PANTEION UNIVERSITY OF SOCIAL AND POLITICAL SCIENCES Department of International Relations and LLP/ERASMUS APPLICATION FORM ACADEMIC YEAR …………………. To be completed and sent to Panteion by all incoming students no later than 15 th June for the winter semester no later than 15th November for the spring semester

I am registering for: the first semester: from __ /__ /___ until __ /__ / ___ Months ……………

(tick as appropriate) the second semester: from __ /__ /__ until __ /__ / ___ Months ………….. the whole year: from __ /__ /__ until __ /__ / ___ Months …………..

PANTEION Department of Registration: ______

Academic Coordinator: ______

1. PERSONAL DATA Surname(s):______First name(s):______Date of Birth: __ /__ /____ Sex: Female Male Nationality: ______Home address: (please note that this is the address we will use to contact you before your departure) ______Postal Code: ______City: ______Country:______Telephone:______Mobile:______Fax:______E-mail:______Study level: Undergraduate Postgraduate Doctoral

2. ACADEMIC INFORMATION Sending Institution: ______Institutional Erasmus Code:______City:______Name of current study programme: ______Institutional Socrates/Erasmus Coordinator Name: ______Address: ______Tel.: ______Fax: ______E-mail: ______

Signature : ______Departmental Coordinator Name: ______Address: ______

Department of International Relations and European Union 136, Syngrou Av. - 176 71 – - tel: +30-210-9201483/4, fax: +30-210-9215767 e-mail: [email protected] Tel.: ______Fax: ______E-mail: ______Signature : ______

Department of International Relations and European Union 136, Syngrou Av. - Athens 176 71 – GREECE - tel: +30-210-9201483/4, fax: +30-210-9215767 e-mail: [email protected] 3. Intention of Attending : Yes No (tick as appropriate)

4. STATEMENT I hereby declare that the information I have submitted is true

Signature of the applicant: ______

Place and date: ______

For your own convenience, make a copy of this form for yourself!

Please return your application at : Panteion University, Department of International Relations and European Union , 136, Syngrou Avenue, 176 71, Athens, GREECE Fax: +30-210-9215767

Department of International Relations and European Union 136, Syngrou Av. - Athens 176 71 – GREECE - tel: +30-210-9201483/4, fax: +30-210-9215767 e-mail: [email protected]