Application Form

DBA STUDENT
Date

Campus Dakar / Paris / Geneva / Luxembourg / DBA à

distance (Fr) / Digital DBA (Eng) / Douala / Other

Last name

First name(s)

Address

Mobile phone number

Email address(es)

Date of birth (dd/mm/yyyy)

Place of birth (city and country)

Nationality

Skype username

SOURCE OF FUNDING (i.e. who will pay your fees?)

Self-funded Yes / No

Name of your employer Leave blank if you are self-funded

Address of your employer Leave blank if you are self-funded

Job title Leave blank if you are self-funded

OTHER INFORMATION
Which industry do you work in?

How many years of professional experience do

you have?

How did you learn about our program?

FILES TO SEND BY E-MAIL WITH YOUR APPLICATION FORM

BUSINESS SCIENCE INSTITUTE Luxembourg - ASBL n° F9655 – Agrément Ministériel 18 mars 2014
Château de Wiltz – L-9516 Wiltz – Grand Duché de Luxembourg
 Application Form
1. Application form 2. Detailed CV

3. Digital photo 4. Copy of your highest diploma or certification

5. Copy of your passport 6. Transcript from your MBA program (or equivalent)

7. Preliminary thesis proposal 8. Cover letter

9. Employer's certificate 10. Application file (IAE)

11. Copy of the bank transfer order (100€)

PLEASE SEND YOUR COMPLETE APPLICATION (FORM and FILES) TO:

apply@business-science-institute.com

BUSINESS SCIENCE INSTITUTE Luxembourg - ASBL n° F9655 – Agrément Ministériel 18 mars 2014
Château de Wiltz – L-9516 Wiltz – Grand Duché de Luxembourg