In doctoral study programme:
Applicant’s name, surname, title:
Date of birth:
Department / workplace:
Study programme / branch:
Supervisor:
Supervisor-specialist:

Start date of study:
Current study form:        full-time  –  distant  –  part-time
A professional debate date (closing date of the study block):
Date of exam in English language:
Obtained publication‘s credits:		Obtained total credits: 

Title of the dissertation thesis:

Applicant signature:

Supervisor signature:

Head of the department signature:

Vicedean signature:

Required attachments:
1.	The list of all passed compulsory courses exams - printed from KOS and signed.
2.	The list of publications and three most important (copies).
3.	The state doctoral exam topics signed by branch board chairperson.