Application form
Master of Advanced Studies Intercultural Communication
Edition 2015 - 2016 (MIC7)
This form must be completed in full and returned to the MIC office.
Deadline: September 30, 2014
MIC Program | Università della Svizzera italiana (USI)
via Giuseppe Buffi 13 | 6900 Lugano | Switzerland
phone +41 58 666 46 52 | fax +41 58 666 46 47
e-mail mic@usi.ch | website www.mic.usi.ch
Completing the application
Important details
The information in the application form is treated as strictly confidential.
Personal data, business data and educational information
The candidate is required to complete the form in all its part. If data are missing, the application cannot be processed.
Official transcripts, degrees and diplomas
Transcripts are required from all colleges, universities and professional schools attended and must include a comprehensive
record of completed courses, grades obtained and an overall grade average. Only original transcripts or notarized copies will
be accepted. Documents may be certified as “original” by school officials or other legal authorities such as embassies or
notaries. If transcripts are not in English, Italian, French, German; Spanish or Portuguese, you must supply a certified translation with the original.
Questionnaire
A questionnaire must be submitted to the MIC Program office along with the full application package.
Costs and cancellation policy
Fees and tuition: CHF 18,000
The master is organized on 9 weeks of courses:
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6 weeks of courses will take place at Università della Svizzera italiana in Lugano in the Executive Center, a reserved
area for Executive Masters. During our week of master in August 2015, we will take the occasion to attend the Locarno Film Festival.
1 week of courses will take place at Université Sidi Mohamed Ben Abdellah in Fès, Morocco *.
1 week of courses will take place partly Lausanne at the Swiss Institute for Comparative Laws (ISDC) in Lausanne
and includes visits to selected Federal Institutions in Bern and International Organizations in Geneva *.
1 week of courses will be held in Bangkok, Thailand *.
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Tuition fees includes the costs of the instructional material distributed in class, test fees, and accommodation (double room
occupancy) during the weeks of master organized abroad: Fez (Morocco) and in Bangkok (Thailand) .
Not included are costs for books, accommodation in Switzerland (Lugano and Lausanne), and travels to Lugano, Lausanne,
Geneva, Berne and abroad.
Should a participant withdraw before January 5, 2015, payment of only the first installment is required. After this date, full
payment of all fees and tuition is required.
In the event of an insufficient number of applicants, the program office reserves the right to cancel or postpone the program
by January 20, 2015. If the program is canceled by January 20, 2015, this contract is voided
Should a participant need a special payment plan, a proposal is requested in written form.
* For organizational reasons, locations are subject to change.
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Personal data
First name
Last name
Title
(Ms./Mr./Dr.)
Marital status
Children
(name/year of birth)
Mother tongue(s)
Other languages
Students fluent in one lan-
Basis
guage (spoken and written)
are required to possess a
Medium
Excellent
Mother
tongue
English
good working knowledge of
the other (reading skills and
listening comprehension).
French
Birth date (dd/mm/yyyy)
Age at start of the program
Nationality 1
Nationality 2
Bürgort/Lieu d’origine/
Luogo d’origine and ZIP
code (only Swiss nationals)
City/Country of birth
(only for non-Swiss nationals)
Residence permit type
(only for non-Swiss nationals living in Switzerland)
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Private contact data
Street
Postal code
City
Country
Phone
Fax
E-mail
Cell phone
Skype
Facebook
Twitter
Business contact data
Professional title (as stated
on business card)
Name of organization
Department
Street
P.O. Box
Postal code
City
Country
Phone
Fax
E-mail
Cell phone
Skype
URL
Where would you like to
receive ground mail correspondence?
Where would you like to
receive e-mails?
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Home address
Business address
Home address
Business address
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Business information
Years of full-time
professional activity
Years with current
organization
Name of organization
Professional title (as stated
on business card)
Position within
the organization
Executive
Top management
Management
Staff
Ow ner/freelancer
No. of team members (excl.
candidate)
Grade of employment
(in percent)
Yearly salary (incl. bonus)
in CHF
Contact in HR department
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Educational information
Please note that this part is mandatory and required by the Federal Office of Statistics (Berne). If the data are missing or
incomplete, your application cannot be processed.
City and country of residence
at the time of high school
diploma
Name of high school
Year of high school diploma
Type of high school diploma
High school diploma title
Higher educational
Diploma
diploma 1
(University, University of
Applied Sciences, Higher
ECTS (European Credit Transfer System Points - if available)
Professional Diploma)
Institution
Year of completion
Higher educational
Diploma
diploma 2
(University, University of
ECTS (European Credit Transfer System Points - if available)
Applied Sciences, Higher
Professional Diploma)
Institution
Year of completion
Higher educational
Diploma
diploma 3
(University, University of
Applied Sciences, Higher
ECTS (European Credit Transfer System Points - if available)
Professional Diploma)
Institution
Year of completion
Matriculation number
(only if university was attended in Switzerland)
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Enclosure checklist
Documents written in languages other than English, Italian, French, German; Spanish or Portuguese require an enclosed
certified English translation.
Please check to make sure that you have enclosed all necessary documents.
To be sent by candidate to MIC office by mail:
Curriculum Vitae
Questionnaire
Passport picture (electronic) in high resolution
Diplomas (official transcripts or notarized copies)
Contract of agreement
Remarks
MIC Program code of conduct
I have read the M I C code of conduct
Place and date
Signature
__________________________________________
___________________________________
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