Application form for admission as a postgraduate student

Statement:
I certify that the information given herein is true to the best of my knowledge. In submitting this Application Form I indicate my willingness to accept the tuition system of the Charles University, Faculty of Pharmacy, and recognize that I will be subject to the rules and regulations of the Charles University.

By sending the registration form, you are confirming that you read the attached information about the processing of your personal data.

Application Form

Study Programme:	Select the programme... Bioanalytical Methods Bioorganic Chemistry Pharmaceutical Analysis Pharmaceutical Chemistry Pharmaceutical Technology Pharmacognosy and Nutraceuticals Pharmacology and Toxicology Clinical and Social Pharmacy Xenobiochemistry and Pathobiochemistry
Which research group would you like to join and why?:	Explore research groups on the Science Portal here
Preferred Supervisor (If Any):
Personal Data
Surname (Last Name):
First and Other Names:
Place of Birth:
Country of Birth:
Date of Birth:
Country of Permanent Residence:
Legal Nationality:
Passport (Identity Card) No.:
Sex:	MaleFemale
Contact Address
Country:
Street:
House Number:
City or Township:
Postal Code:
Telephone:
E-mail:
Previous University Studies
University:
Country:
Study Programme:
Field of Study:
Study Started in:
Study Completed in:	If the study was not completed, fill in Expected Date of Graduation in the box below
Expected Date of Graduation:
Awarded Degree:
Any Additional Degrees:
Proficiency in Languages
English Speaking Ability:	Please select... B1 B2 C1 C2
English Writing Ability:	Please select... B1 B2 C1 C2
Mother Tongue:
Other Languages:
Other Information
CV:
Notes:
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