/ UNIVERSITY OF CRETE
Socrates – Erasmus Programme
Academic Year 200__/200__
Student Application Form

Field of Study

Code

Sending Institution
Name and full address
ID Erasmus Code
Departmental coordinator
(Signature, name, telephone and telefax numbers, e-mail box)
Institutional Coordinator
(Signature, name, telephone and telefax numbers, e-mail box)

STUDENT’S PERSONAL DATA

Surname

First Name

Date of Birth Sex M F

ID Card - Passport

Nationality

Current Address Permanent Address

Valid until Telephone

Telephone

E-mail

LIST OF INSTITUTIONS WHICH WILL RECEIVE THIS APPLICATION FORM (In order of preference)

Institution / Country / Period of Study
From To / Duration of stay (months) / No. of expected ECTS credits
1.
2.
3.

Name of the student

Sending Institution

LANGUAGE COMPETENCE

Mother tongue

Other languages / I am currently studying this language
YES NO / I have sufficient knowledge to follow lectures
YES NO / I would have sufficient knowledge to follow lectures if i had some extra preparation
YES NO

WORK EXPERIENCE RELATED TO CURRENT STUDY (If relevant)

Type of work experience / Firm /Organisation / Date / Country

PREVIOUS AND CURRENT STUDY

Degree for which you are currently studying

Number of higher education study years prior to departure abroad

Have you already been studying abroad ? Yes No

If yes, when ? at which institution ?

Briefly state the reasons why you wish to study abroad

The attached Transcript of Records includes full details of previous and current higher education study.

Details not known at the time of application will be provided at a later stage.

Are you interested in having Greek language courses during your stay in Crete? Yes No

RECEIVING INSTITUTION

We hereby acknowledge receipt of the Application, the proposed Learning Agreement and the candidate’s Transcript of Records.

The above-mentioned student is

Accepted at our institution

Not accepted at our institution

Departmental Coordinator’s signature Institutional Coordinator’s signature

______

Date___/___/___ Date___/___/___

Please send this form to:

Department of International Relations and European Programmes

2208 Faculty of Medicine, 71003 University of Crete, Greece

Tel: +30 2810 394797, Fax: +30 2810 394811

E-mail:

/ UNIVERSITY OF CRETE
Socrates – Erasmus Programme
Academic Year 20__/20__
Learning Agreement

Field of study Code

Name of student

E-mail

DETAILS OF THE PROPOSED STUDY PROGRAMME ABROAD/LEARNING AGREEMENT

Sending institution Erasmus Code

Receiving institution Erasmus Code

Course code (if any) and page nr of the information Package / Course title ( as indicated in the Information Package) / Number of ECTS credits

If necessary, continue this list on a separate sheet

Student’s signature

______

Date___/___/___

SENDING INSTITUTION

We confirm that this proposed programe of study/learning agreement is aproved

Departmental Coordinator’s signature Institutional Coordinator’s signature

______

Date___/___/___ Date___/___/___

RECEIVING INSTITUTION

We confirm that this proposed programe of study/learning agreement is aproved

Departmental Coordinator’s signature Institutional Coordinator’s signature

______

Date___/___/___ Date___/___/___

CHANGES TO ORIGINAL PROPOSED STUDY PROGRAMME/LEARNING AGREEMENT

To be filled in ONLY if appropriate)

Name of student

Sending institution Erasmus Code

Receiving institution Erasmus Code

Course code (if any) and page nr of the information Package / Course title ( as indicated in the Information Package) / Deleted course unit / Added
course unit / Number of ECTS credits

If necessary, continue this list on a separate sheet

Student’s signature

______

Date___/___/___

SENDING INSTITUTION

Departmental Coordinator’s signature Institutional Coordinator’s signature

______

Date___/___/___ Date___/___/___

RECEIVING INSTITUTION

Departmental Coordinator’s signature Institutional Coordinator’s signature

______

Date___/___/___ Date___/___/___