Application is to be submitted in person or by post to: Útvar vzdelávania a starostlivosti o študentov R STU, Vazovova 5, 812 43 Bratislava 1 APPLICATION for a duplicate diploma (EXTRACT FROM THE BOOK OF DIPLOMAS) OF THE GRADUATE: □ Bachelor's degree * □ Engineering degree * TO BE FILL ED BYT HE APP LICA NT APPLICANT’S NAME AND SURNAME: NAME AND SURNAME listed on the diploma: □ PhD * ( * indicate) Titles: Permanent residence: Nationality: : e-mail: Zip Code: Date of Birth: Place of Birth: Country: Year of finishing: ID card No/Passport No: Department: study programme: study field: Reason for application: I grant the permission to process my personal data according the provisions of Article 7 and 9 of Act No. 428/2002, Coll. on the Protection of Personal Data. TO BE FILLED BY THE UNIVERSI TY Date: Protocol Number: Applicant’s signature: Officer’s signature: Date of payment: Payment Method: Notes: Sum: Application processed/date: Please attach the form of payment to the application: Account Number: 7000084007, Bank code: 8180 KS: 0308, VS when paying by: - postal cheque: 901 110 - Bank transfer: in the section for Information for the client write: 901 110 Surname of the sender /e.g.: 901 110 Baláž/. The fee for issuing the document and the methods of payments are governed by the “directive” valid for the relevant academic year and are published on the address: www.stuba.sk under the heading “studygraduate-study documents”.