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O Application for Summer 2011, deadline: February 9, 2011 O 13 days program: O June or O July O 29 days program: O June or O July
O Undergraduate Level O Graduate level
O Application for Distance learning Diploma in European Business Administration 2010, deadline: September 29, you start the program at your own convenience: O Undergraduate Level O Graduate level Name______________________________________________________
Last First MI ID#
Date of Birth ____________ Birthplace ________________ Sex ____ Citizenship_________________
Current Mailing Address:
_____________________________________ _____________________________________
_____________________________________ _____________________________________ Permanent Address:
_____________________________________ _____________________________________
_____________________________________ _____________________________________
Phone Number ________________________ Phone Number ________________________
E-mail Address _______________________________________________
Profession_____________________________________________________________
Address ___________________________________________________________
Telephone ( ______ ) ________________________________________________
How did you learn about this program?
ACADEMIC RECORD
Current University and Program __________________________________________________________
Degree and Date Expected _______________________________________________________________
Previous Higher Education:
University _____________________________________________________________________
Degree and Date Received ________________________________________________________
Major Field of Study ____________________________________________________________
PERSONAL STATEMENT
Please address briefly the subjects below. You may wish to do this on a separate sheet of paper.
1) The reasons for your interest in the Summer Program.
2) How you expect to benefit from the program.
3) Work experience (only if relevant), provide brief information on employers, job title
Signature: ___________________________________________ Date: _________________ Tuition fee has to be transferred within 7 days after inscription on account number n° 123-6800224-75, OBK Banque, Graaf Van Vlaanderenplein 10, 9000 Gent, Belgium, IBAN code BE05 123-6800224-75; BIC code : BKCPBEBB. Withdrawal:
For the summer programs : applicants can withdraw without penalty until the close of business by registered post on February 28, 2010. After that date, 50% of total program cost will be charged for students which are accepted to the program. For the distance learning program: applicants can withdraw without penalty within 9 days after they have sent their application by registered post . After that date, 100% of total program cost will be charged. Any dispute the present inscription might give rise to false within the exclusive competence of the court of Gent, Belgium. The Belgian law shall apply.
Print this form and send your application by postal mail to
IEBA
Papegaaistraat 76
9000 Gent
Belgium
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