<p> National University of “Kyiv-Mohyla Academy” APPLICATION FOR ADMISSION TO MASTER’S PROGRAMS 2017/2018 International Students</p><p>Please provide complete information for each item requested. Please type or print clearly.</p><p>Please indicate which Master’s Program you are applying for:  Applied Mathematics  Biology (Molecular Biology)  Biology (Laboratory Diagnosis of Biological Systems)  Chemistry  Cultural Studies (History and Theory of Culture)  Economy  Ecology and Environment  Finance, Banking and Insurance  History and Archeology (Archeology) Photo  History and Archeology (History)  History and Archeology (History (Judaica)  Computer Science and Information Technology  Journalism  Journalism (Public Relations)  Law  Management (Public Health Management)  Marketing  Philology (Theory, History of Ukrainian Language and Comparative)  Philology (Theory, History of Literature and Comparative)  Philosophy  Physics and Astronomy (Physics)  Psychology  Political Science (European studies)  Political Science (Germany and European studies)  Public Administration and Management  Social Work  Sociology  Software Engineering  System Analysis</p><p>GENERAL INFORMATION</p><p>1. Last (family) name ______2. First (given) name ______3. Middle name______4. Sex: male______female______5. Marital status: single______married______divorced______6. Date of Birth (month/day/year)______Place of Birth______7. Age of Applicant______Citizenship______8. Present Address ______9. Permanent Address ______10. Telephone______e-mail______11. Purpose of your study at the NaUKMA______12. Proposed period of your stay in Ukraine______</p><p>1 ACADEMIC INFORMATION If applicable, please indicate your proposed field of specialization within Master’s Program you are applying for: ______</p><p>EDUCATION Dates attended Institutions attended above Degrees received Fields of study (month/year) high-school level or expected Major/Minor from to</p><p>If you previously submitted a thesis as part of your degree, please give title and a brief resume: ______</p><p>LANGUAGES: Mother tongue: ______Others: Language: Poor Fair Good Excellent</p><p>Please, indicate your level of English and Ukrainian:</p><p>English: Poor Fair Good Excellent Academic Reading Academic Writing Oral Comprehension Special English (your specialization)</p><p>Have you ever submitted Test of English as a Foreign Language (TOEFL) or other equivalent (e.g. IELTS) (for non-native speakers).</p><p>Name of Test______Date______Location______Score ______</p><p>Ukrainian: Poor Fair Good Excellent Academic Reading Academic Writing Oral Comprehension</p><p>2 Special English (your specialization)</p><p>When and how did you learn Ukrainian? ______</p><p>FELLOWSHIPS, HONORS, PUBLICATIONS, EXHIBITIONS, PERFORMANCES, ETC: ______</p><p>PROFESSIONAL EXPERIENCE:</p><p>Type of Activity Date and Duration Employer Place and Country</p><p>Foreign experience (Country, period of stay and purpose) ______</p><p>Do you already have contacts in Ukraine or with Ukrainian citizens? ______</p><p>PASSPORT INFORMATION</p><p>Passport Number______</p><p>Indicate the issuing country and the day through which your passport is valid: Country______Date of Expiration______</p><p>PERSONAL INFORMATION</p><p>Hobbies, interests______Any extracurricular activities you would like participating in______Additional information you would like to share about your stay (health, diet, etc) ______</p><p>Name and address of the person in your home country to be notified in case of emergency ______APPLICATION DEADLINE: July 24, 2017</p><p>3 ATTACHMENTS</p><p>In addition to this completed form, your application must include the following: 1. A copy of your official degree/diploma/certificate.</p><p>2. A university transcript documenting your academic work ( an official document issued by your university/college which lists courses, course hours and grades received, and an explanation of the grading system). Documents must be translated into English or Ukrainian. The translated document must be signed and stamped by an officially certified translator. If a translation of your documents is necessary, you must submit both the original language copy and the translated version</p><p>3. An essay on the topic proposed by a Master’s Program you are applying for.</p><p>4. Abstract from your first degree thesis/term paper (up to 20 pages).</p><p>I certify that I have provided complete and accurate answers to the questions of this application to the best of my knowledge. I further certify that all official documents submitted in support of this application are authentic and unaltered records that pertain to me.</p><p>Date ______Signature ______</p><p>Please return these completed forms to:</p><p>Mariia Vasylets Deputy, Head,International Office International Office National University of “Kyiv-Mohyla Academy” 2, Skovoroda St., Kyiv 04070, Ukraine Tel/fax: +38 (044) 425-5016 e-mail: [email protected]</p><p>4</p>