INTRA-DEPARTMENTAL ERASMUS PROGRAMME IN ECONOMICS AND MANAGEMENT 
APPLICATION FORM
STUDENT APPLICATION FORM
  

TECHNOLOGICAL EDUCATIONAL INSTITUTΕ(T.E.I.) OF ATHENS DEPARTMENT OF PUBLIC AND INTERNATIONAL RELATIONS ADDRESS:          Agiou Spyridonos & Milou Str., no. 1                        GR 122 10 Egaleo                        Athens - GreeceTELEPHONE:      +30 210 53 85 178/7  FAX:      +30 210 53 85 176E-MAIL:              euroffic@teiath.gr,









STUDENT APPLICATION FORM

This application should be completed in BLACK in order to be easily copied and/or faxed

ACADEMIC YEAR

20 /20                                 (photograph)
FIELD OF STUDY:  …………………………………………….
HOSTING INSTITUTION: Technological Educational Institution of Athens

SEMESTER OF STUDIES ABROAD

(WINTER/SPRING)
FROM:……………………………. TO: ………………………………….
 
SENDING INSTITUTION
Name and full address …………………………………………………………………………………………
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Departmental co-ordinator – name, telephone and fax numbers, e-mail box: ………………………..
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Institutional co-ordinator – name, telephone and fax numbers, e-mail box: ………………………….
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STUDENTS PERSONAL DATA: (to be completed by the student applying)
Family name ………………………………………………………………………………………………………
First name(s) …………………………………………………………………………… M/F …………….
Date and place of birth ……………………………………………………………………………………………
Current address: ………………………………………. Permanent address (if different): ……………
……………………………………….…………………… ……………………………………….………………
……………………………………….…………………… ……………………………………….………………
Current address is valid until: ……………………………………….…………………………………………...
Tel + …………………………………………………... Mobile: +…………………………………………..
E-mail: ……………………………………….……………………………………….…………………………
Briefly state the reasons why you wish to study abroad? ………………………………………………….
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LANGUAGE COMPETENCE

Mother tongue:   Language of instruction at home institution (if different)  
Other languages I am currently studying this language I have sufficient knowledge to follow this lectures I would have sufficient knowledge to follow lectures if I had some extra preparation
……………….. YES NO YES NO YES NO
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WORK EXPERIENCE RELATED TO CURRENT STUDY (if relevant)
Type of work experience Firm/organisation Dates Country
       
       
 

PREVIOUS AND CURRENT STUDY

Diploma/degree for which you are currently studying:  
Number of higher education study years prior to departure abroad:  

Have you already been studying abroad?

Yes  ¨      No   ¨
If Yes.  when?  At which Institution?  
 

RECEIVING INSTITUTION

We hereby acknowledge receipt of the application, the proposed learning agreement
The above-mentioned student is              ¨ accepted at our Institution
                                                                 ¨  not accepted at our institution
notes/remarks pertaining to learning agreement:           
Departmental co-ordinator’s signature:   Institutional co-ordinator’s signature:  
Departmental co-ordinator’s name:   Institutional co-ordinator’s name: Dr.Georgios Panagiaris
Date:   Date: