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: 25 - 20 2011

: 25 - 20 2011

i I : 27 2011

II : 30 2011

ϳ II : 4 2011

 

 

II i: 8 2011

 


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12. : 15.01.1998 // ³ . 1998. - 25. .146.


 


 

Application Form

 

.

This Form may be fulfilled either in English, or in Ukrainian language at your discretion.

PERSONAL INFORMATION/ ֲ
First name/': Middle name/ :
Second name/ :

 

CONTACT INFORMATION / ֲ
Permanent Address / :
Phone / : Fax / :
E-mail / :  


 

CONTACT PERSON IN CASE OF EMERGENCY /
First name / ': Middle name/ :
Second name/ :
Permanent Address / :
Phone / : Fax / :
E-mail / :  

 

EDUCATION / ²
Please indicate your educational degree / , , , :
 


 

INFORMATION ABOUT HIGHER EDUCATIONAL INSTITUTION WHERE YOU STUDY/ ֲ ,
First name / ' : Middle name/ :
Second name/ :
Phone / : Fax / :
E-mail / :   Postal address/  

 

information is about a scientific leader (in the case of presence)/ ²Ҳ в( Dz Ҳ)
First name / ': Middle name/ :
Second name/ :
Graduate degree/ : Rank / :
Job /̳ :  


 

OPTIONS /
Membership in ELSA/ ELSA:
Please indicate if you have objections that your name would be available to other participants in case you win at the First Stage of the essay competition / , , , ', , I don't have objections / I have objections /
Do you need accommodation?/ ? Yes, I need/, No, I don't need /

 

Date/ : ___________________

Please send your application forms to / , essay.elsa.org @. gmail.com.

Deadline / : on October, 25 - on November, 20, 2011/ 25 - 20 2011

 

 





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