PLEASE USE CAPITAL LETTERS TO FILL IN this form.	Follow the instructions on page 3.
															            																							Reference No.:
Application for Admission to University Study
	Stamp of the University of Veterinary Medicine and Pharmacy in Košice:

Postgraduate Study – 3rd cycle study programmes		
Academic year:    20      / 20		
Citizenship:		
First name:                                                  Surname:
	Date of delivery:	
Maiden name:	Academic degree:	
Date of birth:             day			month			year						Sex2):           male		female		
Place of birth (city):	Country:	
Personal identification number3)							/						
ID card number (by foreign participant passport number):
	
Telephone number (including country and/or city code) 4):
	E-mail address4): 

Permanent residence 	
Street and street number:	
City:	Postal code:	
County/district:	Country: 	

Mailing address (if different from permanent residence address)	
Street and street number:	
City:	Postal code:	
County/district:	Country: 	

Place of residence in the Slovak Republic3) 	
Street and street number:	
City:	Postal code:	
County/district:	Country: 	

University: The University of Veterinary Medicine and Pharmacy in Košice, Slovak Republic	
Faculty:	
Branch office (if applicable):	
Study programme:	
Study branch (code and title):	
Form of study (daily or external) 5):	Study method (full-time or part-time) 6):	
External educational institution (name, address):	
Title of PhD thesis:
	
Name of tutor:	

Educational attainment (the highest degree of education the applicant has completed):	
University (name and address):
	
Faculty: 	
Branch office (if applicable):	
Study programme:	
Study branch:	
Duration of study (from - to):	Date of graduation:	Awarded degree:	

The applicant shall provide a transcript of records from the university they graduated from for each year of their studies including certified photocopies of evidence of formal education (university diploma, state examination certificate and diploma supplement) according to the requirements laid down by the university.

Participation in conferences and competitions, student scientific activities, authorship of discoveries or industrial designs, and  relevant spare-time activities shall be listed separately and appended to the application. 

Results of previous university studies in each semester 
(or attach the official University transcript, see List of supporting documents on page 3). 	
Semester	
Subject	I.	II.	III.	IV.	V.	VI.	VII.	VIII.	IX.	X.	XI.	XII.	

													

													

													

													

													
Grade point average
(according to the Decree of the Ministry of Education of the Slovak Republic No. 614/2002 Coll. on the credit system of study)													

I confirm that the data is correct. Not necessary if transcript has an official seal.

Date:	Signature:	         the University /Faculty stamp:	

Further education (completed or not completed)7)	
University (name and address):
	
Faculty: 	
Branch office (if applicable): 	
Study programme:	
Study branch:	
Level of education attained8): 	
Duration of study (from - to): 	Date of graduation: 	

Occupation (job title and the employer's details)	
Previous:	
Current:	

Applicant’s declaration and consent to personal data processing

I declare that all the information I have provided is true and I have not concealed any other serious facts.
I declare that I have carefully read the information about personal data protection, and I understand its content.
I give / I do not give my consent1) to the university to process my personal data contained in the documents enclosed with the application form in accordance with the Act No. 18/2018 Coll. on the Protection of Personal Data and on the Amendment of Certain Acts for the purpose of admission procedure.
1) please underline as appropriate	

List of documents supporting the application: 9) 

1.	curriculum vitae (signed)
2.	proof of payment of the admission fee - certified copy of bank statement
3.	applicant's educational attainment documents (certified photocopies of university diploma, state examination certificate and diploma supplement) 
4.	list of published professional and scientific papers
5.	framework project of PhD thesis
6.	professional practice certificate/references
7.	official transcript of study records (with confirmation of data accuracy by the study office of the university from which the applicant graduated including date of issue, signature and stamp) or its certified copy	

Date:	 Applicant’s Signature:	

Instructions for completing the application form:

1) The application form is intended for second cycle graduates (master’s degree and similar) who wish to continue their studies  
at postgraduate level.
2) Put a cross (x) in the relevant box.
3) If you are a foreigner, please provide your Personal identification number, if it has been assigned to you by the Ministry of Interior of the Slovak Republic, and your place of residence in the Slovak Republic.
4) Telephone number and email address are optional data.
5) Please write daily or external.
6) Please write full-time or part-time.
7) If the pre-printed data are not sufficient, include them in a separate attachment. Also, please provide details of duly completed studies, current studies or unfinished studies (e.g. completed semesters).
8) Please select from the options: second cycle or joined first and second cycle or third cycle.
9) The applicant shall attach additional documents according to the university requirements.
As regards applicants with specific needs, the entrance examination procedure may, at applicant’s request, be adapted to suit their specific needs.
Information about personal data processing 

The personal data submitted by the applicant (hereinafter referred to as the “data subject”) to the University (hereinafter the “data controller”) in this application form, are processed by the data controller in accordance with Act No. 18/2018 Coll. on the Protection of Personal Data and on Amendments to Certain Acts (hereinafter referred to as “Act No. 18/2018 Coll.”) and Act No. 131/2002 Coll. on Higher Education Institutions and on Amendments to Certain Acts (hereinafter referred to as “Act No. 131/2002 Coll.”).

Purpose of personal data processing:

Admission procedure and enrollment for study:

The data controller handles the following personal data for the purpose of the admission procedure in accordance with § 58 par. 3 a) of Act No. 131/2002 Coll:

•	first name,		•	date of birth,		
•	surname,		•	place of birth,		
•	maiden name,		•	permanent residence address,		
•	academic degree,		•	sex,		
•	personal identification no.                
or passport no. 		•	student´s portrait,		
		•	citizenship of student;		
		•	phone number (if provided by the student),	
		•	email address (if provided by the student),
	
•	the place of residence in the Slovak Republic is also recorded; the personal identification number is recorded 
if has been assigned by the Ministry of Interior.
	
The data controller processes data on previous or current occupation of the applicant for the purpose of the admission procedure in accordance with § 58 par. 3 b) of Act No. 131/2002 Coll.

The data controller processes data on educational attainment, including the study records and results of the activities related to the study programme to which the applicant applies for the purpose of the admission procedure in accordance with § 58 par. 3  c) of Act No. 131/2002 Coll.

The data controller can also use the above-mentioned data for the purpose of enrolment for study.

Statistical purposes:
The data controller may provide data processed for the purposes of admission procedure to other legal persons and natural persons for statistical purposes in accordance with § 58 par. 4 of Act No. 131/2002 Coll.

Personal data processing which is not required by a special regulation:
If the data controller requires documents including personal data whose processing is not required by a special regulation (e.g. § 58 and § 73 paragraph 3 of Act No. 131/2002 Coll.), it is necessary for the data controller to state the purpose of processing personal data in accordance with Act No. 18/2018 Coll. and process such data based on the data subject consent given.

Granting of consent for processing of the personal data which are part of the enclosures provided with the application form, can be included in the application form. In accordance with § 14 par. 3 of Act No. 18/2018 Coll. the data subject has the right to withdraw their consent at any time. The consent withdrawal does not affect the lawfulness of the personal data processing based on consent given prior to its withdrawal. The data subject may withdraw the consent in the same way he or she has granted it and shall notify the data controller thereof.