ITT Dublin. Erasmus + Application Form 2015-2016

Closing date: 01 June 2014 for arrival in autumn 2015 or 01 November 2015 for arrival in spring 2016

General Information:

ALL sections must be completed. Incomplete forms WILL NOT be processed.

Pay particular attention to postal address and e-mail address.

If possible type this information before printing and signing the form.

YOUR FORM WILL BE TOTALLY IGNORED:

-if you send it by e-mail,

-if you post it later than the deadline,

-if it does not have the signature of your academic coordinator / international officer, or

-if you post it without including 2 passport-type photographs.

We will issue confirmation of receipt of application forms via email only. This confirmation will be emailed after 15 June / 15 November.

Do you require a written letter of acceptance? You must then enclose a self-addressed envelope when you post your form. Do not include a postage stamp.Confirmation letters will be posted after 15 June / 15 November. I regret we cannot enter into email correspondence with students about arrival or non-arrival of application forms before this date.

Decide what you can study in Dublin

1. There are entry restrictions on some courses. Please check with your coordinators at home whether any restrictions apply to your semester(s) in Dublin.

2. Your selection below is not guaranteed (unless specified under the terms of your institute’s bi-lateral agreement with ITT Dublin).

3. If you expect to take modules from 2 or more Departments:

The timetables for 2015-2016 will not be available until the first day of each semester. Therefore you can prepare only a provisional list before arrival. Your final selection of modules must take place after arrival at ITT Dublin.

4. Module (subject) details are available online from May 2015.

5. To find the list of courses: First click on full time courses.

Then click on an academic Department, e.g. Humanities.

Under ‘View courses’ you can find a list of programmes, e.g. Bachelor of Arts.

Click these programmes and view how the course is divided by semester.

Click on the modules to read course descriptions.

Look at these examples, then fill your proposals on the application form :

Name of the course / Department / Year / Semester / Subject/module title
B.A.(Hons) European Studies / Humanities / 2 / 5 / European Union Law
Manufacturing Engineering / Mech.
Engineering / 4 / 7 / Materials Science

6. In the autumn semester you can study modules in semester 1,3,5,7,and 9. In the spring semester you can study modules in semesters 2,4,6,8 and 10. We regret that we no longer offer classes in English as a Foreign Language. This is due to ongoing staff shortages and is outside our control.

ERASMUS+ APPLICATION for 2015-2016 only

Only for Erasmus students already nominated by their home university

Section I: Personal Data

PLEASE USE BLOCK CAPITALS
Surname: ______/ Photo
2 photos are required.
Firmly Attach photo #1 here:
Enclose photo #2 with
application. On the back of
photo #2 write:
  1. your name, and
  2. the semester(s)
you’ll study here.
Example: 1. Tara McKiernan
  1. Full year 2015-16

PLEASE USE BLOCK CAPITALS
First Name:______
Male  Female 
Nationality: Native language: ______
Passport / Identity Number:
Date of Birth:
Circle Your Study period: Winter semester 2015 / Full year 2015-16 / Spring 2016

USE BLOCK CAPITALS TO ENSURE YOU RECEIVE ALL CORRESPONDENCE FROM US !!

PERMANENT ADDRESS :
Telephone (including all codes)
E-mail: PLEASE write very clearly so that you will receive our emails !!!
______
NEXT-OF-KIN - please provide details of a relative (not a friend) who will be contacted ifyou are in a serious accident or other emergency.
Full name : Relationship to you:
Telephone (include all codes):
E-mail of your next-of-kin:
______

Section II : Your studies at your home university.

Home Faculty and/or Department in which you are now studying:
______
YOUR Exchange co-ordinator’s full name:______
e-Mail: ______
Co-ordinator’s full telephone number: ______

How many semesters have you already completed ? ______

Will the credits at I.T. Tallaght count towards your degree qualification? ______

How long (in months) have you spent in an English-speaking country? ______

OUTLINE in ca.150 words

(1) Why You Want To Study Abroad and (2) Why at I. T. Tallaght ( DUBLIN)

(1)

(2)

SPECIAL NEEDS :Please let us know if you have a physical, sensory or other disability, which might in some way affect your studies at ITT Dublin or may require special facilities or treatment. YES / NO

Is your home university aware of this special need? ______

Include brief details of your special needs here:

Section III : Your proposed studies at I T Tallaght (Dublin).

I understand and accept the information and conditions set out on page 1 of this form.

YES NOSignature: ______

The timetables for 2015-2016 will not be available until the first day of each semester. Put your provisional list of modules here. Your final selection of modules must take place after arrival at ITT Dublin.

Name of the course / Department / Year / Semester / Subject/module title

Have you studied abroad before? YES/NO. Give details: (where, when, how long)

______

If you have an address until your arrival in Dublin that is different from your permanent address, please write it here:

______

______

Date you will leave this address: ______

Section IV : Confirmation and Declaration for 2015-2016

Academic / Administrative Confirmation

(To be completed by the academic coordinator OR international officer)

Full Name of home university:

Erasmus Code:

I. I, (name)______confirm that (student’s full name)

______is approved by me to study at ITT Dublin.

II. This student’s current level of English is (please circle as appropriate):

A1 A2 B1 B2 C1 C2

III. I have approved a provisional programme of study with the student.

I understand that final study choices will be made after his/her arrival.

Name & Position ______

Telephone: ______

email: ______

Date: ______Signature______

University stamp / seal:

Student’s Checklist / Declaration:

(To be completed and signed by the in-coming Erasmus student)

ALL sections of this form have been completed . YES / NO

I have used UPPERCASE / BLOCK CAPITALS where requested. YES / NO

My email address is written very clearly on this form. YES / NO

I am respecting the application deadline of 01/06/15 or 01/11/2015. YES / NO

This form will be posted (not emailed) by me / my coordinator. YES / NO

My final subject choices may be made after arrival in Dublin. YES / NO

I require a written letter of acceptance YES / NO

To receive this letter of acceptance from ITT Dublin I am including with this form my own envelope with my name and home address (without postage stamp).

Student’s Name in CAPITALS: ______

Student’s signature ______Date: ______

WE DO NOT ACCEPT APPLICATION FORMS BY E-MAIL
Return forms BY POST ONLY to:

International Office. Attn: Tara McKiernan, ITT Dublin, Tallaght, Dublin 24. Ireland