FALL: 20. Master in Management / Programme Grande Ecole (ESC Dijon)

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APPLICATION FOR ADMI SSION FALL: 20. Master in Management / Programme Grande Ecole (ESC Dijon) Please fill in this form in black ink and in block letters as carefully as possible, apart from the grey parts. This sheet and supporting documents should be sent back by 30 th May Please tick the box: Programme in English Programme in French PERSONAL DETAILS FAMILY NAME:... FIRST NAME:... 1 st NATIONALITY:... 2 nd NATIONALITY:... Gender: M F Date of birth:... Place of birth:... Official use only: Mode of recruitment and contacts: Programme: PGE Anglo/ PGE Franco Admission: AST 1 / AST 2 Student number: Application received on: Application fees: Final decision: 1/8

Professional Status:... Residential Address:... Postal code (if applicable):... City:... Country:... Postal Address (if different from the residential address):......... Postal code (if applicable):... City:... Country:... Home Phone Number:... Cell Phone:... Preferred E-mail Address:... ACADEMIC BACKGROUND University Education UNIVERSITY DEGREE OBTAINED MAJOR SPECIALISATION HONORS RANK OR GRADE YEAR Secondary Education SCHOOL DIPLOMA YEAR Further Studies Please detail:... 2/8

LANGUAGES Maternal language(s):... Language of instruction at home university (if different from above):... Foreign Languages: (please indicate your level of fluency in the categories indicated) 1: fluent 2: very good 3: average 4: poor LANGUAGE READ WRITTEN SPOKEN 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 1 2 3 4 HAVE YOU EVER STUDIED OR TRAVELLED ABROAD. IF YES, WHEN AND WHERE?. PLEASE DESCRIBE A MULTI-CULTURAL EXPERIENCE THAT HAS INFLUENCED YOU IN PARTICULAR. EXPLAIN WHY. 3/8

PROFESSIONAL EXPERIENCE DATE COMPANY POSITION HELD TASKS ASSIGNED TO YOUR POSITION PLEASE COMMENT ON YOUR MOST IMPORTANT LIFE EXPERIENCE (WORK, SOCIAL ACTIVITIES, STUDENTS ORGANISATIONS, EXTRA-CURRICULAR PROJECTS ) HOW HAS IT HAD AN INFLUENCE ON YOUR LIFE? TRAINING PERIODS AND TEMPORARY JOBS DATE COMPANY POSITION HELD TASKS ASSIGNED TO YOUR POSITION 4/8

DO YOU HAVE ONE OR SEVERAL PROFESSIONAL PROJECTS? PLEASE GIVE DETAILS PLEASE EXPLAIN IN WHAT WAY YOUR DESIRE TO STUDY AT ESC DIJON IS COHERENT WITH YOUR CURRENT STUDIES AND YOUR CAREER PLAN. 5/8

PERSONAL QUESTIONS If accepted, how will you be financing this programme? Self-Sponsored Grant Bank Loan in your home country Company Sponsorship Others:... In case of non admission, what alternative have you foreseen? Which other programs have you applied (or do you intend to apply) for? How did you hear about Burgundy School of Business? Presentation Career Days Place... Date... Ads Posters Press Place... Embassy Consulate Alliance Française Place... Careers Advisors Faculty University... Company Internship Personal contacts BSBU website Other 6/8

APPLICATION PROCEDURE: 1- Registration form is submitted to the admissions office for review 2- Interview with the applicant 3- Jury of admission: final decision 4- Applicant confirmation: payment of tuition fees by bank draft or bank transfer, prior to arrival (in case of visa refusal, the fees will be refunded). 5- Issuance of the final letter of acceptance Please check you have enclosed the following documents: Completed application form/dossier de candidature dûment rempli 2 letters of recommendation (one from your school or university and one from one of your professors/2 lettres de recommandation (une de votre Etablissement de formation, une d'un de vos enseignants) Copy of passport/photocopie du passeport A certified copy of your degree/photocopie certifiée de votre diplôme de Bachelor Official academic records (courses attended + grades)/bulletins de notes de votre université/école d'origine (liste des cours et notes) Proof of command of English/preuve de connaissance de la langue anglaise: For students wishing to study in English: IELTS score of 6.5 OR IBT TOEFL score of 88 Pour les étudiants voulant étudier en français: note de TOEIC supérieure à 10/20 ou CET de niveau 6 7/8

DECLARATION I am aware of the extent of the tuition and living costs associated with studying on the programme of studies for which I am applying and I am able to meet all these expenses. I certify that the information that I have provided on this application, and on all other admission application materials, is complete, accurate and true to the best of my knowledge. I understand that misrepresentation of any information may result in cancellation of the application or registration, with no refund of any fees possible. Date:...Signature*:... * If this application form was to be sent by email first, it needs to be sent by post later (original signature compulsory for legal acceptance) Please return application with all supporting documents to: Groupe ESC Dijon Bourgogne International Office 29, rue Sambin F - 21000 DIJON For Groupe ISM students: Nathalie CUREAU Tel: +33 (0)380 725 985 e-mail nathalie.cureau@escdijon.eu For Sichuan University, Nanjing Southeast University and Nanjing University of Aeronautics and Astronautics students: Bérengère MOINDROT Tel: +33 (0)380 725 874 e-mail: berengere.moindrot@escdijon.eu Fax: +33 380 725 888 website: www.bsbu.eu 8/8