TOMAS BATA UNIVERSITY IN ZLÍN, CZECH REPUBLICAPPLICATION FORM FOR FOLLOW-UP MASTER'S PROGRAMME

Tomas Bata University in Zlín (TBU) does not accept application forms sent by post.

APPLICATION DEADLINE: 31 MARCH 2013 (1st round)passport photo

TBU will consider your application only upon receiving all the below mentioned (page 3) to be sent by post

documents with the given validation. Late applications won´t be considered.

Programme Details

Degree programme N7202 Media and Communication Studies

Degree course 8206T037 Marketing Communications

Faculty Faculty of Multimedia Communications

Language of tuition English

Mode of study Full-time

Personal Information

Surname / Last name* * last name in passport/ID

First and other names* * names in passport/ID

Maiden surname

Title* Mr Ms * delete if not applicable

Country of permanent residence

Nationality

Marital status* single married other * delete if not applicable

Valid until date

Valid until date

Contact Details

Permanent address

Street

City / Town / Region

Postal code

Country

Present mailing address (if different from permanent address)

Street

City / Town / Region

Postal code

Country

Email address

Contact numbers Home Mobile ph.

Language Proficiency

Native language

cross (x) where applicable Beginner Elementary Pre-Inter. Intermediate Upper-Inter. Advanced

English

Czech

Return completed (not hand written) form to: mblahova@rektorat.utb.cz.

Date of birth (day, month, year)

Place of birth (city, country)

Birth certificate number - "rodné číslo" (for Czech and Slovak citizens only)

Passport number (non EU citizens)

ID number (EU citizens)

Other (specify):

Academic History

Secondary education

Name of school

Language of instruction

Address

Street

City / Town / Region

Postal code

Country

Web address / Email

Year of enrolment Year of graduation

University education - Bachelor's

Name of university

Name of faculty

Degree programme

Degree course (specialization)

Language of instruction

Address

Street

City / Town / Region

Postal code

Country

Web address / Email

Year of enrolment Year of graduation

Degree obtained

Academic awards, research work,..

Tuition Fee

Payment information

Account holder´s name and address Tomas Bata University in Zlín

Namesti T.G. Masaryka 5555, 760 01 Zlín, Czech Rep.

27-1925270277/0100

IBAN (for payments in CZK) CZ75 0100 0000 2719 2527 0277

43-7565040247/0100

IBAN (for payments in EUR) CZ29 0100 0000 4375 6504 0247

Name and address of the bank Komercni banka, a.s.

Tr. T. Bati 152, 761 20 Zlín, Czech Republic

Variable code 4903649930

Specific code (payment detail) surname of the applicant

SWIFT KOMBCZPPXXX

Student Accommodation

Please complete this section if you want to apply for accommodation in the University Halls of Residence

and you are not a TBU student so far. If you are a first year student and are admitted to University

accommodation, you will have to share a room (only twin rooms are available).

I hereby apply for accommodation in TBU Halls of Residence* YES NO

* delete if not applicable

The tuition fee of CZK 60,000 per 1 academic year shall be paid within 15 days after the enrolment at TBU.

Bank account number (for payments in CZK)

Bank account number (for payments in EUR)

www.kmz.utb.cz

documents must be sent:

BY POST

If you complete your studies in spring/summer 2013 and your Bachelor's diploma and transcript of records will be issued

after the deadline for applications for the follow-up Master's programme in Media and Communication Studies, kindly

provide us with written confirmation from the student affairs department of the university you will complete your

education at, including the expected date of your final examination, the date of receiving your diploma and the transcript

of records, and the list of subjects you have passed before 31 March 2013.

Please see further details on the following website:

Postal address Tomas Bata University in Zlín, International Office (Michaela Blahová)

Namesti T.G. Masaryka 5555, 760 01 Zlín, Czech Republic

title is available in the Dean's Directive.

Form, specification of the entrance examinations, enrolment date and further information available in the

the Dean's Directive available at:

How did you get to know about TBU?*

International / Student Affairs Office / other representative of the educational institution you completed your education at

Ministry of Education / Ministry of Foreign Affairs / Czech Embassy / Czech Centre in your country of origin

Previous stay in Zlín (short-term study, placement, etc.)

TBU student / TBU alumni / TBU employee / friend

Fair, presentation, advertisement (please specify):

Internet website (please specify):

Other (please specify):

*cross out if not applicable

The data are confidential in accordance with the Law No. 256/1992 Coll., on personal data protection in information

systems, Law No. 106/1999 Coll., on access to personal information and Law No. 101/2000 Coll., on personal data

protection and on amendments to selected laws. I hereby give my consent to Tomas Bata Universisty in Zlín to use my

personal data in internal information systems of Tomas Bata University in Zlín.

I hereby declare that all the above data are true, that the documents that I have supplied with this application are

genuine and that I have not withheld any important information.

After sending the completed Application Form to mblahova@rektorat.utb.cz, the following

1. Diploma and transcript of records- Bachelor's degree /study reports from each study year, list of subjects

with number of lessons and leaving certificate/verified by the relevant foreign authority (please see the List of

countries with an overview of the relevant verification groups at: http://web.utb.cz/?id=0_13_4&iid=0&lang=en&type=0

and translated into Czech or English.

2. Original copy or an officially verified copy of the recognized Bachelor's diploma in the Czech Republic.

http://web.utb.cz/?id=0_3_12&iid=7&lang=en&type=0

3. Two passport-sized photos

4. Certificate in English of B2 level or higher, a notary verified copy (please see the Equivalency table of different

English language tests at: http://web.utb.cz/?id=0_13_4&iid=0&lang=en&type=0

BY EMAIL SCANNED DOCUMENTS (mblahova@rektorat.utb.cz)

5. CV (curriculum vitae) typewritten in English.

6. Reference letter from your University (typewritten in English).

7. Essay on the chosen topic of approx. 2,500 - 3,000 words written in the English language. Essay topic

http://web.utb.cz/?id=0_13_4&iid=4&lang=en&type=0

I am aware of the fact that in case I commit a fraudulent practice during the admissions process, I might be in

consequence of this practice and in compliance with Paragraph 67 of the Act No. 111/1998 Coll., on Higher Education

Institutions and on Alterations and Amendments to Other Acts (Higher Education Act), expelled from the University.