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 Please send this medical form to: Glion Institute of Higher Education Phone: +41 (0)21 989 26 77 |
| School – College – University | Certificate – Diploma – Degree | Dates | ||
St.Petersburg State University |
BA in Philology |
2002-2007 |
| Most Recent Company / Hotel | Position held | Dates | ||
|
IQ Consultancy |
manager |
2007-present |
Если Вы несовершеннолетний(яя) - укажите данные одного из ваших ближайших родственников.
Если Вы совершеннолетний(яя) - укажите данные человека оплачивающего ваше обучение. В случае если Вы самостоятельно оплачиваете Ваше обучение - укажите собственные данные.
 Mr. |
Mrs. |
 Miss. |
Nationality | Russian Federation |
| Family Name | Ivanova |
First Name | Anna |
| Profession | manager |
| If you reside in Switzerland, please specify if you have a: |
Swiss B permit
Swiss C permit
|
| Mailing Address | 27/2 Yanvarskiy pr., apt. 16 |
| City | St.Petersburg |
Postal Code | 154069 |
Country | Russian Federation |
| Home Phone | +7 812 3225808 |
Work Phone | +7 812 3225809 |
| Mobile Phone | +7 812 3183390 |
Fax | +7 812 3225810 |
info@iqconsultancy.ru |
Является ли вышеуказанное лицо вашим финансовым спонсором (человеком спонсирующим ваше обучение)?
Если нет - заполните ниже данные вашего финансового спонсора.
| Is the above person your financial sponsor? |
Yes
No - |
If not, please fill in the details of your financial sponsor below. |
| Mr. |
Mrs. |
Miss. |
Nationality |
| Family Name | First Name |
| Mailing Address |
| City | Postal Code | Country |
| Home Phone | Work Phone | Fax |
| Mobile Phone |
|
|
| July/August 20 |
09 |
January/February 20 |
Please return this form duly filled in, and enclose the following:
- Official copy of your High School Diploma/Degree, etc.
- Official copy of your final transcripts
- School information with grading system*
- Official copy of your English Language Certificate (TOEFL, IELTS, etc.)*
- Copy of work certificate (if available)
- Your Curriculum Vitae (resume)
- A Study Plan, duly dated and signed (250 words minimum)*
- A Post Study Plan (only for non European Union passport holders) duly dated and signed (150 words minimum)
- Referral letter of professional or academic nature* (Post Graduate students only)
- 2 passport size photographs
- 1 photocopy of your valid passport showing your name and nationality
- Bank guarantee (for non European Union passport holders) or letter from financial sponsor ( for European Union passport holders)
- Duly filled in, signed and stamped Medical Certificate / Physician Report
*Please refer to the admissions requirements in the Academic Programmes.
|
Industry Professional |
Glion student / Graduate* |
Internet |
|
A representative of Glion* |
Exhibition / Fair* |
School* |
|
Other, please specify |
web-site www.swisshotelschools.ru |
| *Please give the name |
If English is not your mother tongue or if you have not spent at least 3 years in an English speaking school, please indicate the score of one of the following:
|
TOEFL Score: |
Cambridge First Certificate Score: |
IELTS Score: |
|
Other (Name + Score): |
not yet |
Your Mother Tongue: | Russian |
|
I will bring my own laptop which meets the Institution’s requirements |
|
I would like to purchase the laptop through GIHE |
I would like the following room arrangement:
|
A double room (2 beds) part of the main fees |
A smoking room |
A non-smoking room |
| A single room on Campus, if available |
Room A (Glion)* |
Room B (Glion)* |
|
Room C (Glion)* |
Room D (Glion)* |
|
| A double room at the Residence, if available |
Double Room (Glion)* |
|
| A single room at the Residence, if available |
Single Room (Glion)* |
Single Room (Bulle)* |
* Please refer to the Tuition & Fees for the additional price to be paid by semester for room A to D and for the Residence
Поле APPLICATION FEE не заполняется online!
Распечатайте анкету и внесите данные в поле APPLICATION FEE DETAILS от руки. Тем самым Вы даете разрешение на оплату регистрационного сбора университета в размере 100 швейцарских франков. Если по какой-либо причине Вы не хотите осуществлять платеж по кредитной карте, Вы можете сделать это банковским платежом. В этом случае Вам нужно перевести регистрационный сбор в размере 100 швейцарских франков на следующие банковские реквизиты:
Beneficiary : G.I.H.E.
Banque Cantonale Vaudoise
1001 Lausanne
Switzerland
Account No : C5006.72.77
SWIFT : BCVL CH 2L
Clearing : 767
IBAN No: CH03 0076 7000 C500 6727 7
Если Вы перечислили регистрационный сбор (100 швейцарских франков) банковским платежом, необходимо также отправить с остальным пакетом документов подтверждение платежа, предоставленное Вам банком.
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Visa |
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Eurocard/Mastercard |
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American Express |
| Card number | / | / | / |
| Name |
| Expiry date | / |
| Security code number | / | ||
(on the back of the credit card) |
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I hereby certify that all information given on this form is exact and complete. I acknowledge having read and understood this document, the current Academic Catalogue (available from the website www.glion.edu) which includes the Charter, the Rules of GIHE as well as the payment terms and conditions. I agree to abide by them as well as the specific "Glion Spirit" regulations. I understand that the fees are modified once a year and thus accept their revision (in summer). I hereby declare to abide by the Swiss law in case of a dispute related to the interpretation or to the execution of my legal obligation towards GIHE and accept the exclusive competence of the Vaud Cantonal court.
| Date / Signature of the candidate |
Anna Ivanova |
| Date / Signature of the financial sponsor |
