EPLUS_UNISTRASI

Intensive Language Courses for 2024/25 ERASMUS+ students in Italy

APPLICATION FORM

For any need concerning the online EPLUS_UNISTRASI application form, please contact eplus@unistrasi.it

STUDENT'S PERSONAL DATA

Family name (*)

First name(*)

Gender (*)

Date of Birth (*) / / (day/month/year)

City of Birth (*)

Country of Birth (*)

Nationality (*)

Personal e-mail address (*)

Additional e-mail address

Due to the fact that all the communications concerning EPLUS_UNISTRASI courses will be given by email, we take no responsability for incorrect email addresses.
Please be sure to type in correctly your email address.

STUDENT'S HOME UNIVERSITY

Name (*)

Faculty/Department

Erasmus contact person Name (*)

Email 1 (*)

Email 2

Email 3

Telephone

Fax

Type of Erasmus+ (*) Study Traineeship

ERASMUS+ HOST UNIVERSITY (in case of study)

Country Italia

Name (*)

Faculty/Department

Erasmus+ contact person Name (*)

Email (*)

Telephone

Fax

ERASMUS+ HOST ORGANISATION (in case of traineeship)

Name (*)

Contact person Name (*)

City

Email (*)

Telephone

Fax

ERASMUS+ STUDY/TRAINEESHIP PERIOD

Number of months of Erasmus+ period (*) (number)

Starting date of Erasmus+ Period (*) // (day/month/year)

Main subject of studies (*)

LANGUAGE COMPETENCE IN ITALIAN

Level of competence (*)

Requested EPLUS courses

Periods (*) 3-28 February 2025 (80 hours - 8 ECTS - 290€)
3-14 February 2025 (40 hours - 4 ECTS - 150€)

IMPORTANT - Application must be sent by one month before the course starting date

I confirm that the information provided in this application is true and accurate. In case I have to withdraw from the course, I will inform Università per Stranieri di Siena as soon as possible.

Please be sure that you have your Erasmus+ student nomination letter ready to be attached just after submitting the application form.

(*) -> Compulsory field

Family name *()**
First name(*)
Gender *()**
Date of Birth *()**	/ / (day/month/year)
City of Birth *()**
Country of Birth *()**
Nationality *()**
Personal e-mail address *()**
Additional e-mail address

Name *()**
Faculty/Department
Erasmus contact person	Name *()**
	Email 1 *()**
	Email 2
	Email 3
	Telephone
	Fax

Country	Italia
Name *()**
Faculty/Department
Erasmus+ contact person	Name *()**
	Email *()**
	Telephone
	Fax

Name *()**
Contact person	Name *()**
	City
	Email *()**
	Telephone
	Fax

Number of months of Erasmus+ period *()**	(number)
Starting date of Erasmus+ Period *()**	// (day/month/year)
Main subject of studies *()**