year, month, day) (original, non-copied handwritten signature of the authorised representative of the organizing partner)

application form page 2

The Application form should be send to:

Dr. Gyula Bene

Eötvös Loránd University,

Institute of Physics E-mail:

Budapest, Pázmány Péter s. 1/A, Tel: 36-1-372 2500 / ext. 6120

H-1117, Hungary Fax: 36-1-372 2509