Return This Form Thoroughly Filled-In Before the Deadline To

LLP / Erasmus UACEG Code: BG SOFIA04 Incoming Student Application Form www.uacg.bg

University of Architecture, Civil Engineering and Geodesy, Sofia, Bulgaria

Academic Year: 2010 / 2011

DEGREE PROGRAMME TO BE (name from the UACEG site –ECTS- PURSUED AT UACEG, SOFIA respective faculty) ………………………………….

 Autumn Semester Period of study 23 Sept 2010 – 05 Feb 2011 from: ...... Application deadline: 01 July Photograph to: ......  Spring Semester 15 Feb 2010 – 02 July 2011 Duration of stay Application deadline: 31 Dec in months: ......

Sending Institution (Name, Erasmus code, Faculty/Department) ......

Departmental name: ......  ...... coordinator e– ...... fax ...... Signature: ......

Student’s Data Information Family name: ...... Sex: M  F  First name: ...... Citizenship: ...... Date of birth: ...... Place of birth: ...... Current address: Permanent address: street: ...... street: ...... zip/postal code: ...... zip/postal code: ...... city, country: ...... city, country: ......  ...... fax ......  ...... fax ...... e– ...... e– ...... Name of degree programme I am currently Level of Programme: .. (Master , Bachelor) studying : …………………………………… Duration of study: …… years Current year of study: ……. Motivation Why do you wish to study at UACEG? ......

Language Knowledge Mother tongue: ...... reading understanding speaking enough to need more (poor/average/good) (poor/average/good) (poor/average/good) follow lectures study Bulgarian  Yes / No   Yes / No  English  Yes / No   Yes / No  French  Yes / No   Yes / No  German  Yes / No   Yes / No   Yes / No   Yes / No 

Application

I wish to attend the courses mentioned in the enclosed LEARNING AGREEMENT (duly signed and stamped).

Accommodation in student dormitory: Yes  No 

I enclose my Academic Transcript with full details about subjects studied so far

Date: Signature of student: ……………….

RETURN THIS FORM THOROUGHLY FILLED-IN BEFORE THE DEADLINE TO: University of Architecture, Civil Engineering and Geodesy 1 H. Smirnenski Blvd. Centre of International Relations and Mobility 1046 Sofia, Bulgaria Rector’s Office Building, room 206

tel. +359 2 866 6770 fax: +359 2 9631796 email: [email protected]