Incoming KA107 (international credit mobility) student application form – mobility for studies According to data protection and security, the Centre for International Relations will treat the data of the student as being confidential. The data will be available for the Tempus Public Foundation only for the interim and final reporting required by the Public Foundation. Personal information Family name: * First name: * Mother’s family name: * Mother’s first name: * EHA code: Student identification number (OM code) consists of 11 characters Passport number: * Birth information Place of birth: city, country: * Date of birth: * Year Year197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Gender: * Female Male Nationality: * - Select -AfghanistanAland IslandsAlbaniaAlgeriaUnited States Minor Outlying IslandsAmerican SamoaU.S. Virgin IslandsAndorraAngolaBritish Virgin IslandsAnguillaAntarcticaAntigua and BarbudaVaticanArgentinaArubaAustriaAustraliaAzerbaijanBahamasBahrainBangladeshBarbadosBelgiumBelizeBeninBermudaBhutanGuinea-BissauBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiChileCyprusComorosCook IslandsCosta RicaCzech RepublicChadCuracaoDominicaDominican RepublicDjiboutiDenmarkSouth AfricaSouth Georgia and the South Sandwich IslandsEcuadorEquatorial GuineaUnited Arab EmiratesUnited KingdomUnited StatesEgyptIvory CoastEritreaEthiopiaFalkland IslandsBelarusFaroe IslandsFijiFinlandFrench Southern TerritoriesFrench GuianaFranceFrench PolynesiaPhilippinesGabonGambiaGhanaGibraltarGrenadaGreenlandGeorgiaGuadeloupeGuamGuatemalaGuernseyGuineaGuyanaGreeceHaitiHeard Island and McDonald IslandsNetherlands AntillesNetherlandsHondurasHong KongCroatiaIndiaIndonesiaIraqIranIcelandIsraelJamaicaJapanYemenJerseyJordanCayman IslandsCambodiaCameroonCanadaChristmas IslandQatarKazakhstanEast TimorKenyaKiribatiColombiaDemocratic Republic of the CongoRepublic of the CongoSouth KoreaNorth KoreaCubaKuwaitChinaKyrgyzstanCocos IslandsCentral African RepublicLaosPolandLesothoLatviaLebanonLiberiaLiechtensteinLithuaniaLuxembourgLibyaMacedoniaMadagascarHungaryMacaoMalaysiaMalawiMaldivesMaliIsle of ManMoroccoMarshall IslandsMartiniqueMauritiusMauritaniaMayotteMexicoMyanmarMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMozambiqueMaltaNamibiaNauruNepalNicaraguaNigerNigeriaNiueNorfolk IslandNorwayWestern SaharaGermanyItalyOmanRussiaPakistanPalauPalestinePanamaParaguayPeruPitcairnPortugalPuerto RicoPapua New GuineaRomaniaRwandaReunionSaint BarthelemySaint MartinSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSolomon IslandsEl SalvadorSan MarinoSao Tome and PrincipeSeychellesSierra LeoneSpainSri LankaSurinameSvalbard and Jan MayenSwitzerlandSwedenSamoaSaudi ArabiaSenegalSaint HelenaSerbiaSingaporeSlovakiaSloveniaSomaliaSudanSwazilandSyriaTajikistanTaiwanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurks and Caicos IslandsTuvaluTurkeyTurkmenistanUgandaUkraineUruguayVanuatuVenezuelaVietnamWallis and FutunaZambiaZimbabweCape VerdeNorthern Mariana IslandsEstoniaIrelandArmeniaNew CaledoniaNew ZealandUzbekistan Permanent address Postal code, city, street, number: * Contact Mobile phone: * E-mail address: * Please give us an e-mail address that you will use during your mobility period! We cannot accept freemail, citromail, vipmail and indamail Bank information Bank account where the financial support should be paid: * Bank account holder (if different than student): Bank name: * Clearing/BIC/SWIFT number: * With capital letters Account/IBAN number: Acceptable form: HUxx xxxxxxxx-xxxxxxxx-xxxxxxxx Studies Level of studies: * BA/BSc MA/MSc PhD/DLA Short-cycle One-cycle Subject / ISCED code: * - Select - 0011 Basic programmes and qualifications 0021 Literacy and numeracy 0031 Personal skills and development 0111 Education science 0112 Training for pre-school teachers 0113 Teacher training without subject specialization 0114 Teacher training with subject specialization 0211 Audio-visual techniques and media production 0212 Fashion, interior and industrial design 0213 Fine arts 0214 Handicrafts 0215 Music and performing arts 0221 Religion and theology 0222 History and archaeology 0223 Philosophy and ethics 0231 Language acquisition 0232 Literature and linguistics 0311 Economics 0312 Political sciences and civics 0313 Psychology 0314 Sociology and cultural studies 0321 Journalism and reporting 0322 Library, information and archival studies 0411 Accounting and taxation 0412 Finance, banking and insurance 0413 Management and administration 0414 Marketing and advertising 0415 Secretarial and office work 0416 Wholesale and retail sales 0417 Work skills 0421 Law 0511 Biology 0512 Biochemistry 0521 Environmental sciences 0522 Natural environments and wildlife 0531 Chemistry 0532 Earth sciences 0533 Physics 0541 Mathematics 0542 Statistics 0611 Computer use 0612 Database and network design and administration 0613 Software and applications development and analysis 0711 Chemical engineering and processes 0712 Environmental protection technology 0713 Electricity and energy 0714 Electronics and automation 0715 Mechanics and metal trades 0716 Motor vehicles, ships and aircraft 0721 Food processing 0722 Materials (glass, paper, plastic and wood) 0723 Textiles (clothes, footwear and leather) 0724 Mining and extraction 0731 Architecture and town planning 0732 Building and civil engineering 0811 Crop and livestock production 0812 Horticulture 0821 Forestry 0831 Fisheries 0841 Veterinary 0911 Dental studies 0912 Medicine 0913 Nursing and midwifery 0914 Medical diagnostic and treatment technology 0915 Therapy and rehabilitation 0916 Pharmacy 0917 Traditional and complementary medicine and therapy 0921 Care of the elderly and of disabled adults 0922 Child care and youth services 0923 Social work and counselling 1011 Domestic services 1012 Hair and beauty services 1013 Hotel, restaurants and catering 1014 Sports 1015 Travel, tourism and leisure 1021 Community sanitation 1022 Occupational health and safety 1031 Military and defence 1032 Protection of persons and property 1041 Transport services Faculty: * - Select -Faculty of LawMedical SchoolFaculty of HumanitiesFaculty of Health SciencesFaculty of Cultural Sciences, Education and Regional Development in PécsFaculty of Cultural Sciences, Education and Regional Development in SzekszárdFaculty of Business and EconomicsFaculty of Music and Visual ArtFaculty of Engineering and Information TechnologyFaculty of Sciences Language of studies: * - Select -EnglishGermanFrenchItalianSpainHungarianOther Beginning of mobility (year/month): * - Select -17/0617/0717/0917/1017/1117/1218/0118/0218/0318/0418/0518/0618/0718/0818/09 Duration of the mobility (months): * 3 3,5 4 4,5 5 5,5 6 8 Accommodation request Place in a 2 person bedroom in the Student Hostel: * Yes No Sending institution data: Sending Country: * - Select -AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong S.A.R., ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe Institution * Year of study: * - Select -12345 Have you ever participated in an Erasmus program before? * - Select -NoYes In which country/institution? - None -AfganisztánAland-szigetekAlbániaAlgériaAmerikai Egyesült Államok Külső SzigeteiAmerikai SzamoaAmerikai Szűz-szigetekAndorraAngolaAngol Szűz-szigetekAnguillaAntarktiszAntigua és BarbudaApostoli Szentszék (Vatikán)ArgentínaArubaAusztriaAusztráliaAzerbajdzsánBahamákBahreinBangladesBarbadosBelgiumBelizeBeninBermudaBhutánBissau-GuineaBolíviaBosznia-HercegovinaBotswanaBouvet-szigetBrazíliaBrit Indiai-óceáni TerületBruneiBulgáriaBurkina FasoBurundiChileCiprusComore-szigetekCook-szigetekCosta RicaCsehországCsádCuraçaoDominikaDominikai KöztársaságDzsibutiDániaDél-AfrikaDél-Georgia és Déli Sandwich-szigetekEcuadorEgyenlítői-GuineaEgyesült Arab EmírségekEgyesült KirályságEgyesült ÁllamokEgyiptomElefántcsontpartEritreaEtiópiaFalkland-szigetekFehéroroszországFeröer-szigetekFidzsiFinnországFrancia Déli TerületekFrancia GuyanaFranciaországFrancia PolinéziaFülöp-szigetekGabonGambiaGhánaGibraltárGrenadaGrönlandGrúziaGuadeloupeGuamGuatemalaGuernseyGuineaGuyanaGörögországHaitiHeard-sziget és McDonald-szigetekHolland AntillákHollandiaHondurasHong Kong SAR (Kínai Népköztársaság)HorvátországIndiaIndonéziaIrakIránIzlandIzraelJamaicaJapánJemenJerseyJordániaKajmán-szigetekKambodzsaKamerunKanadaKarácsony-szigetKatarKazahsztánKelet-TimorKenyaKiribatiKolumbiaKongói Demokratikus KöztársaságKongói KöztársaságKoreai KöztársaságKoreai Népi Demokratikus KöztársaságKubaKuvaitKínaKírgizisztánKókusz (Keeling)-szigetekKözép-Afrikai KöztársaságLaoszLengyelországLesothoLettországLibanonLibériaLiechtensteinLitvániaLuxemburgLíbiaMacedóniaMadagaszkárMagyarországMakaóMalajziaMalawiMaldív-szigetekMaliMan szigetMarokkóMarshall-szigetekMartiniqueMauritiusMauritániaMayotteMexikóMianmarMikronéziaMoldovaMonacoMongóliaMontenegróMontserratMozambikMáltaNamíbiaNauriNepálNicaraguaNigerNigériaNiueNorfolk-szigetNorvégiaNyugat-SzaharaNémetországOlaszországOmánOroszországPakisztánPalauPalesztín területekPanamaParaguayPeruPitcairnPortugáliaPuerto RicoPápua Új-GuineaRomániaRuandaRéunionSaint-BarthélemySaint-Martin (francia terület)Saint Kitt és NevisSaint LuciaSaint Pierre és MiquelonSaint Vincent és Granadin-szigetekSalamon-szigetekSalvadorSan MarinoSao Tomé és PríncipeSeychelle-szigetekSierra LeoneSpanyolországSrí LankaSurinameSvalbard és Jan MayenSvájcSvédországSzamoaSzaud-ArábiaSzenegálSzent IlonaSzerbiaSzingapurSzlovákiaSzlovéniaSzomáliaSzudánSzváziföldSzíriaTadzsikisztánTajvanTanzániaThaiföldTogoTokelauTongaTrinidad és TobagoTunéziaTurks és Caicos-szigetekTuvaluTörökországTürkmenisztánUgandaUkrajnaUruguayVanuatuVenezuelaVietnámWallis és FutunaZambiaZimbabweZöld-foki KöztársaságÉszaki-Mariana-szigetekÉsztországÍrországÖrményországÚj-KaledóniaÚj-ZélandÜzbegisztán How long (months)? 0.511.522.533.544.555.566.577.588.599.51010.51111.512 hónap ................................................ signature Please print the pdf document you get by e-mail. Sign it with a blue pen and send it to the address you can find at the bottom of the page. * With my signiture, I certify that I will participate in the Erasmus mobility program for the first time: ................................................ signature