DIRECT ENTRY APPLICATION FORM – February 2012 AP degree in Marketing Management EU and NON EU students It is very important that you fill in all spaces and that you enclose a copy of all relevant documents that may support your application. It is important that you make a great effort when filling in this form. Remember that we make a decision about your admission based on your application. Illegible or insufficient applications will not be dealt with! Personal data (please type) Family Name
First name(s)
Date of Birth/Civil reg. no.
Nationality
Sex:
Male
Female
Do you have the intention of applying for a Bachelor Top-up programme after having completed your AP degree?
Yes
_______
No
________
Trongaardsvej 44 DK-2800 Lyngby Tel +45 88 52 66 00 Fax +45 88 52 66 10
Personal data (please type) Address: (to which you want us to send your mail) Street
City
Postal code
Country
Country Code
City Code
Number
Telephone number: Mobile number: E-mail (in CAPITAL letters) IMPORTANT to fill!
Address of contact person in Denmark (if any): Name of contact person in Denmark: Street City
Postal code
Telephone number
Educational qualification (please type) A. Upper Secondary School/High School (age 15-19): Name of School: Address: Telephone number: Web page:
Trongaardsvej 44 DK-2800 Lyngby Tel +45 88 52 66 00 Fax +45 88 52 66 10
Name of headmaster/reference person: E-mail/telephone number of headmaster/reference person: From (month/year):
To (month/year):
Type of certificate/diploma:
B. University/College (previous studies – if any): Name of University/College: Address: Telephone number: Name of reference person: E-mail/telephone number of reference person: From (month/year): Programme/course:
Relevant subjects studied:
Total amount of lessons:
English skills: Date of test: TOEFL score: Date of test: IELTS score:
Trongaardsvej 44 DK-2800 Lyngby Tel +45 88 52 66 00 Fax +45 88 52 66 10
Please highlight your skills in Mathematics/Economics: level, number of lessons etc
Date of examination:
Date of examination:
Date of examination:
Job experience (if any) (please type): Job title
Employer and location
Period
(Copy of references enclosed) Interests (please type) List in order of importance to you, your main extra curricular interests/activities:
Information to support your application (please type): Please write here your reasons for applying, and any further information you wish to give in support of your application:
Reference from at least two academic references, as a minimum (please type): Title
Name
Address
List of copied documents enclosed (certificates, diplomas, job references, TOEFL/IELTS score slip etc) A. B. C. D. E. F.
Date
Signature
Trongaardsvej 44 DK-2800 Lyngby Tel +45 88 52 66 00 Fax +45 88 52 66 10