Exchange Students - Application form

Academic year 2024-2025

You have to fill in the present application with a modern web browser (Firefox, Chrome or Internet Explorer 9). After, you validate and save the pdf file on your computer and print a copy. This copy has to be signed and sent back by post with all the necessary documents (see checklist in bottom of the pdf file) to the Institutional Coordinator.

The deadlines are May 15 for an exchange during the first semester or the full academic year and November 15 for an exchange during the second semester.

Registration in*

Name of your coordinator in Namur*

Home university
- - University name*
  - Faculty/Department*
  - Department / faculty coordinator
    
    Lastname*
    
    Firstname*
    
    Phone*
    
    Fax*
    
    Email*

Personal data
- - Lastname*
  - Firstname*
  - Birth Date*
    - Day (dd)
    - Month (mm)
    - Year (yyyy)
  - Birth Town*
  - Birth Country*
  - Nationality*
  - Sex*
    - M
    - F
  - Civil status*
    - Single
    - Married
    - Other
  - Mobile phone*
  - Email*
  - Legal address
    
    Street + nr*
    
    Zip code*
    
    City*
    
    Country*
    
    Phone
  - Residence in Belgium (to be completed at your arrival by your host Faculty)
    
    Street + nr
    
    Zip code
    
    City
    
    Country
    
    Mobile phone

Exchange data
- - Exchange period*
    - First semester
    - Second semester
    - Full academic year
  - Exchange type*
    - Study period
    - Internship period

Further information
- - Do you register to the French course?*
    - Yes
    - No
  - Do you want to book an accommodation?*
    - Yes
    - No
  - Be careful! Accommodation will be attributed according to the available places and, for considerations of practical nature, in order of arrival of your application form.

Linguistic competences
- - Mother tongue*
  - French level at least B1 on the Common European Framework of Reference for Language. You have to provide this certificate (see checklist)

Previous and current studies
- - Current level of studies*
  - Number of successful higher education study years prior your arrival in Belgium*
  - Important remark: join all your transcripts of records including those of the current year first semester exam session

Motivation
- - Motivation of your application (to be written in French)*