Application form siauliai university exchange_students2014-2015

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Information about Application form siauliai university exchange_students2014-2015

Published on March 6, 2014

Author: giorgijamburia9

Source: slideshare.net

ŠIAULIAI UNIVERSITY Department of International Programmes and Relations Vilniaus st. 88, LT-76285 Šiauliai, Lithuania Tel: +370 41 595742, Fax: +370 41 595743 E-mail: urs2@cr.su.lt WEB: http://www.su.lt/en/siauliai-university-su Application form for Exchange Studies Important information ● Application Deadline:  Autumn semester - June 1  Spring semester - November 30 ● Please type or use block letters. Answer all questions fully. ● Return your completed application form, documentation by the application deadline (address is above). ● Only typewritten applications will be accepted Recent photo 1. Sending Institution Name            Full address Department Coordinator            Contact information Institutional Coordinator            Contact information                                  2. Personal information Family (last) name Date of Birth (dd-mm-yyyy) Citizenship Passport/ID No.                      -     -                                      First name (s) Place of Birth Sex Valid                                 Male Female from       till       3. Applicant contact information                 Current address: House and Street                 City                 Postal code                 Country                 Mailing address E-mail address Telephone number                 Permanent address: House and Street                 City                 Postal code                 Country                 4. Person to contact in case of emergency Family (last) name Relationship to You                                 First name (s) Telephone number                                 1

                Address                 E-mail address 5. Language proficiency Mother tongue Other languages            English:                        :       Language of instruction at school, if different Russian:       French:       E - excellent, G-good, F- fair Have You taken the TOEFEL or IELTS? If “YES” then what was your score? If “NO” then indicate your English proficiency       Speaking:       Yes Date passed: Reading:       No            Writing:       E - excellent, G-good, F- fair 6. Current study Degree for which you are currently studying Undergraduate Number of study semesters prior departure abroad Postgraduate       7. Financial information Please, specify your funding resources for tuition and accommodation Parents Personal Doctorate Scholarship Other 8. Duration of study period at Šiauliai University Type of mobility ERASMUS University bilateral agreement Academic year Choose: Autumn semester: September 1 - December 20 Spring semester: February 1 - June 15 All academic year: September 1 - June 15 Other period: from            to            9. Curriculum you apply for at Šiauliai University List of study subjects for exchange applicants: http://www.su.lt/en/studies/exchange-programmes2 Course code Course unit title Semester (autumn/spring) Number of ECTS credits                                                                                                                                                                                                                                                                                                                     2

10. Required enclosures Please, ensure that the application is complete and that it includes the following items: Motivation letter Copy of passport (for non EU citizens) or ID card (only for EU and EEA citizens) I confirm that information I have provided in this application and in any attached document is true and correct (print and sigh this document). Signature of applicant Date (dd.mm.yyyy) SENDING INSTITUTION We confirm that the proposed programme of study agreement is approved. Departmental coordinator Institutional coordinator’s signature Name, surname, signature Name, surname, signature Date Date RECEIVING INSTITUTION We hereby acknowledge receipt of the application and confirm that this proposed programme of study agreement is approved. Departmental coordinator Institutional coordinator’s signature Name, surname, signature Name, surname, signature Date Date 3

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