Incoming mobility

Nominated participant

Last name *

First name *

Date of birth *

E-mail *

Home University *

Please specify *

Exchange programme *

Selection Document

Attach declaration of the sending institution *

Template provided below

STUDENT_Declaration of sending institution

Attach any formal documents related to the call.

(call, web screen shots, minutes of selection, …)

Does the nominee belong to one of the following categories of participants with disadvantaged backgrounds/fewer opportunities?

Cultural differences, Disability, Economic obstacles, Educational difficulties, Geographical obstacles, Health problems, Refugees, Social obstacles, Barriers linked to discrimination

Yes
No

Please choose the category applying *

Please specify *

Student level *

Mobility type *

Academic field *

Department/Faculty/Centre *

Please specify *

Department/Faculty/Centre *

Please specify *

Department/Faculty/Centre *

Please specify *

Exchange period *

Fall term (Sept - Feb)
Spring term (Feb - July)
Full year (Sept - July)
Other period

If you are nominating a student for research purposes please select other period and specify the exact mobility period.

Please specify *

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