Incoming Student

APPLICATION FOR A STUDENT EXCHANGE
J. Selye University (SK KOMARNO01) – OID: E10161166

Exchange Programme (*)

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BIP programme

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Other

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Academic Year

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Semester

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PERSONAL DETAILS – STUDENT

Last Name (*)

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First Name (*)

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Gender(*)

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Date of Birth(*)

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8. Place of Birth (*)

City(*)

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Country(*)

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Nationality (*)

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Phone Number(*)

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E-mail adress(*)

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Adress(*)

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(Street, NO., City, Postcode, Country)

DATA CONCERNING THE CONTACT PERSON IN CASE OF EMERGENCY

Last and First Name(*)

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Telephone number(*)

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Allergies

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Medicines

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Student with special needs(*)

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DATA CONCERNING CURRENT STUDY

Home Institution(*)

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Erasmus Code (if applicable)

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Study field(*)

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Other

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Study level(*)

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Name of the Institutional Coordinator (*)

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E-mail adress of the Institutional Coordinator(*)

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Phone number of the Institutional Coordinator(*)

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PLANNED STUDIES AT J. SELYE UNIVERSITY

Faculty(*)

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Study Programme - Faculty of Economics and Informatics

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Study Programme - Faculty of Education

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Study Programme - Reformed Theological Faculty

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Please briefly describe Your research area/topic:

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Do you need the help of a consultant?

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Do you need dormitory accommodation?(*)

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ATTACHMENTS

Europass CV(*)

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(.doc , .docx , .pdf )

Invitation letter(*)

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(.doc, .docx, .pdf)