APPLICATION FORM _______________________ ACADEMIC YEAR 200…-200… Please fill in this form in black ink and in capital letters as carefully as possible, apart from the grey parts. This sheet and supporting documents should be sent back by: th


30 June for admission in September

or


30th November for admission in January.


20th May only for applicants for Master in Management / Programme Grande Ecole

PROGRAMME (Please tick the box): Master of Science in International Business Development (MScIBD) Master of Science in International Management (MScIM) Please add

Master in Business (MiB)

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Bachelor in Business (BiB) Master in Management / Programme Grande Ecole (ESC Dijon): English-taught programme French-taught programme

PERSONNAL DETAILS Surname: ..................................................................................................................................................... First Name: .................................................................................................................................................. Gender:

M

F

Nationality: .............................................................. 2nd Nationality: ........................................................... Date of birth: ............................................................ Place of birth:............................................................. Marital status:

Single

Married

Professional Status: .................................................................................................................................... Permanent Address: ................................................................................................................................... Postcode: ................................................................ City:............................................................................ Country: ....................................................................................................................................................... Home Phone Number: ............................................ Cell Phone: ................................................................ E-mail Address: .......................................................................................................................................... 2nd E-mail Address:...................................................................................................................................... 1/6

Address where you wish to receive your mail and your admission results: ............................................... .................................................. .................................................................................................................. Postcode: ................................................................ City:............................................................................ Country: ....................................................................................................................................................... Phone Number: ....................................................... E-mail Address: .........................................................

ACADEMIC BACKGROUND University Education UNIVERSITY

DEGREE OBTAINED

SPECIALISATION

HONORS, RANK OR GRADE

YEAR

Secundary Education SCHOOL

DIPLOMA

YEAR

Further Studies Please detail: ............................................................................................................................................. ...................................................................................................................................................................

LANGUAGES Mother Tongue: ........................................................................................................................................... Language of instruction at home university (if different):............................................................................. Foreign Languages: (please choose the suitable code) 1: fluent LANGUAGE

2: very good

3: average

4: poor

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WRITTEN

SPOKEN

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HAVE YOU EVER STUDIED OR TRAVELLED ABROAD . IF YES, WHEN AND WHERE ?. ..................................................................................................................................................................... ..................................................................................................................................................................... .....................................................................................................................................................................

PLEASE

DESCRIBE A MULTI-CULTURAL EXPERIENCE THAT HAS INFLUENCED YOU IN

PARTICULAR. EXPLAIN WHY. ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... ...................................................................................................................................................................

PROFESSIONAL EXPERIENCE DATE

PLEASE

COMPANY

POSITION HELD

DERSCRIPTION

COMMENT ON YOUR MOST IMPORTANT EXPERIENCE (WORK, SOCIAL ACTIVITIES,

STUDENTS ORGANISATIONS, EXTRA-CURRICULAR PROJECTS…) ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... ................................................................................................................................................................... 3/6

TRAINING PERIODS AND TEMPORARY JOBS DATE

COMPANY

POSITION HELD

DERSCRIPTION

PERSONAL QUESTIONS How will you be financing your programme? Self-Sponsored

Bank Loan in your home country

Grant

Company Sponsorship

Others:........................................................................................................... In case of non admission, what alternative have you foreseen? Which other programs did you apply for? ................................................................................................................................................................... ................................................................................................................................................................... How did you hear about Burgundy School of Business ?

□ Presentation Place

□ Career Days

............................................................ Date .......................................................................

□ Ads – Posters – Press Place

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

□ Embassy – Consulate – Alliance Française Place

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

□ Careers Advisors – Faculty □ University .............................................................................................................................................. □ Company Internship □ Personal contacts □ BSBU website □ Other 4/6

APPLICATION FEES: € 100

PAYMENT TO BE INCLUDED WITH THE APPLICATION FORM.

Please indicate which method of payment you have chosen
I will pay the application fees of € 100 by including a cheque, payable to "Groupe ESC Dijon"
I will pay the application fees of € 100 by bank transfer in Euros to the following account:

Name and address of the bank:

CREDIT LYONNAIS DIJON 6, rue de la Liberté 21000 Dijon

Account Holder:

CCI Dijon (Chambre de Commerce et d'Industrie de Dijon)/ Groupe ESC Dijon Bourgogne BP 50608 21006 Dijon cedex

BIC/SWIFT

CRLYFRPP

IBAN:

FR08 3000 2025 5500 0006 0265 F43

I hereby certify that the data in this application form is true and accurate.

Date: ............. / ................. /............... Signature: ...................................................................

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PLEASE CHECK YOU HAVE ENCLOSED THE FOLLOWING DOCUMENTS


Completed application form
Statement of goals/objectives for studies at Burgundy School of Business
Copy of passport/identity card, and residence permit if applicable
Curriculum Vitae/resume
A certified copy of your degree translated into French or English
Official academic records (courses attended + grades)
TEF, DELF, TOEIC or TOEFL certificate (or equivalent) for non English native speakers
Two recommendation letters (MScIBD and MScIM applicants only)
Application fees of € 100

Please return to:

Groupe Ecole Supérieure de Commerce de Dijon Bourgogne International Office 29, rue Sambin F - 21000 DIJON Telephone +33 380 72 59 85 Fax +33 380 72 59 88 e-mail : [email protected] website: www.bsbu.eu

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