COTRUGLI Business School

Learn From The Best!

APPLICATION FORM

THE DECISION MAKING PROCESS

COTRUGLI Business School will review your current setting and your future goals by carefully reading through this Application Form. Therefore, fill in the information required in this document by following the instructions carefully.

1. PERSONAL INFORMATION
Family name:
First name(s):
Male / Female: / Marital status: / Single / Married
Date of birth: / (day, month, year)
Citizenship:
Home address
Street, City:
Postal code: / Country:
Telephone: / Mobile:
E-Mail: / Personal number:
I prefer to apply for: / Mark your choice
Executive MBA Program
  • Undergraduate degree, Solid knowledge of English, Minimal 5 years of work experience, Managerial position

MBA Program
  • Undergraduate degree, Solid knowledge of English, Minimal 3 year of relevant work experience

2. ACADEMIC BACKGROUND

List in chronological order the post-secondary institutions you have attended:

Year / Institution / Location / Degree / Major

Highest degree obtained (please check as appropriate):

 B.Sc. LL.B.  M.Sc. Ph.D.

 B.A. M.A. M.D. Other ______

LANGUAGE SKILLS

Language: Native language (please specify):______

LANGUAGES / Excellent / Good / Fair / Years of experience / COTRUGLI Test Score (leave empty)
English

Have you taken any other certified English tests? If so, please indicate which one and what was the score? ______

3. EMPLOYMENT RECORD

PRESENT EMPLOYMENT

Company name:
Company address:
City: / Country:
Telephone: / Company website:
No of employees (please state year)
Industry type:
HR director (name, e-mail & telephone)
Employed with current company since
Current function/Job title:
Level of responsibility: /  Senior to top management  Middle management
 Lower management  Expert
No. of persons supervised by you:
Annual gross salary in Euros (including benefits and bonuses)*
Main area of expertise:

* The annaul gross salary data is strictly confidential. This information is relevant for the School in monitoring the growth of participants’ salaries upon completion of the program and as such is required by all business schools wordlwide.

Brief description of current responsibilities: ______

EMPLOYMENT HISTORY

Please describe your previous full-time and part time working positions:

Company / Dates / Position held / Function and responsibilities

Total years of work experience: ______

Total years in management positions: ______

4. PERSONAL STATEMENT

(please answer briefly using up to 5 sentences)

  1. State your career objectives for the next 2 to 5 years!

______

  1. What was the major motive for your decision to apply for the program?

______

  1. Describe your most significant professional achievement?

______

  1. Describe how you can use your E/MBA education in your current position and how your experiences will contribute to the E/MBA group.

______

  1. How did you develop your skills during the career? Please evaluate your skills for everybusiness function with the appropriate mark (5 = highest)

Sales & Marketing / 1 / 2 / 3 / 4 / 5
HRM & Leadership / 1 / 2 / 3 / 4 / 5
Finance & Accounting / 1 / 2 / 3 / 4 / 5
Strategy & Business Development / 1 / 2 / 3 / 4 / 5
Operations & Project Management / 1 / 2 / 3 / 4 / 5
Other... / 1 / 2 / 3 / 4 / 5
  1. What would you suggest are your main strengths and weaknesses?Please write 3terms in each block.

Strengts / Weaknesses
...in relation to work? / 1)
2)
3) / 1)
2)
3)
...in relation to E/MBA? / 1)
2)
3) / 1)
2)
3)
  1. What are the 3 terms that would best describe your expectations from E/MBA?
  2. …
  3. …
  4. …
  1. How did you first found out about COTRUGLI Business School?

______

  1. Optional question: is there any additional information that is critical for the Admissions to know which has not been covered elsewhere in this application?

______

  1. What would be your source of financing for E/MBA (Individual or Company)?

______

5. REFEREES

Application cannot be processed without references. Applicants are responsible for stating the names, addresses and positions of their referees below. Please note that a referee letter is not required at this stage of application.

1st Referee

Name: / Position:
Company:
E – mail: / Telephone:

2nd Referee

Name: / Position:
Company:
E – mail: / Telephone:

6. APPLICANT’S STATEMENT OF INTEGRITY

All the information in this application package is true, accurate and complete to the best of my knowledge. I certify that I have formulated and written all narrative responses myself. I understand that withholding or giving false information will invalidate my application and make me ineligible for admission to the COTRUGLI's E/MBA Programme. I also agree to inform COTRUGLI Business School if any of the above mentioned information changes.

Date / This document is made on a computer and is therefore valid without a signature.

All personal information is treated strictly confidential and is not divulged to people without permission or authority.

Kindly submit this Application form as an e-mail attachment to

1