School of Social and Behavioral Sciences
Name ANR
_ _ _ _ _ _
Address
Postal code
_ _ _ _
_ _
City
Country
S TUDY ABROAD - CONVERSION FORM
Submit this application at
Education and Research Institute,
TSB
Prisma building
Room P1.204, zone O
Phone number:
_ _ _ _ _ _ _ _ _ _
Date:
_ _ - _ _ - 20 _ _
Study program:
Starting year:
Level of study while abroad:
Bachelor
Master
Partner University:
Request to convert my grades and credits obtained at the Partner University
Filled in by student
* Minor course, elective, extra course
(on top), substitute mandatory
course, substitute compulsory
elective course
Include transcript of records and
the course replacement - and/
or course approval form
Name Course & Code:
To be filled in by Examination
Board of TSB
Approved as*:
Dutch
Grade
ECTS Course obtained at
date
1.
__-__-
20
__
__-__-
20
__
__-__-
20
__
__-__-
20
__
2
3
4
In accordance with Article 7.59a of
the Higher Education and Scientific
Research Act, you have the right to
appeal against this decision to the
Examination Appeals Board (CBE)
within six weeks of the date of this
letter. For more information about the
procedure, please go to
http://www.tilburguniversity.edu/
students/study/complaint-appeal/
eab/.
To be filled in by the Examination Board of TSB
Notes:
Signature:
On behalf of the Examination Board of TSB
Date: _ _ - _ _ - 20 _ _
P.O.Box 90153 • 5000 LE Tilburg • Visiting address > Warandelaan 2 • Tilburg • Phone +31 13 466 20 88 • www.tilburguniversity.edu