Application Form

Please note that any scholarship request will imply the parents to provide all official documents about their patrimony and revenues.

This application is only possible for students having received a personal code following a successful audition.

Personal Successful Audition Code *

Mosa Education Program

Education Program

Identification information

First Name *

Last Name *

Gender *

Male

Female

Birth Date *

ID/Passport Student *

Validity student passport

ID/Passport Country *

Email *

Phone *

Street and Number *

Postal Code *

City *

Country *

ID/Passport of a Parent/Tutor *

Validity parent passport

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 Guardian

Email of Guardian

Phone of Guardian

Tuition fee

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

Scholarship

Scholarship Request (EUR 100 file costs refunded in case of acceptance)

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

Yes

Other information

French level *

Beginner

Elementary

Intermediate

Advanced or better

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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