EÖTVÖS LORÁND UNIVERSITY APPLICATION FORM FOR DIPLOMA SUPPLEMENT DUPLICATE Reference No. 1 : The service fee of the issuance of a diploma supplement duplicate is 10 000 HUF. The application must be submitted with a proof of payment. ATTENTION: you must submit the copy of the diploma! Applicant’s data: Name: _______________________________________________ Birth name: _______________________________________________ Date and place of birth:_________________________________________ Mother’s maiden name:____________________________________________ Mailing address: _______________________________________________ Telephone number: _______________________________________________ E-mail address: _______________________________________________ Neptun/EHA code: _______________________________________________ Applicant’s study programme: Name of the programme:___________________________________________ Level of study: BA/BSc, MA/MSc, undivided one-tier programme, vocational training (Please underline the applicable one.) Type of programme: full-time / part-time / correspondence (Please underline the applicable one.) Beginning and end of student status:_____________________________ Data of the original document: Name on the document:____________________________________________ 1 To be filled out by the University.
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EÖTVÖS LORÁND UNIVERSITY
APPLICATION FORM FOR DIPLOMA SUPPLEMENT DUPLICATE
Reference No.1:
The service fee of the issuance of a diploma supplement duplicate is 10 000 HUF. The application must be submitted with a proof of payment. ATTENTION: you must submit the copy of the diploma!
Applicant’s data:Name: ________________________________________________________Birth name: ________________________________________________________Date and place of birth:______________________________________________________Mother’s maiden name:______________________________________________________Mailing address: ________________________________________________________Telephone number: ________________________________________________________E-mail address: ________________________________________________________Neptun/EHA code: ________________________________________________________
Applicant’s study programme:Name of the programme:_____________________________________________________Level of study: BA/BSc, MA/MSc, undivided one-tier programme,
vocational training(Please underline the applicable one.)
Type of programme: full-time / part-time / correspondence (Please underline the applicable one.)Beginning and end of student status:_________________________________________
Data of the original document:Name on the document:______________________________________________________Number and date of the document:___________________________________________Reason for requesting a diploma supplement duplicate (Please underline the applicable one.):
The original document is lost / stolen / destroyed / damaged
Date and place:…………………………………………
…………………….……………….1 To be filled out by the University.
Applicant’s signature
The service fee of the issuance of a diploma supplement duplicate (10 000 HUF via transfer)
Beneficiary: Eötvös Loránd TudományegyetemBeneficiary bank account number: 10032000-01426201-00000000IBAN: HU03 1003 2000 0142 6201 00000000SWIFT: MANEHUHBBIC: HUSTHUHBCurrency: HUFStatement (in accordance with the applicable faculty, EXACTLY as below):Faculty of Law name of the applicant, TSZ:A10303/16 K:A0000
F:9125250000Berzsenyi Dániel Teacher Training Centre
name of the applicant, N14804/17
Bárczi Gusztáv Faculty of Special Needs Education
name of the applicant, G11150/18, G0000
Faculty of Humanities name of the applicant, R940533000 C0000 C11150/18 C094210
Institute of Business Economics
I11150/18-a name of the applicant
Faculty of Informatics name of the applicant, E11150_18Faculty of Education and Psychology
name of the applicant, B11150/18, duplicate
Faculty of Primary and Pre-School Education
name of the applicant, H11150/18, R940533000, H0000, TÓK IRAT_MASODLAT_OKLEVEL
Faculty of Social Sciences
TáTK/F0000/F111/AF9T02/04/ name of the applicant
Faculty of Science name of the applicant, AD9311/95 D0020, diploma duplicate