LLP/ERASMUS PROGRAMME

STUDENT APPLICATION FORM
photo

ERASMUS YEAR: 2013/2014

FIELD OF STUDY: GEOGRAFIA
FACULTY: LITERATURE

SENDING INSTITUTION

University:
UNIVERSIDADE FEDERAL DE VIÇOSA
Country:
BRASILE
Institutional coordinator
Name:
PROF. VLADIMIR OLIVEIRA DI IORIO
Address:
VIÇOSA - MINAS GERAIS
Telephone:
+55-31-3899-1280
Fax:
+55-31-3899- 9021
E-Mail:
vladimir@dpi.ufv.br
Departmental coordinator
Name:
PROF. EDSON SOARES FIALHO
Address:
VIÇOSA - MINAS GERAIS
Telephone:
+55-31-3899- 4053
Fax:
+55-31-3899- 9021
E-Mail:
fialho@ufv.br

STUDENT INFORMATION
Family name:
BERNARDO FERREIRA
First name:
JULIANA IRIS
Sex (M/F):
F
Date of birth:
05/03/1987
Place of birth:
VIÇOSA - MINAS GERAIS
Nationality:
BRASILEIRA
Current address:
AVENIDA DAS ARABIAS N° 785 CASA, BAIRRO: SÃO SEBASTIÃO  
Telephone
+55-31-8656 - 7355
Enrolled to the:
2° year
e-mail:
julianairisferreira@gmail.com
of the couse of study in:
GEOGRAFIA

INSTITUTION WHICH WILL RECEIVE THIS APPLICATION FORM
Institution
Country
Period of study
Duration of stay
(in months)
N° of expected ECTS Credits
From
To
UNIVERSITA' DEGLI STUDI DI ROMA TOR VERGATA
ITALY
19/08/2013
31/07/2014
12
29

ACCOMMODATION
if you need to find an accommodaion in Rome please contact the Erasmus Association "Erasmus Incampus" : info@erasmusroma.eu

ITALIAN LANGUAGE COURSE
Please indicate if you wish to attend an Italian Language Course
Yes
No
1stSemester           2nd Semester           none

Date: _______________
signature: _______________________

 

RECEIVING INSTITUTION
We hereby acknowledge receipt of the application, the proposed learning agreement and the candidate’s Transcript of records.
The above-mentioned student is
 
provisionally accepted at our institution
 
not accepted at our institution
Departmental coordinator's signature
Institutional coordinator's signature
____________________________
____________________________
Date:________________________
Date:________________________