REPUBLIC OF CROATIA
MINISTRY OF FOREIGN AFFAIRS AND EUROPEAN INTEGRATION
APPLICATION FORM
for attending the Croatian language course in the academic year 2010/2011
- Personal information:
1.1. First name……………………………………………………………………
1.2. Family name………..………………………………………………………
1.3. Date and place of birth.. ………………………………………………………………………………
1.4. State of birth …………………………………………… Citizenship……...……………………………
1.5. Gender M F
1.6. Passport No… ………………………………………………………………………………
1.7. Information about previous education (circle): a) Secondary school
- Permanent residence:
- Street ………………………………………………………………………………
………………………
- House No.…………………….
- Place ……………………………………..……………………………………
…………………………..
- ZIP Code ………………………………………………………………………………
………………….
- State ...………………………………………………………………………
…………………………….
- Telephone………………………………………………………
………………………………………….
- E-mail: ………………………………………………………………………………
…………………….
- Reason for applying: ………………………………………………………………………………
…….. ……………………………………………………………………………… ……………………………...………………………………………… …………………………………………………………………...
4. Number of semesters you want to attend (select one option)
- one semester
- winter semester (October 4, 2010 – January 28, 2011)
- summer semester (February 28, 2011 - June 10, 2011)
- 2) two semesters (October 2010 — June 2011)
5.1. I want to use an accommodation in a student dormitory
1) YES
- (circle)
- NO
*the monthly cost in the student dormitory is about HRK 300.00
5.2. Address in the Republic of Croatia for the attendants who ARE NOT STAYING in a student dormitory
………………………………………………………………6. Questions for the applicants who attended the course before
- How many semesters have you finished?
- 1 2 3 4 (circle)
- When did you attend the course?
…………………………………..
- Who paid the tuition fee?
…………………………………..
Date…………………………………….. Signature………………………………
ENCLOSURES: (circle the appropriate number)
- Filled out application form
- Photocopy of the passport
- Proof of Croatian origin in writing (any official document showing the status of the candidate, or one of his parents or ancestors, in this regard)
4. Brief CV
______________________________ ______________________________ ___________________________
Important: Fill out the application form on a computer or typewriter. Incomplete, incorrect and late applications shall not be considered or admitted to the Public Invitation.
For additional information, please call +385 1 4896 320, 4896 304, workdays from 9.00 to 16.00, or send an e-mail to croaticum@mvpei.hr.
MINISTRY OF FOREIGN AFFAIRS AND EUROPEAN INTEGRATION OF THE REPUBLIC OF CROATIA
Trg Nikole Šubića Zrinskog 7-8 ● 10000 Zagreb ● Republic of Croatia ● www.mvpei.hr
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