Erasmus+ Student Application form Academic year 2021-20222022-2023 Type of mobility ---StudyTraineeship Study period ---First semesterSecond semesterAcademic year In case of a traineeship mobility Start date of the traineeship End date of the traineeship Personal data First name * Last name * Gender * Nationality* Date of Birth* Email* Phone* Current address* Permanent address (if different) ID card number* National ID number* Contact person in case of emergency Name(s) of the contact person Kind of relation Email Phone Academic data Sending university* Erasmus + code* Study cycle ---BachelorMasterPhD student Study programme* Number of completed semesters* Email of the contact person* Phone of the contact person* Reasons you wish to study at Agricultural University - Plovdiv* Linguistic preparation English language level A1A2B1B2C1C2 Second language A1A2B1B2C1C2 Accommodation Do you apply for the dormitory YesNo Planned date of arrival Planned date of departure Inclusion Are you an applicant with disadvantaged background or fewer opportunities NoYes If yes, select the reason ---Cultural differencesDisabilityEconomic obstaclesEducational difficultiesGeographical obstaclesHealth problemsRefugeesSocial obstacles Uploads (jpeg or pdf up to 3 MB) ID card front ID card back side Photo Health insurance card Transcript of records Learning agreement for traineeship
