Immatricolazione Physioterapy

Campus Enrollment - Bachelor of Physiotherapy Semmelweis Program

General Informations

Name*

Surname*

Gender*

Family situation*
Celibate/MaidenConjugated/MarriedDivorcedWidower/Widow

Date of birth*

Birth place*

Country of birth*

Nationality*

Authorization to inform parents - Swiss Federal Law on data protection of 19 June 1992 and EU regulation 2016/679 and subsequent amendments*

I authorize the processing of my personal data for institutional, academic purposes*

Personal data

Father name*

Maiden mother surname*

Mother's name*

Father's cell phone*

Mother's cell phone*

Telephone home residence*

Mobile phone*

Email*

Emergency contact*

Emergency phone*

Document

Document type*

Document number*

Document expiry*

Document document issue date*

Document issuing body*

Residence

Residence address (street)*

Residence address (city)*

Residence address (province)*

Residential address (postal code)*

Country of residence*

Home

Home address (street)*

Home address (city)*

Home address (province)*

Home address (postal code)*

Country of home*

languages

language 1*

Type 1 (spoken - written - read)*

knowledge level 1*

Language 2

Type 2 (spoken - written - read)

knowledge level 2

Language 3

Type 3 (spoken - written - read)

knowledge level 3

Degree

Maturity

Vote Maturity

Maturity date

Secondary school name

Maturity document number

university 1st degree

1st Degree

Grade 1st Degree

Date 1st Graduation

university 2nd degree

2nd Degree

Grade 2nd Degree

Date 2nd Graduation

Other Degree

Upload documents

Enrollment application* (pdf, max 2Mb)

ANNEX 1 - Authenticated photocopy of passport or identity card (pdf, max 2Mb)

ANNEX 2 - Certified photocopy of the high school diploma (parchment) (pdf, max 2Mb)

ANNEX 3 - Certified photocopy of any other official documents issued together with the high school diploma (transcript or europass) (pdf, max 2Mb)

ANNEX 4 - Medical report (pdf, max 2Mb)

ANNEX 5 - Medical certificate of good health (to be sent starting from the second year) (pdf, max 2Mb)

ANNEX 6- Certificate of vaccination against hepatitis b (with 3 booster dates) (pdf, max 2Mb)

ANNEX 7 - HIV test (dated no later than 1 year after delivery) (pdf, max 2Mb)

ANNEX 8 - European health insurance card (pdf, max 2Mb)

ANNEX 9 - Passport size photo* (jpg, max 2Mb)

ANNEX 10 - Photocopy of the third party liability insurance policy (r.c.t) and of the accident policy (pdf, max 2Mb)

ANNEX 11 - European Curriculum vitae* (pdf, max 2Mb)

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