SELECTION PROCESS CREATING VALUE THROUGH STRATEGIC FINANCIAL MANAGEMENT October

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					                               SELECTION PROCESS

       CREATING VALUE THROUGH STRATEGIC FINANCIAL MANAGEMENT
                             26th – 28th October, 2009




We thank you for your interest in the CREATING VALUE THROUGH STRATEGIC
FINANCIAL MANAGEMENT program, an international program developed and offered
by HEC Executive Education.


Please return two completed and signed copies of this form to our Admissions
Department. It will be reviewed by the Program Director to determine your suitability
for the program. You may also attach a current resumé or CV if you wish.


We also ask you to read and sign your agreement to the HEC general conditions
outlined below. This document will serve as a contractual agreement, if your
application is accepted.


We invite you to return the form by email, or alternatively by post or fax to the
address below. You will be informed by email of the result of your application in the
following weeks




Admissions Office
Corina Ravelosona and Nancy Piacentini
HEC School of Management, Paris
78351 Jouy-en-Josas, France
Tel : (+33) 1 39 67 96 29
Fax : (+33) 1 39 67 74 30
Email: exedinfo@hec.fr




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                                           REGISTRATION FORM

             CREATING VALUE THROUGH STRATEGIC FINANCIAL MANAGEMENT
                                       26th – 28th October, 2009




Please complete the following form in CAPITAL LETTERS



PERSONAL INFORMATION
   Mr.                           Ms.                     Other (please specify)
Last Name:
First Name:
Date of Birth:
Nationality(-ies):
   …………………….
   …………………….
Level of highest educational degree obtained:
   Undergraduate degrees – less than 3 years higher education
   Graduate degree (BA or BSc) – 3 or 4 years higher education
   Masters degree – 5 years higher education
   PhD



CONTACT DETAILS
Telephone*:
Mobile*:
Email address:
* Please indicate country and area code.



JOB POSITION
Company:
Job Title:
Department/Division:
Number of years professional experience:            Number of years management experience:




                                                                                             2/5
Please briefly describe your position in your company




MOTIVATION
Please briefly present your motivations for joining this program :




COMPANY INFORMATION
Main Field of Activity:
Annual sales (in Euros):
Number of Employees:

Company address

Street:


City, State:
Postal Code:
Country:
Telephone *:
Fax *:
* Please indicate country and area code.


    Self-sponsored candidate                                   Company sponsored candidate




If you are a company sponsored candidate, please give the name and position of the person
responsible for sponsoring you for the program:

Name:
                                                                                             3/5
Job Title:
Company (if different):
Address (if different):
Telephone *:
Fax *:
E-mail:

Billing address:

Name:
Company (if applicable):
Address:
Telephone *:
Fax *:



INFORMATION SOURCE
How did you hear about this program?
  Advertisement in the pres
  Emailing
  Searching the internet
  My company recommended the program
  A friend / colleague recommended the program
  Other (please specify):



Have you already participated in an HEC program?
  TRIUM
  CCC
  HEC EMBA
  Masters
  Open enrolment program
  Custom program
  Other (please specify):




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         CREATING VALUE THROUGH STRATEGIC FINANCIAL MANAGEMENT
                                    26th – 28th October, 2009

Information on attendance

The program begins on Monday 26th October and ends on Wednesday 28th October 2009 and takes
place at “Le Château” on HEC Campus in Jouy. Participants are expected to arrive on Sunday 25th
October before 7pm.

HEC reserves the right to replace designated faculty by professors of comparable calibre.

It is understood that during the program you will be free of other duties and will be able to participate
fully.

Fees and Payment Information

Catalogue Program Fees for 2009: €3,600

Fees include teaching and do not include accommodation, meals and transport

Tuition fees should be paid in full in advance. A place in the program cannot be guaranteed until full
payment is received. Checks for tuition fees should be made out to CCIP - Groupe HEC.


Fees, Cancellation, and Refund Policy

There will be a full refund given to those unable to attend the program if cancellation is made at least
30 days prior to the start of the program. A 50% refund will be given for cancellations received 30 days
or less before the beginning of the program.

HEC reserves the right to cancel the seminar and will inform participants at least 30 days before the
start of the seminar. In such a case, HEC will reimburse participants fully.

The applicant acknowledges that s/he has read the description of the program and understands the
commitments.

Please sign and date this document. Please precede your signature with the phrase "read and
approved".
We will return one copy of the document signed by Bertrand Moingeon, Deputy Dean of HEC Paris, in
order to confirm admission onto the program.

On behalf of HEC Paris – Bertrand MOINGEON                               Name of participant:
Deputy Dean of HEC Paris
in charge of Executive Education
and Academic Development

Date, Signature & Stamp:                                                 Date & Signature:




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