Metropolitan University Prague

Requirements Checklist: copy of the receipt of payment of the administrative fee for the operations relating to the admission Application Form procedure for Final State legally attested (certified/notarised) copy of the applicant’s Master’s or Doctoral diploma Rigorosum Examination P R A G U E graduates of foreign educational institutions: legally attested (certified/notarised) copy of the certificate of Application received on: recognition of foreign diploma (“nostrification“) at Metropolitan University Prague (for office use only) Rigorosum Thesis proposal in the extent stipulated by the relevant Rector’s Decision for the 201 /201 academic year Registration no.: copy of Master's Dissertation (if applicable) (for office use only)

The application form must be completed legibly, electronically or in capital letters, printed double-sided, signed, and submitted in an envelope marked “Application” to the following address: Metropolitan University Prague International Student Services Dubečská 900/10 100 31 Praha 10 – Strašnice Czech Republic

University: Metropolitan University Prague Specialisation: International Relations and European Studies

Last Name1: First Name1: Maiden Name1 Other Names1

(if applicable): (if applicable): Sex: Status: Citizenship:

Date of Day: Place of Birth – City: Birth: Month: Place of Birth – Country: Year: Birth Number2:

Permanent Street and No.: Phone: Address: Town/City: E-mail: @ Country: Postal Code:

Mailing Street and No.: Phone: Address: (if different Town/City: E-mail: @ from above) Country: Postal Code:

Additional Full Name: Contact Information Street and No.: Phone: : Town/City: E-mail: @ (optional) Country: Postal Code:

1 Please make sure to use diacritics as they appear in your official documents. 2 Applicable to Czech citizens, Slovak citizens born before 1 January 1993, and individuals with an allocated Czech birth number. © 2016 – Metropolitan University Prague Previously Department: Attended University: Degree: (highest degree Study Programme: attained) Specialisation: Year of Degree Year of Matriculation: Graduation: Awarded:

Previously Name: Attended University: Department: Degree: Study Programme: Specialisation: Year of Degree Year of Matriculation: Graduation: Awarded:

Suggested Title of Rigorosum Thesis:

The applicant hereby certifies that all data provided in this application form are true and accurate. Furthermore, the applicant hereby certifies that he/she is acquainted with the effective version of MUP Examen Rigorosum Code and the relevant Rector’s Directives available at the electronic Official Board of Metropolitan University Prague (hereinafter the “MUP”) at www.mup.cz, and he/she undertakes to comply with these Internal Rules and Regulations. The applicant undertakes to pay the administrative fee for submission of applications for Final State Rigorosum Examination in case of payments in EUR to the account administered by Sparkasse Oberlausitz-Niederschlesien, IBAN: DE17 8505 0100 0232 0135 19, BIC/SWIFT: WELADED1GRL, in case of payments in CZK to MUP bank account no. 294 158 339 / 0800 administered by Česká spořitelna, a.s. (IBAN: CZ33 0800 0000 0002 9415 8339, BIC/SWIFT: GIBACZPX). The applicant undertakes to state his/her birth number (applicants who do not have an allocated Czech birth number and citizens of the Slovak Republic born after 1 January 1993 must state their date of birth in the following format: YYMMDD) as the variable symbol (in case of international transfers or payments in Euros, this number shall be stated in the field reserved for comments for the payee or in the field reserved for the purpose of payment); in the field reserved for comments for the payee, purpose of payment, or notes, the applicant must write his/her first and last name and the word “application” (e.g. Jerry Smith application). The applicant undertakes to pay the adequate fee at the latest on the day of submission of the application to MUP. Administrative fees for submission of applications for Final State Rigorosum Examination are non-refundable. MUP is not obliged to accept applications in case the applicant fails to prove that the payment of the fee for submission of applications for Final State Rigorosum Examination has been transferred to the above specified MUP bank account. The applicant undertakes to complete the application form legibly, in an electronic form, or in capital letters; and he/she shall be held responsible for the accuracy and truthfulness of the provided data. In case the application form includes incorrect, untrue, or illegible information that, in turn, results in the fact that MUP cannot deliver the announcement of Final State Rigorosum Examination and other notifications to the applicant, MUP shall not be held responsible for these consequences, and the applicant shall not be entitled to a refund of the administrative fee for submission of applications for Final State Rigorosum Examination. The applicant hereby provides his/her consent with the collection, maintenance, and processing of personal data included in this application form by the data administrator, i.e. Metropolitan University Prague, with registered office at Prokopova 100/16, Prague 3, 130 00, Czech Republic, a company recorded in the register of public benefit companies at the Municipal Court in Prague, section O, insert 231, company registration number 26482789 (or, as the case may be, by an employee of the data administrator) for the purposes specified below. This consent is granted by the applicant for all data included in this application form for the duration of the necessary period of time needed to fulfil the below specified purpose. By the same token, the applicant certifies that he/she is fully aware of his/her rights pursuant to the provision of Section 12 and 21 of Act no. 101/2000 Coll., on Personal Data Protection. The applicant is fully acquainted with all completed parts of this application form; all provided data are accurate, true, and they are provided voluntarily. Pursuant to Section 5 of Act no. 101/2000 Coll., on Personal Data Protection, all data provided in this application form shall be collected and administered exclusively for the purpose of verification of payment of the administrative fee for submission of applications for Final State Rigorosum Examination, and for the purpose of contacting the applicant via electronic mail to inform him/her on the details concerning the administration of the Final State Rigorosum Examination and the relevant requirements. The summarized data from this application may be used by the administrator for statistical purposes – for internal use of the administrator – and for the purposes stipulated for the administrator in the Higher Education Act. The administrator hereby certifies that they will collect personal data only in an extent that is necessary for the compliance with the stipulated purpose, and they will process the personal data solely in accordance with the purpose of their collection. The employees of the administrator or other persons who are processing personal data on the grounds of a contract with the administrator, and other persons are obliged to maintain confidentiality on personal data – even after their employment or other affiliation is terminated. Furthermore, the applicant hereby grants his/her consent to receive commercial communication from Metropolitan University Prague in the intent of Section 7 of Act no. 480/2004 Coll., on Certain Information Society Services, as amended, for the purposes of receiving news and information on current affairs relating to Metropolitan University Prague.

Date: Applicant’s Signature: