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IVAN FRANKO NATIONAL UNIVERSITY IN LVIV (IFNU)

Preparatory School for International Students (PSIS)

2003-2004 academic year

Application Form



APPLICATION FOR ADMISSION

(This application and supporting documents become the property of IFNU)


ADMISSION INFORMATION


General conditions:


Cancellations: All cancellations must be made in writing to the university. For cancellations received less than two weeks before the commencement of the course no fees are refundable except at the IFNU President discretion in the case of illness or emergencies.

Liability:

A student is liable to pay any damage to the university's property, whether intentional or not. The Dean reserves the right to exclude from class any student who is restricting the class's progress because of poor attendance or bad behaviour. The same conditions are valid for students lodging in a hostel.


1. Last name


..............................................................................................


Please attach a recent photo



2. First and middle names


..............................................................................................




3. Date of birth (da/mo/yr)


..........................................

4. Sex:

Male Female




5. Nationality


........................................................................

6. Passport No.


............................




7. Permanent Home Address:

Street


.......................................

City


..................................

Zip/Country


...............................................

Telephone

Fax

E-mail

www Home page


...................


.......................


....................................


..................................

8. Name and address of a person to be contacted in emergency


.............................................................................................................................................


..............................................................................................................................................

Telephone

Fax

E-mail

www Home page


.....................


........................


.....................................


..................................

9. Family Status: Single Married


10. Place of Employment and Profession of Parents


...................................................................................................................................


...................................................................................................................................


^ SELECTION OF COURSES

(Please check the box where appropriate)

11.






Full course, UAP (6 years, including Preparatory Department)

School You wish to enter

(refer to Catalogue)


.....................................................................................






Five-month USP-course of Ukrainian/Russian

Specific purpose (, e.g. private, business, research etc.)


.....................................................................................






Course of Ukrainian / Russian during the Summer




Beginner



Intermediate


Advanced






Private individual tutorials (PIT)




12. Enrollment

Desired Enrollment Date
(year, month)


.....................................................................................




13. Indicate the foreign language proficiency level

Language

Beginner

Intermediate

Advanced




.................................













.................................













.................................











NOTE: Application must be signed and dated below in order to be valid.

I certify that the information in this application is true and complete to the best of my knowledge. I understand that inaccurate information may affect my enrollment. Further, I will abide by its rules and regulations.


14. Documents enclosed:

1. ....................................................................................................................................


2. ....................................................................................................................................


3. ....................................................................................................................................


4. ....................................................................................................................................

NOTE: All the documents must be translated into English, French, German or Spanish and notarized by the Ukrainian Embassy in your country










Applicant’s Signature




Date

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