AY 2019-2020 Application Form for Incoming Students Posted on 26 Febbraio 2019 by tutor AY 2019-2020 Application Form for Incoming Students APPLICATION (To fill the form please use only English alphabet letters with no accents). Use all your names and surnames exactly as they are write in your passport/id Family Name/s - exactly as your Passport/ID * Name/s - exactly as your Passport/ID * Email * ID Card – Passport * NumberNumber ID Card – Passport - dd/mm/yyyy * date of expiredate of expire Sex * M F Nationality * Date of Birth - dd/mm/yyyy * Place of Birth - City * Place of Birth - Country * Address for correspondence - Street * Address for correspondence - City * Address for correspondence - Postal Code (number) * Address for correspondence - Country * Phone number * International prefixInternational prefix International Prefix Phone number * Home NumberHome Number Home Number Phone number * Mobile NumberMobile Number Mobile Number Period of Stay * First Semester Second Semester Whole Year Duration of stay - total months (in Number) * Duration of stay - FROM - Day/Month/Year * Duration of stay - TO - Day/Month/Year * Programme * Double-Degree Erasmus + KA107 Erasmus+ for study Erasmus+ for traineeship Globus for study Globus for traineeship Visiting Student Proposal subject to study in Cagliari * I wish to take courses Do a project work/thesis do a traineeeship Level * Bachelor Master phd - Doctoral Country of your University * Name of your University * Erasmus code of your university * Field of study * Field of study code * Departmental Coordinator Name Tel Fax e-mail * Institutional Coordinator Name Tel Fax e-mail * MEDICAL INSURANCE You should send a copy of the medical insurance that you have I have the European Health Card ? * No Yes, If Yes Nr:Yes, If Yes Nr: Do you have a disability/special needs (including dyslexia)/medical condition? * No Yes, Please state details of this disability/special need/medical condition:Yes, Please state details of this disability/special need/medical condition: If you require any special assistance as a consequence of condition stated above, please outline there LANGUAGE COMPETENCE Mother Language * ITALIANO - I am currently studying this language * Yes No ITALIANO - I have sufficient knowledge to follow lectures * Yes No ITALIANO - I would have sufficient knowledge to follow lectures if I had some extra preparation * Yes No Photo and ID Check the box and upload the documents(Not more than 8 mbyte are allowed) * Photo ID Card or Passport EHIC - European Health Insurance Card - (if possessed) upload here your ID card/passport AND the photo * Trascina qui il tuo file o fai clic per caricarlo Scegli file Dimensioni massime caricamento: 9.8MB. UPLOAD LIMIT: 9.8 MB. If you are human, leave this field blank.