UNIVERZITET U SARAJEVU /UNIVERSITY OF SARAJEVO

...........................................................................................................Zahtjev za priznavanje inostrane visokokolske kvalifikacije

Application for recognition of foreign higher qualificationI - PODACI O PODNOSITELJU ZAHTJEVA/INFORMATION ABOUT APPLICANT

1. OSOBNI PODACI PODNOSITELJA ZAHTJEVA / APPLICANTS PERSONAL INFORMATION

Ime / First namePrezime i roeno prezime / Last name (and birth name)

Datum roenja / Date of birthGrad i drava roenja / City and Country of birth

Dravljanstvo / CitizenshipSpol: ensko / Female Muko / Male

Ulica i broj / Street and number Potanski broj i mjesto / Zip code, City

Drava / CountryE-pota / E-mail

Telefonski broj / Phone numberBroj mobilnog telefona / Cell phone number

2. RJEENJE DOSTAVITI NA ADRESU (zaokruiti) / ADRESS WHERE YOU WANT FINAL DECISION TO BE DELIVERED (round):

Podnositelja zahtjeva / Applicants address Neku drugu / Other Ime i prezime / Name and last name ______________________________________________________

Ulica i broj / Street and number: ______________________________________________________

Potanski broj, mjesto i drava /

Zip code, city, country ______________________________________________________

II - PODACI O STEENOJ STRANOJ VISOKOKOLSKOJ KVALIFIKACIJI ZA KOJU SE TRAI PRIZNAVANJE / INFORMATION ABOUT HIGHER EDUCATION DOCUMENT FOR WHICH A RECOGNITION IS REQUESTED

Naziv visokokolske institucije na izvornom jeziku / Name of the Institution of Higher Education in original language

Adresa visokokolske institucije / Address of Higher Education Institution

Grad / CityDrava / Country

Web adresa visokokolske ustanove / Web address of Higher Education Institution

Naziv studijskog programa / Higher Education programme

Nain studiranja (redovno, uenje na daljinu, drugo / For of study (full-time, longdistance learning, other please specify)

Naziv strane visokokolske kvalifikacije ije priznavanje se trai na izvornom jeziku i na jednom od slubenih jezika u BiH /Name of the Higher Education document in original language and in one of the official languages in Bosnia and Herzegovina

Naziv javne isprave kojom se dokazuje strana visokokolska kvalifikacija, na izvornom jeziku / Name of supporting public document proving higher education qualification, the recognition of which is requested, in original language as stated in original supporting public document (npr./for example Diploma, Certificate)

Vrsta studija / Type of study:

Univerzitetski / academic Struni/strukovni / professional

Slubeno trajanje studija (broj godina/semestara/ECTS bodova) / Official length of study program (years / semesters / ECTS credits)

Datum upisa na studij / Date on enrollment /___/___/_____/

Datum zavretka studija / Date on finishing the study /___/___/_____/

Datum sticanja strane visokokolske kvalifikacije / Date of acquisition of qualification (Date of issue of higher education document) /___/___/_____/

Dodatni uvjeti sticanja strane visokokolske kvalifikacije (zaokruiti) / Additional graduation requirements (circle):

Pisani zavrni rad (thesis tema / title):___________________________________________________________________________________

Zavrni ispiti / final exams:

___________________________________________________________________________________

Drugo / other___________________________________________________________________________________

III - PRIJANJE OBRAZOVANJE / PREVIOUS EDUCATION1. SREDNJEKOLSKO OBRAZOVANJE / SECONDARY SCHOOL EDUCATION

Naziv institucije / InstitutionGrad i drava / City and ContryNaziv steene kvalifikacije / Acquired qualificationGodina upisa / EnrolledGodina zavretka / Finished

2. PRIJANJE STEENO VISOKO OBRAZOVANJE / OTHER HIGHER EDUCATION

Naziv institucije / InstitutionGrad i drava / City and ContryNaziv steene kvalifikacije / Acquired qualificationGodina upisa / EnrolledGodina zavretka / Finished

3. SVRHA PODNOENJA ZAHTJEVA / PURPOSE OF APPLICATION

1. Struno priznavanje / Professional recognition2. Nastavak zapoetog nivoa visokog obrazovanja / Continuation of the same cycle of higher education3. Ukljuivanje u nivoe visokog obrazovanja (master, doktorski studij) / Enrollment in cycles of higher education (master studies, doctoral studies)

Naziv fakulteta/akademije i studijskog programa / please indicate institution and study programme:

_____________________________________________________________________________________________________

NAPOMENA / NOTE:

Za tanost podataka odgovara podnosilac molbe.

(The applicant is responsible for the correctness of the information given)Uz zahtjev prilaem slijedee / Please find enclosed:

1.

2.

3.

4.

5.

6. .

7. .

8. .

U / In :____________________, ____________________________________________

(grad/city) (datum,date) (potpis podnosioca zahtjeva/applicants signature)