BİRUNİ UNIVERSITY
2018-2019 ACADEMIC YEAR
ERASMUS+
STUDENT MOBILITY FOR STUDIES
APPLICATION FORM
Please fill out the form electronically.Handwritten applications will not be accepted!(You can check the boxes () by double clicking on them. Choose either “checked” or “not checked” and then click OK.)
STUDENT’S PERSONAL INFORMATION
Name(s):
Surname :
ID Number:
Nationality :
Place of birth :
Date of birth :
Home address :
Mobile Phone / Home Phone:
E-mail :
STUDENT’S ACADEMIC INFORMATION
Student no :
Faculty / Department :
Study Cycle : / Vocational School Undergraduate M.A. or M.S.
Doctorate
Academic Advisor at Biruni University (Title, Name, Surname) :
Any disabilities? (Yes/No)
If yes, you can apply for
other additional grant in order to cover the extra costs which may occur during your Erasmus+ Mobility. / Yes No
Have you already participated in the Erasmus+ Mobility? (If yes, did you receive an Erasmus+ grant and when? / Yes, Dates:…….
No
Which term you would like to participate the mobility? / Fall Term
Spring Term
UNIVERSITY PLACEMENT PREFERENCE
* Please indicate at which partner university you would like to participate within the Erasmus+ Study Program. The list of placements is available at int.biruni.edu.tr.
1 / 1st Preference
2 / 2nd Preference
3 / 3rd Preference
STATEMENT OF PURPOSE
* Please briefly explain why you want to participate in the Erasmus+ Student Mobility for Studies. (Min. 150 - 200 words)
I hereby certify that the information given is correct.
Name:
Surname :
Date: ...... /...... /2018
Signature:
Please print out the filled-in form and submit it to the Office of International Relations until 11th of May 2018, Friday.
ATTACHMENTS:
- A recent Transcript of Records (English)
- Invitation/Confirmation Letter from the Host University
- Learning Agreement for Studies
- Copy of ID (Identity Document)
- Euro Pass CV