Please fill out this form electronically and send your documents per email to:


For your information:
UniLaSalle (former Institut Polytechnique LaSalle Beauvais)
International Direction–Incoming Students
 +33 (0)3 44 06 00 39
 +33 (0)3 44 06 25 26
19 rue Pierre Waguet / B.P. 30313
60026 BEAUVAIS Cedex – FRANCE
/ Geological Field School in France
ACADEMIC YEAR: 2017/2018
Application deadline: February 15th, 2018

General information

Last name: / Date of birth (D,M,Y):
Town of birth:
Country of birth:
First name(s): / Gender: Female
Male
Nationality: / Mother tongue:
Current personal address:
Street & number: ………………………………………………………………………………………………
City: ……………………………………………………………….… Postal code: ………………………...
Country: ……………………………………………….. / Cellphone:
E-Mail (personal):
Person to contact in home country in case of emergency(name, phone number and e-mail address):
Home university: (full name and full postal address)
Faculty / College: / Erasmus+ code
for European Universities
………………………………….
Contact person at home university: (name, tel., e-mail address, faculty)
Contact person at home university to send the transcript of records(if different from contact above) (name, tel., fax, e-mail address, faculty)
Health matters:
-Do you have any health issue?
………………………………………………………………………………………………………………………………………
-Do you have any dietary restrictions based on medical, cultural or religious reasons?
………………………………………………………………………………………………………………………………………
-Do you have any allergies?
………………………………………………………………………………………………………………………………………

Academic background

Last degree obtained (name,year, level and location):
Current level / year / major-minor in your home university:
Have you studied in France before?: Yes No
If yes:
-Where? (school name and town):
-What for? (level of study and/or name of degree/program):
-Dates:
-Number INE (Identification National Etudiant) if you know it:
Knowledge of languages:
French
English
Other ……………...... / Excellent Advanced Intermediate Basic (oral)
Excellent Advanced Intermediate Basic (written)
Excellent Advanced Intermediate Basic (oral)
Excellent Advanced Intermediate Basic (written)
Excellent Advanced Intermediate Basic (oral)
Excellent Advanced Intermediate Basic (written)

Documents to be provided

Official copy of exam of:

* English language - 785 TOEIC level as a minimum (if you are not a native speaker of English)

Transcript of records of the 3 last years from the home university (in English or French)

1 résumé (Curriculum Vitae)

Learning Agreement - Duly completed & signed by your home coordinator and yourself

1 passport copy with photo

1 photo– ID format for your future student card

After acceptance only:

Proof of international Health Insurance coverage

  • For non-European students, you have to subscribe a special health insurance in your country covering you during your whole stayin France(plus an extension for Italy because 2 days of the field trip are in Italy).
  • For European students, you need to send us a copy of your European Health Insurance Card.

Proof of Liability Insurance coverage

  • For non-European and European student, you have to subscribe to a liability insurance in your country covering you during your whole stayin France

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Application form UniLaSalle