Application Form

Student

Personal Successful Audition Code *

First Name *

Last Name *

Birth Date *

Email *

Phone *

Street and Number *

Postal Code *

City *

Country *

Full Name of Father

Email of Father

Phone of Father

Occupation of Father

Full Name of Mother

Email of Mother

Phone of Mother

Occupation of Mother

Full Name of Tutor

Email of Tutor

Phone of Tutor

Occupation of Tutor

Applicable Tuition Fee (must be consistent with the student's nationality) *

European Tuition Fee (6,375 EUR)

Extra-European Tuition Fee (12,750 EUR)

Hosting Preferences *

Boarding School from Monday to Sunday (EUR 4.800 per School Year)

Boarding School from Monday to Friday (EUR 4.000 per School Year)

Boarding School from Sunday Evening to Friday (EUR 4.000 per School Year)

External with lunch at Mosa (EUR 1.200 per School Year)

Request for a Hosting Family during Week-ends and Holidays (EUR 1.200 per School Year)

Scholarship Request (EUR 40 file costs refunded in case of acceptance)

Is your Application Conditioned to the Receipt of a Scholarship? *

Yes

End-of-year school reports from the previous two years *

ID/Passport Student *

ID/Passport of a Parent/Tutor *

Remarks/Additional Info

Please check this box to confirm your engagement for which you declare to be informed of the invoicing schedule of the selected services *

Job

Department

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