Questionnaire for admitted pupils for the school year 2025/2026 - ready

QUESTIONNAIRE FOR NEW STUDENTS

Information about the pupil:

Select a class

1.EE Electrical power engineering and electrical machinery

1.EM Electromobility and alternative drives

1.ER Robotics and control technology

1.S Mechanical Engineering

Student registration number (six-digit number identical to the registration number in the DiPSy system):

Name:

Last name:

Birth number including slash (if the pupil does not have a birth number, add 0000):

Date of birth:

Place of birth:

Nationality:

ID card number (if the student already has one):

Phone number:

E-mail:

Name of the health insurance company:

Health insurance company code:

Permanent residence:

Address:

City:

ZIP CODE:

Transient residence (if the student does not have a transient residence, do not fill in):

Address:

City:

ZIP CODE:

Enter the name and address of the previous school (typically primary school):

Indicate any disability:

List any medical conditions with which the teacher should be familiar (e.g. asthma, allergies, diabetes, etc.):

Upload a passport photo of the student measuring 2.8 cm in width and 3.4 cm in height, ensuring the photo is of sufficient quality. Before uploading, name the photo as follows: prijmeni_jmeno_den_mesic_rok_narodeni. The only allowed format is .jpg. Example of naming a photo: novak_josef_02112009.jpg.

Upload a correctly named photo

Information about the legal representative(s):

First legal representative:

mother

father

Trustee

Name:

Last name:

Titles:

Phone number:

E-mail:

Residence:

Address:

City:

ZIP CODE:

Occupation:

The office phone:

Second legal representative:

mother

father

Trustee

Name:

Last name:

Titles:

Phone number:

E-mail:

Residence:

Address:

City:

ZIP CODE:

Occupation:

The office phone:

Want to order an ISIC card? By ticking YES, you agree to order an ISIC card. Payment for the ISIC card will be charged to the school cash register.

YES

By submitting this questionnaire, I agree to the processing of my personal data in accordance with Regulation (EU) No 2016/679 of the European Parliament and of the Council (GDPR).