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ERASMUS Student application FORM
http://www. u-szeged.hu	

ACADEMIC YEAR   2018 / 2019	FIELD OF STUDY: 		
This application should be completed in BLACK in order to be easily copied and/or telefaxed.
Deadlines for receiving the applications:
for the
    1st semester / or full academic year:
                           15 June, 2018
    2nd semester:    
31 October, 2018	Please send your application to:
International Mobility Centre
University of Szeged
6720 SZEGED
Dugonics tér 13.
HUNGARY	Queries about your application:
Ágnes PETŐ 
(in charge of incoming ERASMUS students)
Tel: +36 62 546 366
Fax: +36 62 546 365
E-mail: petorekt.u-szeged.hu	
SENDING INSTITUTION 
Name and full address: 	
Institutional coordinator - name, telephone and telefax numbers, e-mail box: 	
	
Departmental coordinator - name, telephone and telefax numbers, e-mail box:

STUDENT’S PERSONAL DATA 
(to be completed by the student applying)

Family name: 	
Date of birth: 	
Sex:                    female  /  male 
Nationality: 	
Permanent address: 	
City and Postal code: 	
Country: 	
Tel (including country code): 		
First  and middle name (s): 	
Place of Birth: 	
Passport No: 	
Mother tongue: 	
Mailing address (if different): 	
City and Postal code: 	

Tel: 		
E-mail: 		

We inform you that filling in all the requested information is compulsory. To protect your Personal Data your file is used for administrative and data history purposes only.
PERIOD OF STUDY AT THE UNIVERSITY OF SZEGED: 
From ....................................... 201.. .        to ............................ 201.. .    Duration of stay: ............................. (months).
Number of expected ECTS .........................................................................
Which department do you wish to study at? ……………………………
Level of knowledge of Hungarian: ………………………………..      Do you wish to study  Hungarian? Yes / No 

Student’s signature					    Institutional coordinator’s signature
....................................................................................                    .....................................................................................
....................................................................................                    
	Departmental coordinator’s signature
Date:...........................................................................                    .....................................................................................

Stamp of sending institution

Briefly state the reasons why you wish to study abroad?

	

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	

………………..							

………………..							

………………..							

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. Details not known at the time of application will be provided at a later stage.	

RECEIVING INSTITUTION

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

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

Departmental coordinator’s signature                             Institutional coordinator’s signature     

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