ECTS - PWSZ im. Witelona w Legnicy

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The Witelon University of Applied Sciences in Legnica - Introduction ROK AKADEMICKI: 20… /20…. KIERUNEK STUDIÓW: ......................................................... ECTS Course Catalogue 2010/2011 (Zdjęcie) Formularz należy wypełnić CZARNYM kolorem, ponieważ może być powielany, wysyłany faksem lub pocztą UCZELNIA WYSYŁAJĄCA Nazwa i pełny adres:.......................................................................................................................................................... ............................................................................................................................................................................................ Koordynator wydziałowy – imię i nazwisko, numer telefonu i faksu, adres e-mail ........................................................ ............................................................................................................................................................................................. ............................................................................................................................................................................................. Koordynator uczelniany - imię i nazwisko, numer telefonu i faksu, adres e-mail............................................................. ............................................................................................................................................................................................. ............................................................................................................................................................................................. DANE OSOBOWE STUDENTA (wypełnia student występujący o przyjęcie na studia) Nazwisko: ......................................................... Data urodzenia: ................................................. Płeć: .................................................................. Obywatelstwo:................................................... Miejsce urodzenia: ........................................... Aktualny adres: ................................................. ........................................................................... ........................................................................... ........................................................................... Aktualny adres ważny do: ............................. Tel.: ................................................................... E-mail: Imię/ Imiona : .............................................................. Stały adres (jeżeli inny niż aktualny): ......................... ...................................................................................... ...................................................................................... ...................................................................................... ...................................................................................... Tel.: .............................................................................. LISTA UCZELNI, KTÓRE OTRZYMAJĄ NINIEJSZE ZGŁOSZENIE ( według preferencji studenta): Uczelnia Kraj Okres studiów Okres pobytu Liczba punktów, jaką od do (w miesiącach) student planuje uzyskać w uczelnii zagranicznej ......................................... Państwowa Wyższa Szkoła Zawodowa im. Witelona w Legnicy ECTS – EUROPEJSKI SYSTEM TRANSFERU I AKUMULACJI PUNKTÓW .................... FORMULARZ ZGŁOSZENIOWY STUDENTA ............. ........... .................. ................................... 18
The Witelon University of Applied Sciences in Legnica - Introduction Imię i nazwisko studenta: ................................................................................................................................................ Uczelnia wysyłająca: ………………………………………………………………………………………................... Kraj: ……………………………………………………………………………………………………......................... Proszę krótko uzasadnić, dlaczego chciałby /chciałaby Pan/Pani studiować za granicą? ........................................................................................................................................................................................... ........................................................................................................................................................................................... ........................................................................................................................................................................................... ……………………………………………………………………………………………………………....................... ZNAJOMOSC JĘZYKÓW Język ojczysty: ...................Język wykładowy w uczelnii macierzystej ( jeśli inny niż ojczysty)................................... Inne języki Obecnie uczę się tego języka ............................. ............................. ............................. ECTS Course Catalogue 2010/2011 Znam ten język dostatecznie dobrze, by rozumieć wykłady Potrzebuję dodatkowego przygotowania językowego, by rozumieć wykłady tak nie tak nie tak nie DOŚWIADCZENIE ZAWODOWE( jeżeli jest związane z obecnym kierunkiem studiów) Rodzaj pracy ............................................ ............................................ Firma/ organizacja ........................................... DOTYCHCZASOWY PRZEBIEG STUDIÓW Okres pracy ........................... ........................... Kraj ...................................... ...................................... Jaki dyplom/ tytuł zawodowy uzyska Pan/Pani po ukończeniu studiów ........................................................ Liczba zaliczonych przed wyjazdem za granicę lat studiów: .............................................................. Czy studiował / a Pan / Pani za granicą ? Tak Nie Jeśli tak, kiedy I w jakiej uczelni ? ............................................................................................................. Załączony wykaz zaliczeń zawiera pełne dane o dotychczasowym przebiegu studiów. Informacje, które nie mogą być podane w momencie ubiegania się o przyjęcie na studia, zostaną uzupełnione w terminie późniejszym Czy zamierza Pan / Pani ubiegać się o stypendium na pokrycie dodatkowych kosztów związanych z okresem studiów za granicą? Tak Nie UCZELNIA PRZYJMUJĄCA Niniejszym poświadczamy przyjęcie zgłoszenia, proponowanego programu zajęć i wykazu zaliczeń studenta. w/w student Podpis koordynatora wydzialowego ........................................................................... Data: ................................................................ Został wstępnie przyjęty na studia w naszej uczelnii Nie został przyjęty na studia w naszej uczelni Podpis koordynatora uczelnianego ...................................................................................... Data :............................................................................ 19
Page 1 and 2: ECTS EUROPEJSKI SYSTEM TRANSFERU I
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ECTS - PWSZ im. Witelona w Legnicy

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