Application Form for Erasmus+ KA107 Incoming Students Posted on 17 Ottobre 2022 by vcarboni Application Form for Erasmus+ KA107 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 please don't use dd.mm.yyyy * date of expiredate of expire Sex * M F Undefined Nationality * Date of Birth - dd/mm/yyyy please don't use dd.mm.yyyy * Place of Birth - City * Place of Birth - Country * Mobile Number with international prefix * + International prefix/mobile number+ International prefix/mobile number International Prefix Emergency Number * Emergency NumberEmergency Number Home 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 * Erasmus + KA107 for study Erasmus + KA107 for traineeship Level * Bachelor Master phd - Doctoral Country of home University * Name of home University * Faculty/Department * ISCED code only numbers (ask to your University) * Departmental/Institutional Coordinator of home University Name Tel - e-mail * MEDICAL INSURANCE You should send a copy of the medical insurance that you have I have the European Health Card * No yes 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 Do you wish to attend an Italian language course? * Yes No Other language competences (Language + level) Documents Required Check the box and upload the documents (Not more than 8 mbyte are allowed if bigger send them to erasmuska107@unica.it) * Passport Curriculum Vitae Transcript of Records Learning Agreement Motivation Letter English/Italian Language Certificate (If possessed) upload here your required documents * Drop your file here or click to upload Maximum upload size: 8MB. Scegli file Dimensioni massime caricamento: 9.8MB. UPLOAD LIMIT: 9.8 MB. If you are human, leave this field blank.