KU Leuven Study Abroad Programme

in European Culture & Society

Academic and financial information

Name:

Home University:

Academic year:20 / 20

Period: (Fall, Spring or Year)

1. ACADEMIC INFORMATION

In what year did you obtain your high school degree? ......

Present year: 1 - 2 - 3 - 4 – 5

I plan to graduate in the year: ......

Field of study

Major(s): ...... Minor(s): ......

......

Overall academic result and scale: ......

(for example US: GPA 3.0 / 4.0, Canada: 70% ...)

List all courses in which you are currently enrolled at your home university (title and expected grade)

1......

2......

3......

4......

5......

6......

Include the transcripts of your university education so far. Please list the colleges or universities from which you have included transcripts:

......

......

......

......

2. STUDY PROGRAMME AT KU LEUVEN

List at least 30 ECTS credits worth of courses per semester that you would seriously consider taking and that meet with the approval of your advisor. Check our website to make sure that your courses do not overlap.

First Semester (September –December/January):

Course codeCourse title

1...... : ......

2...... : ......

3...... : ......

4...... : ......

5...... : ......

6...... : ......

Second Semester (February– June):

Course codeCourse title

1...... : ......

2...... : ......

3...... : ......

4...... : ......

5...... : ......

6...... : ......

3. SECTION FOR THE STUDY ABROAD ADVISOR / EXCHANGE COORDINATOR

Advisor’s statement:

I have discussed both the programme and the conditions for study abroad at KU Leuven

with ...... and hereby

❍Unconditionally approve of this student’s participation in the programme.

❍Conditionally approve of this student’s participation, with the reservation(s) listed below:

......

......

......

......

Will your institution grant credit for the courses taken at KU Leuven towards this student’s degree?

(please use an additional sheet if necessary)

❍Yes

❍Yes, provided that the student’s programme meets the conditions below:

❍No, for the reasons below:

......

......

Is this student currently in violation of any code of student conduct?

❍No

❍Yes (please explain)

......

......

Advisor's signature Name (capitals) Date

4. SIGNATURE OF APPLICANT

I declare, upon my honor, that this information is correct and complete, and that I have sufficient funds to cover my expenses resulting from enrolment at KU Leuven. I acknowledge that I claim no financial or material aid whatever from KU Leuven during my studies. I agree that any false statement I make in this application shall result in immediate cancellation of my application.

I also certify that all responses made on my health information form are true and accurate, and that I will notify PECS hereafter of any relevant changes in my health that occur prior to the start of my study abroad period at KULeuven.

Applicant's signature Name (capitals) Date

KU Leuven, Study Abroad Programme in European Culture & Society

Blijde-Inkomststraat 21/3312, B-3000 Leuven (BELGIUM)