ERASMUS+

STUDENT APPLICATION FORM		

(Photograph)

ACADEMIC YEAR:	20... / 20...
FIELD OF STUDY: 	.......... 

SENDING INSTITUTION

Name and full address: 			Erasmus code: ....... 

Departmental coordinator - name, phone, e-mail box 
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Institutional coordinator - name, phone, e-mail box 
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STUDENT’S PERSONAL DATA (to be completed by the student applying)

Family name: ..................................................	
First name(s): .................................................	
Date of birth: .................................................		
Sex: ............ Nationality: ...............................		
Place of birth: ................................................		
Current address: ............................................
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.......................................................................	Permanent address (if different): .....................
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ID card number is valid until: .........................		
Phone: .............................................................		
	
E-mail address: ..............................................................……………………………………….	

Briefly state the reasons why you wish to study at Gál Ferenc College?

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LANGUAGE COMPETENCE
Mother tongue: ………… Language of instruction at home institution (if different): ………….	
Other languages	I am currently studying this language	I have sufficient knowledge to follow lectures	I would have sufficient knowledge to follow lectures if I had some extra preparation	
	yes	no	yes	no	yes	no	

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WORK EXPERIENCE RELATED TO CURRENT STUDY (if relevant)
Type of work experience

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	Firm/organisation

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	Dates

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	Country

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PREVIOUS AND CURRENT STUDY
Diploma/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? ………………………………………………………………………
The attached Transcript of records includes full details of previous and current higher education study. 	

RECEIVING INSTITUTION
Hereby we acknowledge 			 the receipt of the application, 
					 the proposed learning agreement and 
					 the candidate’s Transcript of records.

The above-mentioned student is			 provisionally accepted at our institution
 not accepted at our institution

Departmental coordinator’s signature                 Rector’s signature     

……………………………………………        ……………………………………………………….
Date: …………………………………….. 	Date:…………………………………………………

The data given here are handled by Gál Ferenc College as stipulated in its data-handling and data protection regulation.