ANNULMENT OF REGISTRATION FOR PERSONAL REASONS AFTER THE START OF ACADEMIC ACTIVITY AND UP TO 15TH NOVEMBER

PERSONAL INFORMATION

Name: / First surname: / Second surname:
Identity card number (or passport number): / Addressforwritten correspondence:
Post code: / Town: / Telephone:
Mobile telephone: / URV email address:
I am a student on the Master's Degree in: / Faculty/School: / Universitat
Rovira i Virgili
Have you applied for a grant? / YES / NO (annulment of registration also means annulment of grant applicationand registration fee payment)

I REQUEST: The annulment of my registration for personal reasons before the start of academic activity

NEW DOCTORAL STUDENT: / YES / NO
If yes, indicate one of the following:
I will collect the documents that I submitted for registration:
I wish to receive the documents that I submitted for registration by post:
* Annulment of registration means that you will lose your place on the course. You will have to go through the pre-registration procedure again if you wish to begin any other course.
I am aware that once my request has been accepted, the Secretary's Office of the Faculty/School will, if necessary, begins the process of returning my registration fees to me.

[place]______, [date]______

(signature)

Please specify the account number that should be debited:

The same account number as when I enrolled (data base) (in this case you need not provide any more details)
My account number is the following:
Client's account code
IBAN / Name of bank / Branch / Control / Account number
SWIFT
Account holder
Identity card/passport number / Firstsurname / Second surname / Name

 I will collect the notification in person from the secretary’s office of the faculty/school.

Mr/Ms, Dean, Director of the Faculty/School - Head of the Secretary's Office

DUTY TO INFORM: The URV is responsible for your data and processes them for the purpose of managing your academic transcript and organising your teaching and study, in compliance with its duty to provide a public service. Your data will only be shared with third parties if the URV is legally obliged to do so or if you subscribe to any of the services provided by third parties that are indicated during this procedure. You have the right to access, rectify, remove, request the transfer, oppose the handling and restrict the processing of your data. You can more detailed information onData Protection on the website of the URV (


Student information
Full name:

Identity card number/passport number:
Addressfor written correspondence:

Post code: Town:

Course:

RESOLUTION OF APPLICATION TO ANNUL REGISTRATION FOR PERSONAL REASONSAFTER THE START OF ACADEMIC ACTIVITY AND UP TO 15TH NOVEMBER

Stamp of Faculty/School / Stamp of Faculty/School
The student's registration will be annulled. / The application is declined because:
the student is not up to date with payments.

[place]______,
[date]______
the application was presented outside the established period.
[place]______,
[date]______
The Head of the Secretary's Office
as delegated by the General Manager / The Head of the Secretary's Office
as delegated by the General Manager

This decision is not the end of the administrative process and, should you wish to do so, you can appeal to the rector of the URV within one month of having been informed of this decision.

STUDENT GRANTHOLDER
Date of reception at SGA: …………………......

The student signs this form to demonstrate that he/she has received and understood this resolution.

(signature)......

______[place], ______[date].