APPLICATION FORM FOR EXCHANGE STUDENTS 2015-2016



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APPLICATION FORM FOR EXCHANGE STUDENTS 2015-2016 Please, read carefully the application procedures and fill all the required fields. (Please use capital letters if handwriting to avoid any misunderstanding) 1. HOME INSTITUTION: Home University Name:... Country:.. Department/Faculty: Exchange coordinator: Name: E-mail: Telephone: Fax:.. Address: 2. PERSONAL DATA: Family name: Name: Date of birth: Place of birth: Nationality: ID number / Passport number: Gender: Male Female E-mail: Telephone (country code + phone number): Address: 1

3. ACADEMIC DATA Language Skills Native language: Other languages: Spanish level: Excellent Good Sufficient None Date and grade of the last Spanish test you have taken: Study details Diploma or degree for which you are currently studying: Department: How long have you been studying at the university level? Study program at the Civil Engineering School of Barcelona (ETSECCPB) Undergraduate studies Postgraduate studies Degree in Civil Engineering 4 years Degree in Construction Engineering 4 years Degree in Geological Engineering 4 years Master in Civil Engineering (Màster en Eng. Civil) Master in Civil Engineering (Màster en Eng. Camins, Canals i Ports) Master in Environmental Engineering (Màster en Eng. Ambiental) Master in Structural and Construction Engineering (Màster en Eng. Estructural I de la Construcció) Master in Geological and Mining Engineering (Màster en Eng. Geològica i de Mines) Other: Type of program at the Civil Engineering School of Barcelona Courses Research work Double diploma How long are you planning to study at the Civil Engineering School of Barcelona? First semester (September to January) Second semester (January to June) Whole year (September to June) Expected dates of your stay: Starting date (day/month/year): Ending date (day/month/year): 2

4. IMPORTANT Applications must arrive to the Civil Engineering School of Barcelona: - Before 22 nd May 2015 for stages starting on September or annual stages - Before 30 th October 2015 for stages starting on January Remember the Civil Engineering School of Barcelona registration policies: - You cannot mix subjects from different curricula. - You must take from 20 to 30 ECTS credits per semester (from 40 to 60 ECTS credits for whole year exchanges). - You cannot take courses from the 1 st year program. Please, attach to the application the following documents: - Transcript of Records - Motivation Letter - Curriculum Vitae Students have to send the application form, along with the rest of required documents listed below, by e- mail (mobilitystudents.camins@upc.edu) and present the original documents when he/she comes to do the registration. 3

LEARNING AGREEMENT If you are thinking about doing courses (Fill the following document in the next page) If you are thinking about doing a research project Name of the professor who will supervise your research at the Civil Engineering School of Barcelona: Department: Name of the professor who will supervise your research at Home University: E-mail: I herewith declare that all statements given in this form are correct and complete. I apply for acceptance Date and signature: Student s name: HOME INSTITUTION S APPROVAL Name of responsible coordinator: Position: RECEIVING INSTITUTION S APPROVAL M. Rosa Estela Carbonell Vice-Dean of Innovation and Mobility ------------------------------- Date, Signature & Stamp ------------------------------- Date, Signature & Stamp 4

ACADEMIC YEAR: 2015/2016 ERASMUS+ PROGRAM / ECTS LEARNING AGREEMENT Name of student:. Student s e-mail address: Sending Institution: DETAILS OF THE PROPOSED STUDY PROGRAMME ABROAD/LEARNING AGREEMENT Receiving institution:... Country: Course unit code (as indicated in the course catalogue) Course unit title (as indicated in the course catalogue) Semester (autumn/spring) Number of ECTS credits........................................................................ Student s signature: SENDING INSTITUTION Date:. RECEIVING INSTITUTION Date:. Date: Date: Date: 5

CHANGES TO ORIGINAL LEARNING AGREEMENT (to be filled in ONLY if appropriate) Name of student: Sending Institution: Course unit code (as indicated in the course catalogue) Course unit title (as indicated in the course catalogue) Deleted course unit Added course unit Number of ECTS credits If necessary, continue this list on a separate sheet Student s signature Date: SENDING INSTITUTION Date:. RECEIVING INSTITUTION Date:. Date: Date: 6