CUIAVIAN UNIVERSITY WLOCLAWEK

KUJAWSKA SZKOŁA WYŻSZA WE WŁOCŁAWKU

PL. WOLOŚCI 1,87-800 WŁOCŁAWEK
INTERNATIONAL@KSW.WLOCLAWEK.PL
+48 660 719 054
HTTPS://KSW.WLOCLAWEK.PL/EN/

October 2023

MBA 1 yr English Preparatory course

MBA 2 yrs Physiotherapy
Nursing Tourism
Public Administration

INTENDED STUDY PROGRAM AFTER SUCCESSFULLY COMPLETING ENGLISH LANGUAGE:

PHYSIOTHERAPY
NURSING,
ECONOMICS,

LOGISTICS,
MBA
PUBLIC ADMINISTRATION

PLEASE COMPLETE BELOW ELECTRONICALLY

Surname
First name
Second name
Date of Birth
Place of birth (city and country)
Nationality
Passport number
Expire date
Home Address
Post code, city, country
Phone number +(......)
Email address
Embassy you're applying from (city, country)
Emergency contact full name
Emergency contact home address
Emergency contact email address and phone number

Date and full name signature ( handwritten)_____________________.

Name of Parent or Legal Guardian
Signature
Date Signed