Vous êtes sur la page 1sur 2

University of Miskolc, Hungary

Faculty of Earth Science and Engineering

MS in Petroleum Engineering program

Application Form

1. Last Name ___________________ First Name ____________________

2. Current citizenship _______________________________

3. Date of birth (dd/mm/yy) _____ / _____ / _____

Place of birth, country _______________________________

4. Present address until _____ / _____ / _____

Post/Zip code ___________ Country _______________

Telephone: ________________ Fax: ________________

Current e-mail: ___________________

5. Home address ( if different from above)

Post/Zip code ___________ Country _______________

Telephone: ________________ Fax: ________________

6. Gender: __ Male __ Female

To be sent to:
Faculty of Earth Science and Engineering
Petroleum Engineering Department
H-3515 Miskolc-Egyetemváros, Hungary
7. Include the degree, the name of the university or other institution from which you graduated, the
classification of award and date the degree was awarded. A full transcript of your results, the
courses taken and the grades granted must be supplied in support of your application
Institution Location Time Major courses Title of Date granted/To be
period degree granted

8. English language proficiency

A. Is English your mother tongue? Yes __ No __

If ‘No’ which language do you normally speak
at home ________________
at work ________________
what was the language of tuition for your BS degree? ________________

B. Please give full details below of your examination in English language (TOEFL or IELTS)

Examination or test Grade or score Subject Date

9. Please enclose:
__ Copy of BS in PE diploma __ Official Transcripts
__ 2 Photos __ CV
__ Copy of passport or ID card

Applicant’s Agreement
I certify that the information given is complete and accurate to the best of my knowledge.
The Admissions Committee may verify any and all parts of my application materials.

Date _____ / _____ / _____ Applicant’s signature ________________