Short Courses Application

Program Choice

Which Short Course are you applying for? *

Personal Data

First Name *
Last Name *
Date of Birth*
Country of Birth*
Place of Birth*

Current Address*

Address Line 1 *

Address Line 2

City *
Postal Code *
Region *
Email *
Confirm Email *

Academic/Educational Information

Education Completed *
Year Received *
Did you receive a degree? If yes, please specify.*
Institution Name *
Institution City *
Institution Country *

English Knowledge

Language proficiency (any language certification? If yes, provide details) *
Please provide more information below.
Please provide a description of your current employment *

Additional Information

Do you have any information or additional comments that you would like to share with the admissions committee?

How did you hear about the CIMBA Short Courses?

Direct E-mailPressRadioFairCIMBA Website

Other Websites: Please indicate which website:

Personal Recommendation: Who can we thank for referring you to CIMBA?

Other: Please specify how you heard about us.