1 Application Form - Academic Year 2017-2018

Application Form Academic Year 2017-2018

Please fill in this form in black ink and in block letters as carefully as possible.

Submit this form along with therequired supporting documents:

June 30th for visa-seeking students

CHOICE OF PROGRAMME (PLEASE TICK THE BOX):

MSc in International Business Development (MSc IBD)

MSc in Arts and Cultural Management (MSc ACM)

MSc Corporate Finance & Investment Banking (MSc

CFIB)

MSc in Global Marketing & Negotiation (MSc GMN)

PERSONAL DETAILS

Family Name: ...........................................................................................................................................................................................

First Name: ...............................................................................................................................................................................................

1st Nationality: ....................................................................................... 2nd Nationality: ..........................................................................

Gender: M F

Date of birth (dd/mm/yyyy): ............................................................... Place of birth: ............................................................................

Professional Status: ...................................................................................................................................................................................

Residential Address: ..................................................................................................................................................................................

Postal code (if applicable): ................................................................... City: ...........................................................................................

Country: ....................................................................................................................................................................................................

Postal Address (if different from the residential address): ......................................................................................................................

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Postal code (if applicable): ................................................................... City: ..........................................................................................

Country: ...................................................................................................................................................................................................

Home Phone Number: (country code) ................................................. (Number): .................................................................................

Cell Phone: (country code).................................................................... (Number): .................................................................................

Preferred E-mail Address: ........................................................................................................................................................................

Skype ID (mandatory for interview): ........................................................................................................................................................

Official use only:

Programme: IBD GE CFIB GMN ACM

Student number: ...............................................................................................................................................................................

Mode of recruitment and contacts: ..................................................................................................................................................

Final decision: ...................................................................................................................................................................................

Application received on: ...................................................................................................................................................................

Application fees: ...............................................................................................................................................................................

Affix Photograph

here

2 Application Form - Academic Year 2017-2018

ACADEMIC BACKGROUND

University Education

Name of University Degree obtained Major/Specialisation Mark/Grade Start year End year

Secondary Education

Parallel Courses/ Certificates

Please detail: .............................................................................................................................................................................................

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Languages

First language (mother tongue): ...............................................................................................................................................................

Language of tertiary education (if different from above):.........................................................................................................................

English test (if any):

Test IELTS TOEIC TOEFL

Score

Date

Other languages ....................................................................................................................................................................................................................

Language Read Written Spoken

1 2 3 4

1 2 3 4

1 2 3 4

1 2 3 4

1 2 3 4

1 2 3 4

1 2 3 4

1 2 3 4

1 2 3 4

Please mark the correct box (1: fluent / 2: very good / 3: average / 4: poor)

Name of School Diploma

3 Application Form - Academic Year 2017-2018

Cultural experience

Have you ever studied abroad? Yes No

If yes, where and when?

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Describe a multicultural experience that has influenced you in particular. Explain why (The experience does not have to have taken

place abroad. It could be a multicultural experience in your own country).

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Experiences (employment/ internship/ volunteer activities)

Organisation Function Tasks assigned to you Period

Please comment on your most important life experience (work, social activities, students organisations, extra-curricular projects...).

How has it had an influence on your life?

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Motivation for the programme:

Why Burgundy School of Business?

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Why this programme?

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Your professional project?

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4 Application Form - Academic Year 2017-2018

PERSONAL QUESTIONS

If you are admitted to the programme, how will you finance your studies?

Self-Sponsored..................................................................... Grant

Bank Loan in home country Company Sponsorship

Others: .................................................................................................................................................................................................

In case of non-admission, what alternative have you foreseen? What other programmes do you intend to apply for?

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How did you hear about this programme ?

Search Engine:

Google.com Ask.com

Yahoo.com Other:...............................................................................................

Website:

Masterstudies.com studyportal.eu/ mastersportal.eu

Education Fair:

Name of the fair: ......................................................................................................................................................................................

Advertisement: .........................................................................................................................................................................................

French government Agency:

Alliance Française Institut Français

Consulate CampusFrance

University - Name: ...............................................................................................................................................................................

Personal or professional contacts: .......................................................................................................................................................

Declaration

I affirm that I have been informed of the cost of tuition fees for the ................................................................... programme, as well as

the average cost of living associated with studying in Dijon, France and that I am able to meet these expenses. I certify that the

information I have entered in this form is complete and accurate to the best of my knowledge and that the accompanying documents

are true. I understand that misrepresentation of any of the information submitted may lead to the cancellation of my application

and/ or registration, with no refund of any of the fees possible.

Date:

Signature:

5 Application Form - Academic Year 2017-2018

Please check you have enclosed the following documents:

Completed application form

Statement of goals for your studies at Burgundy School of Business

Curriculum Vitae/resume

Official academic records of courses attended with marks (in English or French)

Certified copy of your Bachelor’s degree translated into French or English (for students enrolled in their last year, a certificate of

enrollment will be required)

Recommendation form

TOEIC, TOEFL or IELTS certificate for non-native speakers of English

Copy of passport/identity card, and residence permit if applicable

Payment of € 100 application fee

APPLICATION FEE (€ 100)

Please indicate which method of payment you have chosen.

I will pay the application fees of € 100 by cheque. The cheque will be made to «Groupe ESC Dijon» I

will transfer the amount of € 100 to the bank account of Groupe ESC Dijon:

Account Holder’s name

ESC Dijon-Bourgogne

Account Holder’s address 29 rue Sambin – BP 50608

21006 DIJON Cedex FRANCE

Name of bank

BP BOURGOGNE FRANCHE-COMTE

Address of bank BPBFC DIJON TREMOUILLE

14 Boulevard de la Trémouille - 21000 Dijon

BIC/SWIFT

CCBPFRPPDJN

IBAN

FR76 1080 7004 0172 3213 7072 772

APPLICATION FORM SUBMISSION:

Please send this application form, marked for the attention of Ms Bérengère MOINDROT to the following address:

BSB - Burgundy School of Business

29 Rue Sambin-BP 50608 21006

DIJON Cedex France

Or send it as an e-mail attachment to: berengere.moindrot@bsb-education.com

IMPORTANT!

Your last name & the name of your programme (Msc ACM / MSc CFIB / Msc IBD / MSc GMN)

should be given as reference for the bank transfer.