Statutory Declaration/Affidavit (must be submitted in Czech or English)


I,
...................................................................................................
... (name and surname)

born on
............................................................................................. (date
of birth)

residing at
.............................................................................................
(place of permanent residence),

hereby declare on oath the following:

Fill in the required information (see page no. 2):




In Brno on …………………. 2022


Signature:


................................................................










If you are applying for a bachelor’s study programme, please specify:

1. name of your secondary school (also indicate in Ukrainian in Ukrainian Cyrillic),

2. the location of your secondary school,

3. the name of the secondary school certificate,

4. the date of issue of the document,

5. any other information concerning the secondary education, if applicable.


If you are applying for a master's study programme, please specify:

1. the name of the university attended (also indicate in Ukrainian Cyrillic),

2. the location of the university attended,

3. name and type of higher education diploma (i.e. bachelor's, specialist, master's, candidate of
science, doctoral, or other),

4. the name of the degree programme/field of study completed,

5. the date of issue of the diploma,

6. Information from your Diploma Supplement:

·         the location of the university,

·         place of study,

·         the level or type of education obtained (i.e. bachelor's, master's, specialist, doctoral,
or other),

·         the name of the degree programme/field of study completed,

·         the period of study,

·         a list of courses or information about courses taken, or information regarding
internships, state final exams or thesis, or any other information about the education completed.