Application Form Studies
Application Form Studies
Application Form Studies
YY
Please read the Guidance Notes to Applicants before completing the form. Complete the form in CAPITAL letters and black ink.
1. Language of study:
Polish
(you would like to participate in one year of the preparatory
Polish language course and pass an examination)
Polish
English
(you would like to participate in one year of preparatory
English language course and pass an examination)
English
Bachelor
Master
October intake
February intake
3. Personal details
Surname / Family name
First names
Male
Country of birth
Polish descent
Yes
Date of birth
No
Citizenship
Female
Y Y Y Y MM D D
Passport number
Home telephone
Telephone
Mobile
Mobile
Fax
Fax
YYYY
To
YYYY
YYYY
To
YYYY
YYYY
To
YYYY
University
From
University
From
Qualifcation
(include grade)
Date obtained
Y Y Y Y MM D D
Y Y Y Y MM D D
Y Y Y Y MM D D
Grade / score
Date of examination
Y Y Y Y MM D D
Y Y Y Y MM D D
Y Y Y Y MM D D
IELTS
TOEFL
OTHER
Date
Nature of Work
9. Accommodation
Do you wish to book a place in a student hall of residence?
Yes
No
10. Declaration
I agree to abide by the University Regulation.
I confrm that, to the best of my knowledge, the information given in this form is correct and complete.
Signature of Applicant
Date
Y Y Y Y MM D D
12. Attachments
For Bachelor studies: a copy of the secondary school certifcate (in English or Polish)
For Master studies: a copy of BEng / BSc / BTech degree certifcate (in English or Polish) and a transcript of records
Complete application form and supporting documents should be sent to:
WROCAW UNIVERSITY OF TECHNOLOGY
ADMISSION OFFICE
50-370 WROCAW
WYBRZEE WYSPIASKIEGO 27
POLAND