To the Rector

of National Research University

Higher School of Economics
Y.I. Kuzminov

APPLICATION

I, _____________________________________________________________________________,
full name

hereby request to be registered for the competition to enter HSE University for the following Master’s
studies: 01.04.02 Applied Mathematics and Information Science in a full-time mode of study / Master’s
programme “Master of Data Science” on a fee-paying basis, under ta paid educational services agreement.

My personal details:

Gender: Male Female

Passport details: Series ________________ Number

__________________________

Issued by:
_______________________________________________________________________________

______________________________________________________________________________________
Issuing authority:
Subdivision code __________________ Issuance date:
Citizenship: __________________________________________________________________________

Date of birth:______________________ Place of birth __________________________________

Registration address:
_____________________________________________________________________

___________________________________________________________________________________

Residential address: ____________________________________________________________________

______________________________________________________________________________________

Home telephone number: (_____) __________ E-mail: ________________________________

code telephone number block letters

Contact telephone number: __________________________________________________

if possible, enter mobile phone number
Prior Education:

Graduated from ___________________________________________________________________

full name of the educational institution
______________________________________________________________________________________

Location of the educational institution (region and city) _______________________________

Level of education ___________________________________________________________________

Bachelor's/Specialist/Master’s
Serial number of degree certificate __________________
Date of issue ______________________________

To be filled in only if the applicant is submitting international degree certificates and if the below-
mentioned documents have not been provided along with this application!

I hereby submit the conclusion about the recognition of my foreign education as per established procedure
in HSE University’s bylaws, or submit a certificate recognizing my foreign education, except in cases
when such a certificate is not required, as well as submit a confirmation of completed legalization or
apostille procedures (of necessary) no later than the final date for the acceptance of enrolment consents.

__________________ ______________________
(date) (applicant’s signature)

I understand my responsibility for any accuracy of information indicated herein

__________________ ______________________
(date) (applicant’s signature)

I have read and understood HSE University’s license for the provision of educational services (and
its attachments), the certificate of state accreditation of HSE University for my chosen field of study (and
its attachments); the admission policy for HSE University’s Master’s programmes and the appeals policy
for entrance examination results, including via public information systems.
Furthermore, I have been informed of the deadline for submission of my enrolment consent, and I
am aware of the date for the provision of the original official degree certificate.

__________________ ______________________
(date) (applicant’s signature)