INCOMING EXCHANGE STUDENT APPLICATION FORM

RECEIVING INSTITUTION: Saimaa University of Applied Sciences
Faculty:   
Program:  

I apply for the following period of study:  
 autumn semester 20 (from end of August/beginning of September till end of December)
 spring semester 20 (from beginning of January till mid/end of May)
 academic year 20 - 20

Please specify the dates if you are applying for a shorter period than a full semester or academic year (dd.mm.yyyy) 
. 20 to . 20

Exchange programme 
Other, please specify  

SENDING INSTITUTION
Name of the home institution:
Institutional / Departmental
co-ordinator – name, address, telephone
and telefax numbers, e-mail:
 

STUDENT'S PERSONAL DATA (Please write your name as it is in the passport)
Family name:
First name(s):
Date of birth (dd.mm.yyyy):   
Passport nr:
Sex:
Nationality:  
Country:  
Place of birth:  
Current address:
 
Permanent address (if different):
Current address is valid until:
Mobile:
Tel:
Email:  

CONTACT IN CASE OF EMERGENCY
Full name:
Relationship:
Address:
 
Tel:
Fax:

EDUCATIONAL BACKGROUND
Degree programme/major subject/specialization at the home institution:
Beginning of studies at the home
institution (month / year):
Expected month and year of graduation:
Name of the degree:

LANGUAGE COMPETENCE
Mother tongue:
Language of instruction at your
home institution (if different):
Your level of English:



ATTACHMENTS 
Name:
Type:  
Attachment:  



Additional information you want us to know:
Date and place: