APPLICATION FORM DAY PROGRAMMME nd 22 EDITION Brussels, from 14/09/15 to 11/12/15 Name ……………………………………………………… Surname ……………………………………………………… sex: M or F Place of birth ………………………………… Date of birth ……../..……/…..… Nationality ….…………………………………… Address (street, square...) ….……………………………………….……………………………………………………… n. ………..…… ZIP code ……………………….. City/Town ……………………………………………… Country………………………………………… ID/Passport n. ………………………………………………………………………………… Expiry date .………………………………... E-mail …………………………………………………………….....…………………………………………………………………………………… Cell (or fixed) phone number (with country code): .………………………………………………………………………………… DECLARES to have obtained or will obtain the university degree in …………………………………………………………….....…………………………………………..…………… at the University of / Institute of…………………………………………………………….....…………………………………………… on the (date) ……../..……/…..…, with the following degree mark …….. out of …….. (indicate the maximum) to have obtained or will obtain the post-university degree in …………………………………………………………….....…………………………………………..…… at the University of / Institute of …………………………………………………………….....…………………….…………………….. on the (date) ……../..……/…..…, with the following degree mark …….. out of …….. (indicate the maximum) SDS 26 mod 01/A rev6 HOW HAVE YOU LEARNED ABOUT THE MASTER IN EUROPEAN STUDIES? Europeanmaster.net Poster, brochure Masterin.it FindAMasters.com Eurobrussels.com Facebook European Voice European Commission other ………………………… BELGIAN-ITALIAN CHAMBER OF COMMERCE - INSTITUTE OF EUROPEAN STUDIES OF THE CATHOLIC UNIVERSITY OF LOUVAIN APPLICATION FORM DAY PROGRAMMME nd 22 EDITION Brussels, from 14/09/15 to 11/12/15 ENCLOSES 1. An English language knowledge certificate (if available); 2. The scholarship application form duly filled (if eligible according with the criteria stated in the Scholarship Application Form); 3. A copy of university diploma or equivalent degree (for last year students a certificate with the transcripts of results and grades obtained); 4. A CV (European format) in English; 5. A cover/motivation letter in English; 6. One passport-sized photo; 7. A copy of passport or other identification document. …………………………….. ………………………..…………………………… Date Candidate’s signature Only the application forms sent by 30th June 2015 will be considered. The application package shall be sent by registered post to: European Desk – Belgian-Italian Chamber of Commerce Day Programme International Master Avenue Henri Jaspar 113, 1060 Brussels – Belgium Or by email (all the documents shall be signed and scanned) to: info@europeanmaster.net The selection’s criterions are illustrated in the web-site www.europeanmaster.net. IMPORTANT: due to the high number of applications, candidates who reach an evaluation of 75% th according to the assessment criteria will be directly admitted to the course before the deadline of 30 June 2015, by following chronological order. SDS 26 mod 01/A rev6 The list of the selected candidates, drawn up on the base of the documents received, will be formulated by the Belgian-Italian Chamber of Commerce and the Institute of European Studies of the University of Louvain. Personal data will be exclusively used for organizing the course’s enrolments. The tuition fee to attend the Master is 5.500 € (or 3.500 € if a scholarship is awarded). The application form shall be sent together with the scholarship application form. st If you are selected, you shall confirm your enrolment by transferring the 1 instalment of the tuition fee (1.000 €) within 5 days. This Master degree does not provide university credits. BELGIAN-ITALIAN CHAMBER OF COMMERCE - INSTITUTE OF EUROPEAN STUDIES OF THE CATHOLIC UNIVERSITY OF LOUVAIN SCHOLARSHIP APPLICATION FORM DAY PROGRAMMME nd 22 EDITION Brussels, from 14/09/15 to 11/12/15 The Belgian-Italian Chamber of Commerce awards scholarships of 2.000€ each, to partially cover the tuition fees of the Master. If you are awarded of a scholarship, your tuition fees will be reduced to 3.500€. Please, note that you will not be transferred directly any cash; the scholarship consists of a reduction of the Master’s fees. IMPORTANT: Indicate either your personal income (if you are independent) or your family’s income (if you are financed by your family). Note that scholarships are given on the basis of income and merit. To be admitted as candidate for a scholarship you need to satisfy the following criteria: o Yearly personal income not higher than 8.000 € or yearly family income not higher than 30.000 €; o A score of at least 60 % in the evaluation of your Master’s application. Please, note that you need to satisfy both criteria to be admitted as a candidate for the scholarship. I, the undersigned, …………………………………………………………., applicant for the 22 nd edition of the International Master in European Studies, declare that (cross and fill only one choice): 1 I am independent and my yearly personal income is € ………………………………… Family in charge ………………………………… Disabilities ………………………………… Other relevant info ……………………………………………………………………………………………………… 2 I depend financially from my family and my yearly family income is € ………………………………… Single parent family Number of brothers/sisters ………………………………… Disabilities ………………………………… Other relevant info ……………………………………………………………………………………………………… I fully understand that any information furnished above, if proved incorrect or false will render me liable for any penal action or other consequences as may be prescribed in law or otherwise warranted. Any false declaration on my part will as well result in the cancellation of my application form. I acknowledge that the Belgian-Italian Chamber of Commerce reserves the right to request supporting SDS 26 mod 04/A rev6 documents or certificates at any time to prove the information provided above. …………………………….. ………………………..…………………………… Date Candidate’s signature Indicate the net yearly income resulting from the most recent available tax declaration. The amount must be expressed in Euros. 2 Indicate the sum of the net yearly income resulting from the most recent available tax declaration of the members of the family. The amount must be expressed in Euros. 1 BELGIAN-ITALIAN CHAMBER OF COMMERCE - INSTITUTE OF EUROPEAN STUDIES OF THE CATHOLIC UNIVERSITY OF LOUVAIN ENGLISH KNOWLEDGE SELF-STATEMENT DAY PROGRAMMME nd 22 EDITION Brussels, from 14/09/15 to 11/12/15 I, the undersigned, …………………………………………………………., declare that I am able to understand spoken and written English as well as interact in this language. My knowledge of this language is: Fluent I have reached this English knowledge level through the following activities: ……………………………………………………………..…. for months …………………… ntry …………………………………………………………………………….for months …………………… ……………………………………………………. for months …………………… country …………………………………………………………. for months …………………… …………………………………………………………. for months/weeks …………………… ………………………………………………………….………………………………………………………….……………………………. Faithfully, ………………………..…………………………… Date Candidate’s signature SDS 26 mod 03/A rev6 …………………………….. BELGIAN-ITALIAN CHAMBER OF COMMERCE - INSTITUTE OF EUROPEAN STUDIES OF THE CATHOLIC UNIVERSITY OF LOUVAIN
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