05.06.2014 Views

information on the university - PWSZ im. Witelona w Legnicy

information on the university - PWSZ im. Witelona w Legnicy

information on the university - PWSZ im. Witelona w Legnicy

SHOW MORE
SHOW LESS

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

The Witel<strong>on</strong> University of Applied Sciences in Legnica – Informati<strong>on</strong> <strong>on</strong> <strong>the</strong> University<br />

The Witel<strong>on</strong> University of Applied Sciences in Legnica<br />

ECTS – EUROPEAN CREDIT TRANSFER SYSTEM<br />

STUDENT APPLICATION FORM<br />

ACADEMIC YEAR: 20… /20….<br />

FIELD OF STUDY: .........................................................<br />

(Photograph)<br />

This applicati<strong>on</strong> should be completed in BLACK in order to be easily copied and/or telefaxed.<br />

SENDING INSTITUTION<br />

Name and full address:........................................................................................................................................................<br />

.............................................................................................................................................................................................<br />

.............................................................................................................................................................................................<br />

Department coordinator - name, teleph<strong>on</strong>e and fax numbers, e-mail ...............................................................................<br />

.............................................................................................................................................................................................<br />

.............................................................................................................................................................................................<br />

Instituti<strong>on</strong>al coordinator - name, teleph<strong>on</strong>e and fax numbers, e-mail ...............................................................................<br />

.............................................................................................................................................................................................<br />

.............................................................................................................................................................................................<br />

STUDENT’S PERSONAL DATA<br />

(to be completed in capitals by <strong>the</strong> student applying)<br />

Family name: .....................................................<br />

Date of birth: .....................................................<br />

Sex: ......................................................................<br />

Nati<strong>on</strong>ality:.........................................................<br />

Place of Birth: ....................................................<br />

Current address: .................................................<br />

...........................................................................<br />

...........................................................................<br />

...........................................................................<br />

Current address is valid until: .............................<br />

Tel.: ...................................................................<br />

E-mail:<br />

First name (s): .........................................................................<br />

Permanent address (if different): ............................................<br />

.................................................................................................<br />

.................................................................................................<br />

.................................................................................................<br />

.................................................................................................<br />

Tel.: ........................................................................................<br />

LIST OF INSTITUTIONS WHICH WILL RECEIVE THIS APPLICATION FORM ( in order of preference):<br />

Instituti<strong>on</strong> Country Period of study Durati<strong>on</strong> of stay N° of expected ECTS<br />

from to (m<strong>on</strong>ths)<br />

credits<br />

..........................................<br />

.........................................<br />

.................... ............. ........... .................. ...................................<br />

Course Catalogue / ECTS Informati<strong>on</strong> Package 2011/2012 20

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!