I, (FIRST AND LAST NAME) _______________________________________, born on (DD/MM/YYYY) ___/___/______, ask to be enrolled, for the Academic Year 2019/2020, in the following course:
Faculty/School: FACULTY OF ARTS
Course: MASTER IN SONIC ARTS (ENGLISH VERSION).

I hereby declare that the following information is true.

Personal Information
First Name*:
Last Name*: 
Sex (M/F):
Nationality*:
Date of Birth (DD/MM/YYYY)*: 
Country of Birth*: 
City of Birth*: 
E-Mail*: 
Mobile Number:

Permanent Residence
Address*: 
City*: 
Country*:
Zip Code*: 
Telephone Number:

Current Residence where you would like to receive correspondence (do not complete if the same as Permanent Residence)
Address: 
City: 
Country:
Zip Code: 
Telephone Number:

Degree
University or College*: 
Degree title*:
If you graduated*:
Grade (XXX/XXX): 
Date of Graduation (DD/MM/YYYY): 
Academic Year of Graduation (YYYY/YYYY): 

* required fields