Centre for Entrepreneurship and Business Incubation
Application for Registration for Continuing Professional Development Study-Units
Academic Year 2014-15
APPLICATION FOR STUDY-UNITS TO BE OFFERED DURING JULY 2015:
EBI5001 - Introduction to Entrepreneurship (10 ECTS credits)
SECTION A: PERSONAL DETAILS
I.D. Card No.
Gender: Male
Surname:
Name:
Maiden Surname:
Date of Birth:
/
dd
Nationality: (1)
/
mm
Female
Age:
yyyy
(2)
Address
House No.:
Home Tel. No.:
Street:
Work Tel. No.:
Town:
Mobile No.:
Postcode:
Email Address:
Country:
Section B: EDUCATIONAL AND EMPLOYMENT INFORMATION
Tick  as appropriate
Tick  as appropriate
Employed
Self-employed
Unemployed*
Long-term unemployed**
Inactive***
Inactive in Education and Training****
Pensioner
Primary or Lower Secondary Education (ISCED 1 & 2)
Upper Secondary Education (ISCED 3)¹
Post-secondary non tertiary education (ISCED 3)²
Tertiary Education (ISCED 5 & 6)
*Unemployed: all persons above 15 years of age who were actively seeking work during the previous 4 weeks and are currently available for work
**Long term unemployed: any person who has been unemployed for 12 months of the previous 16 months or 6 of the previous 8 months in the case of persons unde
years of age
*** Inactive: all persons who are not employed nor registering for work at Employment and Training Corporation (ETC)
**** Inactive person in education or training: all persons who are not employed nor registering for work at Employment and Training Corporation (ETC) and are curre
participating in a course which promotes their chances of employment
¹ Upper Secondary Education: Sixth Form
² Post-Secondary non Tertiary Education: Vocational Secondary school (including MCAST, ITS etc etc)
Operational Programme II – Cohesion Policy 2007-2013
Empowering People for More Jobs and a Better Quality of Life
Training part-financed by the European Union
European Social Fund (ESF)
Co-financing rate: 85% EU Funds; 15% National Funds
Investing in your future.
Section C: CONTACT PERSON IN CASE OF EMERGENCY
Relationship to Applicant:
Surname:
Address: Same as Applicant?
Yes
Name:
No
If No, please specify:
Telephone/Mobile No.:
Section D: DISABLED APPLICANTS
Do you have any disability that the University of Malta should be aware of? Tick  as appropriate
Yes
No

If yes, please specify:
Hearing Impairment
Mobility Impairment
Specific Learning Difficulty
Visual Impairment
Other
Section E: DISCLOSURE OF PERSONAL DATA TO THIRD PARTIES
In accordance with the University of Malta privacy policy, your details will be used for the sole purpose of conducting
internal business and any personal information will not be disclosed to third parties without your consent in writing.
Computer and paper records are kept about each student’s studies, both during the course and after completion of
studies.
Except that, given that the ITP course is part-financed through the European Social Funds, the following details are
required as per Commission Regulation (EC) No 1828/2006 which refers to data on participants in ESF and ERDF
operations. In this regard, this form is to be filled in by each participant who will be taking part in the training sessions
mentioned above. The University of Malta can make use of all the personal information submitted by the data subjects.
All personal data shall be processed in accordance with the Data Protection Act, Chapter 440.
Attendance at training sessions is closely monitored by the Planning & Priorities Coordination Department (PPCD) as
Managing Authority, which is responsible for monitoring, evaluation, drawing up and submitting the Annual
Implementation Report (AIR) to the European Commission. In this regard, this information is therefore disclosed to PPCD
and may also be forwarded to other third parties for the purpose of follow-up studies, monitoring, auditing, reporting and
evaluation activities inherent in training co-financed by the European Social Fund.
The Registrar receives requests to forward emails on behalf of University of Malta / Junior College staff / students, Senate
recognised students' organisations related to activities being organised, questionnaires required for research etc.
Would you agree to receive such material?
Yes, I agree
No, I do not agree
Operational Programme II – Cohesion Policy 2007-2013
Empowering People for More Jobs and a Better Quality of Life
Training part-financed by the European Union
European Social Fund (ESF)
Co-financing rate: 85% EU Funds; 15% National Funds
Investing in your future.
Section F: STATEMENT OF INTEGRITY
It is important to read carefully the statement below before ticking the box.
I declare that the information given is correct and complete at the time of submission of this application. I bind
myself to produce proof of payment of the study-unit fee by the date indicated to me. I hereby authorise the University of
Malta to request and obtain any information from any institution, entity, body, unit, organ and/or organisation, provided
this information is considered necessary by the University of Malta for the purposes of this application. The University of
Malta reserves the right to withdraw or amend any offer made or terminate any subsequent registration should the
information given in the application be found to be incorrect.
____________________________
Applicant’s Signature
___________________________
Date
Operational Programme II – Cohesion Policy 2007-2013
Empowering People for More Jobs and a Better Quality of Life
Training part-financed by the European Union
European Social Fund (ESF)
Co-financing rate: 85% EU Funds; 15% National Funds
Investing in your future.