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Application Form for University Study

first and second cycle joined to one unit


University: Comenius University in Bratislava
Faculty: Jessenius Faculty of Medicine in Martin
Study program: General Medicine

Form of study: full-time

Academic year: 2021 / 2022


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Mother:
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Father:
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Contact person (in case of emergency) :
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(*) Required
Permanent address:
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Correspondence address (if different from above):
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(*) Required
Secondary school
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Study results according to the final report in particular years at secondary school (optional)
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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3

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Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3


(*) Required
**Grades for each study year for example 1.:A,2.:B, .... or 1.:1,2.:3


School-leaving examination
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Declaration and Agreement
I hereby declare that all the information I have given is true and that I have not concealed any serious facts. In accordance with Regulation 2016/679 of the European Parliament and of the Council on the protection of individuals with regard to the processing of personal data and on the free movement of such data, repealing Directive 95/46/EC (the General Data Protection Regulation, the GDPR Regulation) I hereby grant my consent that the University may process my personal data for the purposes of the admission procedure for the time necessary to process the information on the admission procedure. This consent applies to the personal data listed in the application form and its annexes, which the University is entitled to apply pursuant to Section 58 (5) of Law Act No. 131/2002 Coll. on Higher Education Institutions and on Amendments to Certain Law Acts, as amended (hereinafter “the Law Act”), except for the data under Section 58 (3) of the Law Act. I acknowledge that I may withdraw this consent at any time at the appropriate university or faculty. At the same time, I note that the data may be processed only by authorized persons who are obliged to comply with the provisions of the GDPR Regulation and the data processed will be archived and disposed of in accordance with valid legal regulations of the Slovak Republic. I also acknowledge that any other information on the processing of my personal data and information on my rights in the processing of my personal data is available at the school´s website.
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Attachments to application form:
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surname, given names, date of birth, place of birth and citizenship indicated in your passport are required
(format -.jpg, .jpeg, .gif, .tif, .bmp, .png)
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(*) Required

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