College of Management International Relations Office



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Data30.04.2016
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College of Management International Relations Office,

ul. Krakowska 56-62 , 50-425 Wrocław, Poland



__________________________________________________________________________________


ERASMUS
APPLICATION FORM 2012/2013




Student’s personal Data

Family name:




First name(s):

Parents names:






Date and placeof birth




Place of birth




Nationality




Subject of study




Year of study in 2011/2012




Current address:




Tel:




Permanent address

(if different):






Tel:

+48




+48

E-mail:

@

Nr of maturity/BA certificate:

Sending Institution

Name of Sending Institution




Faculty:




Institute:




Institutional Erasmus




Co-ordinator:







Partner Institution Applying For:

Full name of the Institution:

COLLEGE OF MANAGEMENT “EDUKACJA”

Erasmus code:

PL WROCLAW 13

Country:

POLAND

Period of study at the

From / / to / /

Partner Institution:




Number of months:







Language Knowledge

Mother tongue:




Language of instruction at home institution (if different)




Other languages:

I am currently studying this language

I have a sufficient knowledge to follow lectures

I have a sufficient knowledge
to write papers

1.










2.










3.










4.










5.













Courses during winter semester at home institution

1.







Acceptance of Receiving Institution

We hereby acknowledge receipt of the candidate’s application and the proposed learning agreement. The above mentioned student is:
□ accepted at our institution □ not accepted at our institution





Departamental Erasmus co-ordinator

…………………………………………….……………

Date and Stamp


Institutional Erasmus co-ordinator

…………………………………………….……………

Date and Stamp





____________________________________________________________________________________________

Wrocław 50-425 , ul. Krakowska 56-62, Poland, tel. 0048 71 3772152,



e-mail:international@edukacja.wroc.pl





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