EXECUTIVE DOCTORATE OF BUSINESS ADMINISTRATION APPLICATION FORM

Transcription

1 EXECUTIVE DOCTORATE OF BUSINESS ADMINISTRATION APPLICATION FORM To be completed and sent to: Ms.Liz Shani, Programme Director. Galilee International Management Institute P.O.Box 208, Nahalal 10600, Israel. Tel: eshani@galilcol.ac.il Last Name (Family Name): First Name: PERSONAL INFORMATION Gender: Female Male Date of Birth: Place of Birth: Country of Citizenship: City: State: E - Mail: Phone Number: Fax (Include Country and Area Codes) : Cellular Phone Number: Country: Zip Code:

2 YOUR EDUCATION HIGHER EDUCATION ONLY Achievements in reverse date order Name of School/University Address Dates Attended Degree & Date Name of School/University Address Dates Attended Degree & Date Name of School/University Address Dates Attended Degree & Date PROFESSIONAL QUALIFICATION Professional Body: Dates: Main Subjects Covered: Qualifications Gained: Professional Body: Dates: Main Subjects Covered: Qualifications Gained: Professional Body: Dates: Main Subjects Covered: Qualifications Gained:

3 ENGLISH FLUENCY Fluency in English is a requirement for entry to the programme EMPLOYMENT HISTORY CAREER SUMMARY (Current or most recent post first) Dates From: Date From: Date From: Date From: DUTIES AND RESPONSIBILITIES (of your present or most recent post)

4 YOU AS A PERSON Please outline your career and personal objectives and how the Executive DBA will help you achieve them: Have you undertaken any forms of research? Please give details and explain what you gained from this experience: What is the management issue on which you plan to focus your Executive DBA? The different fields of research are the following: Decision Making Sciences, Finance, Marketing, Management & Governance, Organizational Behavior, Strategy, Technology & Operations Management, Entrepreneurship.

5 ITEMS TO BE ATTACHED TO THIS APPLICATION FORM Resume/CV Application Fee of 75 Photocopy of a valid passport or identify card Transcripts covering all years of studies after high school A covering letter explaining your motivation and professional goals Certified degrees received and/or awarded Three passport size photographs Two reference letters FEES AND FUNDING TUITION FEES FOR THE ACADEMIC YEARS Full Payment (1 st option) Payment Plan (2 nd option) Full Payment (1 st Option) Pay by 1st July st Payment July nd Payment Feb Payment Plan (2 nd Option) 3 nd Payment Aug nd Payment May 2017 Total 29,500 8,000 8,000 7,450 7,450 30,900 *Please make your payment to Galilee International Management Institute FINANCING YOUR STUDIES How do you expect to finance your education? Bank Loan Finance Myself Sponsorship from employer Scholarship (which Organization) Other

6 Please Note: The fees are tuition fees ONLY. Seminars at Paris Business School: Participants are required to make their own arrangements for accommodation, transportation, study materials, social security, medical insurance and other incidental fees and costs related to the programme. Seminars at Galilee International Management Institute: Participants are required to pay 2,800 fee for living expenses during their stay at Galilee Institute. The fee covers: full board accommodation (single), medical insurance, visa, computer facilities, wireless internet, airport transfers, study facilities, weekend guided excursions, laundry service. The 2,800 payment will be made directly to Galilee International Management Institute. Please note: the fees do not include flight costs. APPLICANT AGREEMENT I certify that the information given is complete and accurate to the best of my knowledge. I am aware that all the materials submitted in support of my application are the property of Pole ESG. The Admissions Committee has the right to verify any and all parts of my application materials. I am aware that any misrepresentation of facts in my application will justify the denial of admission, the cancellation of admission or expulsion. Applicant s Signature: Date: