| Given/first
name* |
|
| Family
name* |
|
| Date
of birth* | Day
Month
Year
|
| Four
last numbers/P-number (if you have studied at LiU before) |
|
|
Gender | |
|
Citizenship* | |
Current address |
| Valid
from (date) |
|
| Valid
to (date) |
|
| C/O
(name on the door if it is different from your own name) |
|
|
Street and number* |
|
| Postal
code* |
|
| City* |
|
| Country* |
|
|
Email* |
|
| Telephone
number (incl country code)* |
|
| Mobile/cell
phone |
|
Permanent
address |
| Valid
from (date) |
|
| C/O
(name on the door if it is different from your own name) |
|
| Street
and number* |
|
| Postal
code* |
|
| City* |
|
| Country* |
|
|
Email |
|
| Telephone
number (incl country code)* |
|
| Mobile/cell
phone |
|
Academic
Data |
|
Exchange Programme* | |
|
Sending university | |
If your university is not in the list please write the name here (incl telephone,
fax, and e-mail) |
|
Coordinator/Contact person at sending university (incl telephone, fax, and
e-mail) *Compulsory |
|
|
Present university studies |
|
| Current
year of study | |
|
Previous university studies: Bachelor |
Years |
|
Previous university studies: Master |
Years |
| | |
| Spring
semester (VT) 1st
period (Please note that some of these courses run during the whole semester)
2nd period
Part time courses
(if you want to choose more than 1 part-time course, use the Comments section)
Swedish
language course (evening course) Exchange
students also have the possibility to select courses from the Faculty of Arts
and Sciences. Write the full name of the course and its code and credits value
in the following box.
|
COMMENTS:
If you wish
to study more than one Part-time course or a course taught in Swedish, write the
course name here. If you have any other comment, you are also welcome to write
it here.
|
Please note that you
have to book accommodation in Norrköping separately, directly to the housing
company
Studentbo. More information and application forms can be found at
www.studentbo.se