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![]() Please send this application form to:
The Admissions Department
Phone: +41 (0)21 989 26 44 |
| School - College ?- University | Certificate - Diploma - Degree | Dates | ||
University of Economic and Finance |
Specialist (5 years) |
1997-2002 |
| Most Recent Company / Hotel | Position held | Dates | ||
IQ Consultancy |
Financial Director |
2003-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 | Ivanov |
First Name | Vladimir |
| Profession | General Director |
| Mailing Address | the same |
| City | the same |
Postal Code | the same |
Country | the same |
| Home Phone | the same |
Work Phone | the same |
Fax | the same |
| Mobile Phone | +7 812 3183390 |
info@iqconsultancy.ru |
| If you reside in Switzerland, please specify if you have a: |
Swiss B permit
Swiss C permit
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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 |
| Mobile Phone | Fax |
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Please tick the program you wish to enroll on (one choice only). The courses below start either in January or July:
Please indicate the year you wish to start:
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Please indicate the year you wish to start:
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Les Roches Educational Counselor*
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Industry Professional |
Student / Alumus |
dvertising / Article in
newspaper or magazine* |
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Education Fair*
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Internet ? Website |
Your School Counselor* |
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Other, please specify |
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): |
Your Mother Tongue: | Russian |
I will bring my own laptop which meets the Institution?s requirements |
I would like to purchase the laptop through Les Roches |
I would like the following arrangement:
A double room (2 beds) part of the main fees |
A double room in Peter's Farm* |
A single room*
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An uncovered parking space* |
No room and board required (please refer to the Tuition Fees to check which program and semester do not have compulsory lodging and full board).
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* 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:
UBS SA, 1002 Lausanne, SWITZERLAND
Account number: 243 H6167514.0
Beneficiary’s name: GESTHOTEL SA, Hotel Management School Les Roches
Swift Address: UBS WCHZH10A
IBAN: CH 1600243243H61675140
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 |
Eurocard/Mastercard |
American Express |
| Card number | / | / | / |
| Name |
| Expiry date | / |
| Security code number | / | ||
(on the back of the credit card) |
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I hereby declare that all information given on this form is exact and complete. I acknowledge having read and understood this document and all other pertaining documents and will abide by the Standards of Excellence of Les Roches.
I understand that the fees are modified once a year and I 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 Les Roches and accept the exclusive competence of the Valais Cantonal court
| Date & Signature of the Financial Sponsor (if not the legal guardian): |
Please return this form fully completed and make sure the following are enclosed:
* See admission requirements in the Academic Program leaflet
| Date & Signature of the candidate: |
| Date & Signature of the parent / guardian: |

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Заполните в соответствии с Вашей медицинской историей. Распечатайте заполненную форму, поставьте собственную подпись и подпись Вашего спонсора, если Вам нет 18 лет. Перевод основных болезней.
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| No | Yes | (if yes, when) | No | Yes | (if yes, when) | No | Yes | (if yes, when) | |||||
| Chicken Pox | ![]() |
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Diabetes | ![]() |
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Epilepsy | ![]() |
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| Rubella | ![]() |
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1983 |
Tuberculosis | ![]() |
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Psychological Disorder | ![]() |
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| Measles | ![]() |
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Hepatitis A/B/C | ![]() |
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Sleeping Disorder | ![]() |
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| Mumps | ![]() |
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please specify | Eating Disorder | ![]() |
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For the following points, please specify if you:
| Have any other disease or have had an operation recently | no |
| Have dyslexia or other learning problems (indicate to what degree) | no |
| Have allergies to any medicine or other products | no |
| Take any medication on a regular basis | no |
| Take or have taken antidepressants | no |
| Are on a special diet | no |
| Have had any accident with mental or physical consequences | no |
With regards to any of the above special needs or medical condition you may require, Glion aims to create an environment which enables all students to participate fully to the campus life. To help us make reasonable adjustments, it is imperative to clearly indicate your special needs (ie. dyslexia) or medical condition. Please note that consideration of how we can meet any special needs is separate to the assessment of your academic suitability.
How would you describe your general health condition?
Excellent
Very good
Good
Poor
In keeping with the Institute?s policies regarding preventive health measures, the School Director may request a student to undergo a medical checkup at any time during his/her studies at Les Roches.
I hereby certify that the above information is correct and that I agree to undergo a medical checkup if required. Deliberate false statements ma Les Roches will not be held responsible in case of incorrect medical information stipulated on the Medical Certificate and Physician?s Report.
| Signature of the applicant | Soifa Ivanova |
Date | 01/02/09 |
| Signature of the parent or legal guardian | Vladimir Ivanov |
Date | 01/02/09 |
