Application Form ID 23

Programmes

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Application Form

Application process

"*" indicates required fields

1Contact details

2Programme details

3Invoice

4Confirmation

Contact details

Enthusiastic about BSN and ready to join? Fantastic! Complete the form below to submit your application now.
Fields marked with an asterisk (*) are mandatory.

Personal details

Title

First name*

Surname*

E-mail address*

Phone number*

Date of birth*

Address

Street Address City ZIP / Postal Code Country

Nationality

Please indicate your marital status.*

Married

Not Married

Have you ever been enrolled in a Doctorate programme with any institution?*

Yes

SDG Scholarship

Would you like to apply for the programme with the SDG Scholarship?

Company details

Company name*

Job title*

Address*

Street Address City ZIP / Postal code Country

Provide a brief description of your company's most important products or services and your role.*

Confirmation

Further comments

How did you hear about BSN/the programme?

Please provide the name of the person who referred you (if applicable)

Signature

The signatory hereby applies to be registered for the programme on this application form and agrees that upon acceptance of this application by BSN, and acceptance of the Unconditional Offer Letter by the applicant, a legally binding agreement between him/herself and BSN is established. Should the applicant/student have misrepresented the truth in this application form then this should be grounds for termination of this agreement by BSN. Termination of the agreement based on this misrepresentation is no cause for restitution of the programme fees to applicant/student. Should you not finalise your studies within the allotted 24-36 month period, then an additional charge of € 2500 will be levied per year for years 5,6,7 etc. The signatory also confirms that they have permission to conduct research and assignments within the context of his/her organisation in accordance with Action Learning methodology.

Signature

The signatory hereby applies to be registered for the programme on this application form and agrees that upon acceptance of this application by BSN, and acceptance of the Unconditional Offer Letter by the applicant, a legally binding agreement between him/herself and BSN is established. Should the applicant/student have misrepresented the truth in this application form then this should be grounds for termination of this agreement by BSN. Termination of the agreement based on this misrepresentation is no cause for restitution of the programme fees to applicant/student. Should you not finalise your studies within the allotted 24-36 month period, then an additional charge of € 4 000 will be levied per year for years 5,6,7 etc. The signatory also confirms that they have permission to conduct research and assignments within the context of his/her organisation in accordance with Action Learning methodology

Signature

The signatory hereby applies to be registered for the programme on this application form and agrees that upon acceptance of this application by BSN, and acceptance of the Unconditional Offer Letter by the applicant, a legally binding agreement between him/herself and BSN is established. Should the applicant/student have misrepresented the truth in this application form then this should be grounds for termination of this agreement by BSN. Termination of the agreement based on this misrepresentation is no cause for restitution of the programme fees to applicant/student. The signatory also confirms that they have permission to conduct research and assignments within the context of his/her organisation in accordance with Action Learning methodology.

Applicant's signature

First name*

Surname*

Place*

Date*

Toegestande landen

Application Fee

Application Fee*

Price:

On submission of this form you will be prompted to pay a non-refundable application fee of €50. This form is not submissable without payment of the application fee.

Application Fee*

Price:

On submission of this form you will be prompted to pay a non-refundable application fee of €75. This form is not submissable without payment of the application fee.

Application Fee*

Price:

On submission of this form you will be prompted to pay a non-refundable application fee of €75. This form is not submissable without payment of the application fee.

Comments

This field is for validation purposes and should be left unchanged.