Media Science and Technology

Mediterranean School for Advanced Studies

MSAS Media Science and Technology

 Application form a.a. 2006/2007

Note: please do not use inverted commas (") when filling in the form.


This address will be used for all subsequent communication.
First Name
Last Name
Street and Number
Posta Code
Phone (with full code)
Fax (with full code)
Cellular (with full code)
E-Mail Address (only one)

Candidate Profile Information

All information given will be treated in the strictest confidentiality.
Date of Birth
Last Degree
Graduation Date
Mark or Average
Final Dissertation Title
Current Profession (if it exists) Baccalauréat Nature
Baccalauréat Year
Mark or Class

High School Studies (year by year)
Please specify: Year, Level, Institution, Result and Average

Professional Experience

Other Information


Select according to a preference order:

Multichannel Communication : Content Design
Multichannel Communication : Management and Technology

I declare on my honour the correctness of all information mentioned above and I undertake to present the originals of diplomas and certificates of marks if my candidature is selected by the scientific committee. Any erroneous mention entails the cancellation of my candidature.

This application form has to be received by November 6, 2006.
Each application form with incomplete information will be not be examined


copyright © Mediterranean School for Advanced Studies