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SEMMELWEIS UNIVERSITY FACULTY OF HEALTH SCIENCES
PHOTO (signed)
Clip. Do not glue,
tape or staple
B.SC. AND M.SC. PROGRAMS IN ENGLISH
APPLICATION FORMTo Begin Studies in September 2013
1. Type or block print all information.
2. These items should be attached to the application:
Required documents
Completed Application Form
Application Fee of 200 EUR
Test Fee
Secondary School Leaving Certificate
Medical Certificates (in English): general medical report, HIV
test result,
Hepatitis B vaccination certificate, a chest X-ray result
Five Signed Photographs
Copy of Passport/ID card
Letters of Recommendation
Please note that the Faculty accepts only:
the original English document OR the attested copy of the
original English document OR
the authorized English translation of the original
non-English
document.
3. Sign the application form on page 2.
4. Submit all application documents to your local
representative:
Deadline for application: August 15, 2013*
Preferred location of the aptitude test:
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. . . . . .If no otherwise indicated send it directly to Semmelweis
University Faculty of Health Sciences,International Students
Secretariat (H-1088 Budapest, 17 Vas str., Hungary), or to the
Student Service Center
(College International, H-1406 Budapest 76, P.O. Box 51,
Hungary).
I apply for Physiotherapy B.Sc. Nursing B.Sc. Midwifery
B.Sc.
Please, tick () the appropriate box.
Family Name (Surname)
First Name (Given name)Please, write your name as written in the
passport.
Sex (F/M) Birthdate (D/M/Y) Birthplace (City / Country) Passport
/ ID card No.
Citizenship** Mothers full maiden name
Permanent Address (No. / Street / City / Town / Postal Code /
Country)
Phone/Fax at Perm. Address E-mail
* Applicants turning in their applications between 16/08/2012
till the end of zero week in semester 2013/14/1 have
to pay EUR 200 extra fee.
** If you have a dual citizenship please underline the country,
whose passport you will use during your stay on Hungary.
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ACADEMIC RECORD
1. List the details of your previous studies
Name of secondary school:
Location:
Dates: (from to)
Certificate:
Date and place of secondary school leaving exam:
Certificate issued by:
Certificate no.:
Main studies: (please underline) Biology Chemistry Physics
Activity after graduation if any:
2. What is your mother tongue?
Other languages? Speak: Read: Write:
Hungarian? Speak: Read: Write:
PERSONAL INFORMATION
3. Your marital status
4. Fathers full name Occupation
Address
Mothers maidenname Occupation
Address
5. Person to contact in case of emergency:
Name Relationship Daytime Phone
Address (No. / Street / City / Postal Code / Country) Daytime
Fax
6. CURRICULUM VITAE.Attach separate page
I hereby certify that all information provided by me in this
application is accurate and complete. I declare
that I am fully aware of the contents of the official English
language brochure of Semmelweis University
Faculty of Health Sciences, and fully accept the given
conditions.
(Signed) Date:
Where and how did you firstlearn about this program (please,
specify):
Where else did you get further information from:
www.se-etk.hu local representative www.studyhungary.hu
educational fair/seminar
a Budapest-student friend/relative my high school advertisement
other
