Sou a: ETSETB /

Application Form

Application Form for Exchange Students

IMPORTANT:

  All applications must be approved by the academic responsible of your University.
  Please attach to the application the academic certificate of your exams.

  Applications for Final Project are collected all year long.
  All other applications must arrive to ETSETB:
  - Before 1st June for stages starting on September
  - Before 1st December for stages starting on February

  Documents to be delivered once you arrive at ETSETB:
  - Socrates certificate signed by your University
  - Medical Insurance (E-128, E-111 or others)
  - 2 Photos



Home institution


   Country of University:
    
   Name of University:
    
   Department/Faculty:
    
   Erasmus (Socrates) / Exchange coordinator.
   Name:
    
   E-mail:
    
   Telephone:
     		   Fax:
    
   Address:
    
Personal data

   Family Name:
    
   Name:
    
   Date of birth (day/month/year):
    
   Country of citizenship:
    
   ID number / Passport number:
    
   Sex:
      Male     Female
   E-mail:
    
   Telephone (country code + phone number):
    
   Address:
     
 



   Native language:
    
   Other languages:
    
   Spanish level:
     Excellent    Good   Sufficient      None
   Diploma and degree for which you are currently studying:
    
   How long have you been studying at the university level?:
    
   Have you been studying abroad?:      yes    no
   Where?:
    
   With an Socrates Erasmus grant?:
     yes    no 
   Studies financed by:
     Parents    Myself    Scholarship
Study program at ETSETB


   Major:
     Telecommunications engineering  
     Electronic engineering
   Form of program planned:
     Project    Double Diploma  
     Courses    Courses & Project
   How long are you planning to study in the ETSETB?:      1 semester     2 semesters  
     3 semesters    4 semesters
   Starting semester of your stay:
     Fall semester     Spring semester 

   Expected dates of your stay:
     Starting date (day/month/year):
    Ending date (day/month/year):  




If you are thinking about doing courses
Code
Name
ECTS Credits



If you are thinking about doing the project

   Which is the field you are interested in?:
   
   Have you contacted a professor at the ETSETB? Who?:
   



   Other remarks:
    
Signature of applicant


I herewith declare that all statements given in this form are correct and complete.

I apply for acceptance.

Date & Applicant's Signature
 



Approval of home institution

   Name of responsible coordinator
     (if different from erasmus/exchange coordinator): 
    
   Date (day/month/year):
    

Home Institution Signature
 




Please, print a copy of the application form, get it signed by your university and send it via ordinary post to:

Relacions Internacionals ETSETB
Universitat Politècnica de Catalunya
Campus Nord UPC, Edifici B3
c/Jordi Girona 1-3
08034 Barcelona SPAIN

Remember that this application form will only be taken into account when the printed copy is received by the UPC.

© UPC. Telecom BCN - ETSETB Última actualització: divendres 9 de maig de 2008 a les 12:44:08
Escola Tècnica Superior d'Enginyeria de Telecomunicació de Barcelona