ECTS - EUROPEAN CREDIT TRANSFER SYSTEM

STUDENT APPLICATION FORM 		                 	Photo
											          
ACADEMIC YEAR 200../200..
FIELD OF STUDY: .........................................................

This application should be completed in BLACK in order to be easily copied and/or telefaxed.

SENDING INSTITUTION
Name and full address: ......................................................................................................................................
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Department coordinator - name, telephone and telefax numbers, e-mail box ..................................................
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Institutional coordinator - name, telephone and telefax numbers, e-mail box ..................................................
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STUDENT’S PERSONAL DATA
(to be completed by the student applying)

Family name: .......................................................
Date of birth: .......................................................
Sex: ...............Nationality:...................................
Place of Birth: .....................................................
Current address: ..................................................
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Current address is valid until: .............................
Tel.: .....................................................................
	First name (s): .................................................................

e-mail:

Permanent address (if different): ....................................
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Tel.: ..................................................................................	
LIST OF INSTITUTIONS WHICH WILL RECEIVE THIS APPLICATION FORM (in order of preference):

Institution
	Country	Period of study
from          to	Duration of stay (months)	N° of expected ECTS credits	
1. ........................................
2. ........................................
3. ........................................	.....................
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Name of student: ...............................................................................................................................................

Sending institution:................................................................ Country: ......................................................

Briefly state the reasons why you wish to study abroad ?
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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. Details not known at the time of application will provided be at a later stage.	

ACCOMMODATION

Do you wish accommodation at Vilnius University student dormitory:	
 Yes 	I enclose the housing request form. Vilnius University is able to guarantee housing if the application is received at least 2 months before your date of arrival in Vilnius. Housing request form is available on the website http://www.vu.lt/site_files/TPRS/english/housing_request.doc 	
 No 	I have already taken care of my own accommodation. 	

RECEIVING INSTITUTION	
We hereby acknowledge receipt of the application, the proposed learning agreement and the candidate’s Transcript of records.	
The above-mentioned student is                       

Departmental coordinator’s signature

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Date: ....................................................................	provisionally accepted at our institution
not accepted at our institution
Institutional coordinator’s signature

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Date :................................................................................