Application form (Incoming ERASMUS+ students 16-17)
Proposed Erasmus Study Period
Subject Area of Study:
Level of study (e.g. undergraduate, postgraduate):
Start date of Erasmus study period:
End date of Erasmus study period:
Sending Institution
Full name of your home university/institution:
Erasmus code:
Erasmus Institutional Coordinator name:
Tel:
Fax:
Email:
Fax:
Email:
Erasmus Academic Coordinator name:
Tel:
Student’s Personal Data (to be completed by the student applying)
Contact Details
Correspondence Term-time Address:
Family name/surname:
First name:
Date of birth:
Sex:
Country of birth:
Nationality:
Permanent Address (if different)
Country of permanent residence:
Applicants not born in the European Union, please state date of first
entry in to the EU/UK:
(Please use date format DD/MM/YY)
Tel:
Do you need a visa to study in the UK?
Mobile phone:
Yes
Email:
No
If yes, please provide:
Disabilities and special needs (See Notes for Guidance)
Passport number:
Please enter appropriate letter here:
Issue date:
Description:
Expiry date:
Briefly state the reasons why you wish to study abroad:
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English Language Competence
What is your first language:
Other languages spoken:
Please give details of English language courses taken/to be taken (e.g. IELTS, TOEFL)
Qualification:
Date taken and location:
Overall score:
Written score:
PLEASE ATTACH TO YOUR APPLICATION FORM COPIES OF CERTIFICATES AND TRANSCRIPTS AWARDED.
Work Experience related to current study (if relevant)
Type of work experience
Organisation
Dates
Country
Current Study
What is the title of the diploma/degree you are currently studying:
Is your diploma/degree undergraduate, postgraduate or doctorate level?
What year of study are you in your current degree/diploma? eg 2nd, 3rd:
Total number of higher education study years to date (including any previous higher education):
Have you already spent time abroad studying?
If YES, when and at which institution?
DECLARATION
Student: I confirm that the information I have given in this form is true, complete and accurate and no information or other
material information has been omitted. I consent to the processing of my data by the university.
Student’s signature: ……………………………………………..……………….Date:
As an exchange student studying at the University of Brighton you are able to become a member of the University of Brighton
Alumni Association when you leave. If you would like to opt in to this, please place a cross here.
Sending Institution:
Erasmus Code:
We hereby confirm that this student is enrolled at this institution and is eligible for the Erasmus exchange programme. This
institution supports the application.
Academic Coordinator’s signature: ………………………………………….…Date:
Receiving Institution: University of Brighton
Erasmus Code: UK BRIGHTO02
We hereby confirm receipt of the above-named student’s application, and that the above student is:
Accepted
Not Accepted
Academic Coordinator’s signature:
Institutional Coordinator’s signature:
…………………………………………………………………….
Date:
………………………………………………………………………………..
Date:
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Notes for Guidance (Incoming ERASMUS+ students 16-17)
General
Please ensure that all parts of your application form are completed clearly in black ink or preferably typed. The form should
be signed and dated by yourself, and both your home institution Academic Coordinator and Institutional Coordinator.
Before completing the form, please ensure that you read these notes for guidance carefully.
The Data Protection Act 1998 and Disclosure of Applicant Information
The information which you have given on your application will be used for the following purposes only:

to enable your application to be considered;

to enable this institution to compile statistics, or to assist other organisations, such HESA (Higher Education Statistics
Agency), or individual research workers to do so, provided that no statistical information would identify you as a
person will be published;

to enable the institution to set up your student record and allocate a student number.
The university reserves the right at any stage to request applicants or enrolling students provide further information relating
to any aspect of their application or enrolment. If such further information is not provided within the period stipulated, then
the university reserves the right to refuse to consider the application or the enrolment.
Section 1 Sending Institution
Please provide full name, address, Erasmus code and contact details of the Institutional Coordinator and your Academic
Coordinator at your home institution.
Section 2 Student’s personal data
Disability/Special Needs
Please enter in the box the code from the list of statements below which is most appropriate to you. Please record any
special needs or support required in the space provided. The university will use this information to make appropriate
arrangements to support your studies at the university.
Disabilities/support required:
A
No disability
B
You have a social/communication impairment such as Aspergers syndrome/other autistic spectrum disorder
C
You are blind or have a serious visual impairment uncorrected by glasses
D
You are deaf or have a serious hearing impairment
E
You have a long standing illness or health condition such as cancer, HIV, diabetes, chronic heart disease, or epilepsy
F
You have a mental health condition such as depression, schizophrenia or anxiety disorder
G
You have a specific learning difficulty such as dyslexia, dyspraxia or ADHD
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H
You have physical impairment or mobility issues, such as difficulty using your arms or using a wheelchair or crutches
I
You have a disability, impairment or medical condition that is not listed above
J
You have two or more impairments and/or disabling medical conditions
Passport Information
If you require a visa to study in the UK, you must provide passport information to enable us to support your visa application.
Further information on obtaining a visa for non-EEA nationals can be found on the following web page:
Student Visitor Visa (if your study period here is less than six months):
https://www.gov.uk/study-visit-visa
Student (Tier 4) Visa (if your study period here is for more than six months):
http://www.brighton.ac.uk/international/immigration/
For all queries about visas, please contact: visas@brighton.ac.uk
Section 3 English Language Competence
Please state whether or not you hold an English Language qualification, e.g. IELTS or TOEFL. Please give the overall grade and
the grade achieved for writing ability. Please enclose copies of certificates and transcripts awarded.
NB The minimum English language requirements are outlined in the university prospectus on our website for each course and
are also stated on the Erasmus+ bilateral agreement with your home university. If you are unsure what the minimum English
language requirements are for modules you will be following at University of Brighton as an Erasmus student, please contact
the University of Brighton Erasmus Academic Coordinator for further advice. We do expect that students will meet the
minimum requirements.
Section 4 Work Experience
Please include all your work experience and training, paid or unpaid, full or part-time.
Section 5 Current study
Please state the qualification for which you are currently studying at your home institution and your current year of study.
Declaration
When you sign the form, you agree to the following conditions:
a) The information you have given is complete and accurate.
b) The university tries to process applications and related decisions efficiently and accurately. However we will not be
liable for any mistakes or delays or any loss or damage caused by mistakes or delays.
c) If you accept an offer of a place, you agree to abide by the rules and regulations of the university.
Learning Agreement
The Learning Agreement should be completed and sent with your application form.
If you need assistance regarding which modules to choose, please liaise with your home institution academic coordinator in
the first instance. If you need more information, please contact the University of Brighton Erasmus Academic Coordinator.
Your learning agreement must be agreed with both your tutor at your home institution and your Erasmus Academic
Coordinator at University of Brighton.
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Amendments to Learning Agreements
Any amendments made to your learning agreement after your arrival at University of Brighton must be formally agreed
between yourself, your home tutor and your Erasmus Academic Coordinator at the University of Brighton. An amendment
form entitled ‘Changes to original proposed study programme/Learning Agreement’ is provided to record any such
amendments. This should be completed without delay, signed by all parties and returned to the European Programmes
Administrator at University of Brighton.
Transcript of Record
At the end of your study period at the University of Brighton, you will be provided with a transcript of record, indicating the
modules you have studied, and the grades. This will be produced based on the number of modules for which you have been
formally registered via the University of Brighton’s central “CAMS” system (Credit Accumulation Management System), and
for which you have successfully completed the necessary assessments/examinations.
Where a University of Brighton transcript shows the credits achieved as CATS credits (the acronym stands for 'Credit
Accumulation and Transfer System') and not ECTS, the accepted exchange rate is 2 CATS credits are equivalent to 1 ECTS.
Where to send your completed application form
Please check all sections of your application form have been completed and the application is signed by you and the relevant
person at your home university. The application form should be returned by post with your learning agreement and
certificates or transcripts evidencing your English language competence level to:
Maria Marzaioli
Partnership Administrator
Registry (Partnership Office)
University of Brighton
Mithras House
Lewes Road
Brighton
BN2 4AT
UK
Application Deadline
Please return your application form as soon as possible, but no later than:
Semester 1: 30th April ‘16
Semester 2: 15th October ‘16
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