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APPLICATION FORM
POSTGRADUATE PROGRAMMES
2010 - 2011
Applicant, please complete:
NATIONALITY: ....................................................................
DATE OF BIRTH:.................................................................
.08A
ONLY FULLY COMPLETED APPLICATION FORMS WILL BE CONSIDERED.
PLEASE COMPLETE IN BLOCK CAPITAL LETTERS
PERSONAL INFORMATION
E-MAIL: ....................................................................................................................
SOCIAL SECURITY NUMBER: /__/ /__/__/ /__/__/ /__/__/ /__/__/__/ /__/__/__/ /__/__/
(For applicants already living in France only)
ADMISSION INFORMATION
Postgraduate Programmes
Please tick
Location Date
here if the
Name of High School (City/Countr (Month/Year Specialization / major exam was
y) ) in English
Please list the last 4 years’ post secondary school and universities attended.
Please write the full name of the school; do not abbreviate or use initials.
Please tick
Date of
Location Date of
Complet Name of here if the
Past Entry degree / programm
(City/Countr ion Major e was
School/University (Month/Ye diploma
y) ar)
(Month/Ye taught in
ar) English
Expecte
Name of Please tick
d date
Date of here if the
Current Location of degree /
Entry programm
(City/Countr Complet diploma Major
School/University (Month/Ye e was
y) ar) ion taught in
(Month/Ye English
ar)
English
French
Have you completed one of the following tests of English in the last 24 months?
(If yes, attach a certified copy of your results)
Any test planned: At ESC Rennes School of Business (for applicants living in
France only)
Name of the test and when approximately to be taken:
_________________
Powerpo Others
Word Excel Internet
int Please specify
Employer
Period Job Title Responsibilities
(Name/City/Country)
Where did you hear about the ESC Rennes School of Business Programmes?
Advertisement in a magazine /
newspaper (please specify)
Others
DECLARATION
I am aware of the extent of the tuition and living costs associated with studying
on the programme of studies for which I am applying and I am able to meet all
these expenses. I understand that it is my responsibility to request that school
records from each academic institution I have attended be submitted to ESC
Rennes School of Business. I certify that the information that I have provided
on this application, and on all other admission application materials, is
complete, accurate and true to the best of my knowledge. I understand that
misrepresentation of any information may result in cancellation of the
application or registration, with no refund of any fees possible.
I will pay the 60€ application fees by including a cheque, payable to ESC
Rennes School of Business.
I will pay the 60€ application fees by bank transfer in Euros to the following
bank account:
In order for your application to be processed rapidly, please mail the completed
application form and relevant materials to the following address:
Other:
……………………………………………………………………
….
Cancelled:
………………………………………………………………….
Programme Director /
Programme Director / Manager :
Manager:
Date:
…………………………………... Date: ……………………………………
.