Apply Now! - The Hague School of Business and Management

Before completing this form, please review the admission requirements for the chosen course/program of study on
the HSBM website. Please write in BLOCK CAPITALS using black ink and complete all sections.
Section One: Personal Details
Please enter your name exactly as it appears on
your passport or other official document.
GENDER:
FAMILY NAME:
Male = M, Female = F
DATE OF BIRTH:
FIRST NAME:
(DD/MM/YYYY)
st
MIDDLE NAME(S):
1 CITIZENSHIP:
PREFERRED NAME:
2 CITIZENSHIP:
nd
Section Two: Contact Details
HOME ADDRESS:
CORRESPONDENCE ADDRESS (if different):
CITY:
CITY:
POSTAL / ZIPCODE:
POSTAL / ZIPCODE:
STATE / PROVINCE:
STATE / PROVINCE:
COUNTRY:
COUNTRY:
TELEPHONE:
+
MOBILE:
+
EMAIL ADDRESS:
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HSBM ADM 02-2014
Section Three: Entry Requirements
Please attach the following documents with your application.
ENGLISH LANGUAGE CERTIFICATE:
ACADEMIC TRANSCRIPT(S):
REASON FOR MISSING DOCUMENT(S):
Please send only copies of the original document(s). Please do NOT send originals.
Section Four: Additional Information
Please indicate Y (yes) or N (no) to the following questions?
Y
N
Do you have a physical disability that requires you to have Y
support during your academic studies?
N
Have you ever been convicted of a criminal offense?
Section Five: Selection of Study
Please mark the Program or Diploma to which you are applying to with an X.
Degree Programs
BSc in Accounting and Control
BSc in Banking and Finance
BA in Business Management
BA in Human Resource Management
BA in Corporate Communication
BA in Health and Environmental Sciences
BA in International Marketing
BA in International Relations
BA in Hotel & Resort Management
Diploma in Business Management
Diploma in Information Technology
Diploma in Corporate Finance
Diploma in English Language
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Diploma in Hotel Management
MBA in Marketing
MBA in Finance
MBA in Human Resource Management
MBA in Accounting
Doctor in Business Administration
PhD in Leadership
Section Six: Administration Fee
The Hague School of Business and Management applies a € 200 non-refundable administration fee to all
Applications. Please review the terms and conditions online at www.hsbm-thehague.com prior to submitting
your application. Applicants should make sure their names and course field are clearly written when making
payments.
Please make the payment directly to:
Beneficiary: Stichting The Hague School of Business and Management
Account No.:
7067486
IBAN:
NL19INGB0007067486
Swift Code:
INGBNL2A
Bank Address: ING Bank The Hague, The Netherlands
Section Seven: Personal Declaration
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HSBM ADM 02-2014
Once you have completed this application form, please read the following statements carefully. By signing this application form you
confirm your acceptance of these statements. If you do not sign this form, we cannot process your application.
I confirm that the information I have provided on this application form is (to the best of my knowledge) true, accurate, current and
complete; and I agree to notify The Hague School of Business and Management promptly if any information contained on this
application form should change.
I confirm that all supporting work submitted as part of this application is entirely my own original work, except where clearly
indicated otherwise, and does not include any plagiarized materials.
PLEASE NOTE:
All admissions decisions taken by The Hague School of Business and Management rely on the statements made on the application
form and in the supporting materials supplied by you and your referees. This information will be held and used for the purpose of
processing your application for study.
If The Hague School of Business and Management believes that any information or statement contained on your application form
may not be true, accurate, current and complete, or that any material submitted in support of your application may not be entirely
your own original work, except where clearly stated otherwise, it may take any necessary steps to verify that information or statement,
or to confirm that any supporting material is entirely your own original work, except where clearly stated otherwise.
•
I consent to the collection, processing, sharing and use of relevant personal data by The Hague School of Business and
Management for the purposes of processing my application for study is subject to the provisions of the Data Protection Act
1998.
•
I understand that such personal data may be used and shared with third parties, some of which may be located overseas
(including outside the European Economic Area), for the purposes of verifying my identity, qualifications, work experience,
references and any submitted work.
•
I understand that The Hague School of Business and Management will normally only discuss my application with me, unless
I have specified otherwise.
•
I understand that if any information or statement provided on or to support this application form is not true, accurate, current
and complete, or any supporting material is not entirely my own original work, except where clearly stated otherwise, The
Hague School of Business and Management may process and use this fact as relevant personal data. Such data may be used
and shared with third parties, including Higher Education institutions, some of which may be located overseas (including
outside the European Economic Area), to the extent necessary for the purpose of preventing fraudulent or dishonest
applications for study, funding and/or visas.
•
I understand that if I become a registered recognised student, any personal data collected by The Hague School of Business
and Management as a result of my application will form part of my student record.
Please sign below to confirm acceptance of these statements
NAME:
SIGNATURE:
DATE:
Please scan and email your completed application to:
administrationoffice@hsbmthehague.com
Or deliver your Application in one of HSBM regional Offices
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