<p> 4th IESEG International Summer Academy (1 – 30 July, 2011) Application Form</p><p>Read carefully the Application Procedures and the Terms and Conditions before completing the form. Submit the completed form and other supporting documents by email to [email protected] BEFORE 15 MAY 2011.</p><p>Personal Information (please complete all fields) Family / Last Name: First / Given Name(s): Gender: Female Male Date of Birth: / / Nationality: (DD/MM/YYYY) Email Address: Postal Address: (Post Code, City) (State, Country) Phone (Home): Phone (Mobile): </p><p>Courses Topic-based Courses (60 contact hours / 8 ECTS credits) Fees Please refer to the course schedule and choose one course from each week below:  International Business Economics Topic-based Week of  Mergers & Acquisitions in an International Context Courses 1630€ 11 July  International Financial Markets and Derivatives French Language  Strategy Implementation and Changes Course  Social & Environmental Strategy in a Globalized World Hospitality 1150€ Week of  International Human Resources Management Package 18 July  International Business in a Globalized World Administrative 200€  Corporate Responsibility and Sustainability Fee  Cross Cultural Marketing Week of  Cultural Aspects in Services Marketing Total: 2980€* 25 July  Managing a Global Luxury Brand  Ethics in Marketing French Language Course (33 contact hours / 4 ECTS credits) What is your level of French language? Please refer to the Council of Europe’s Self-Assessment Grid to find out your level of French language. Understanding: A1 Speaking: A1 Writing: A1</p><p>Emergency Contact Family / Last Name: First / Given Name: Relationship with Applicant: Email Address: Phone (Day): Phone (Night): </p><p>Home University University Name: Field of Study (Major): Undergraduate Graduate Coordinator’s Name: Coordinator’s Email Address: </p><p>Payment Method Account Holder’s Name: IESEG Name of Bank: SOCIETE GENERALE Bank Address: SG LILLE NORD PME (01098), 28 RUE DES ARTS, 59020 LILLE, FRANCE Account Number: 00050270588 IBAN: FR76 30003 01106 00050270588 - 96 BIC-Address SWIFT: SOGEFRPP * Please pay the first instalment (50% of the fees) by bank transfer and cover the necessary charges to reserve your place at the IESEG International Summer Academy. There is a 10% discount for students from IESEG Partner Institutions; a group of 10 to 20 students receives a waiver on the Administration Fee per student. </p>