Department of English and Comparative Literary Studies Study Abroad (Intercalated Year): Expression of Interest Form. (Please return to English Office by Monday, November 30th, 2015 along with a short reference letter by a tutor who knows you). Name: ______________________________________________________________ Warwick email: _______________________________________________________ Personal email: _______________________________________________________ Mobile phone: ________________________________________________________ Degree: _____________________________________________________________ English degree pathway (if applicable): _____________________________________ Name of personal tutor: _________________________________________________ Name and address of referee: ____________________________________________ ____________________________________________ ____________________________________________ ____________________________________________ Interest in (please tick below): • Canada exchange: University of Toronto _____ University of Western Ontario _____ • European exchange (Erasmus): Paris IV (Sorbonne) _____ University of Aix-Marseille _____ Berlin Freie University _____ Bogazici University (Istanbul) _____ University of Padua _____ • Australian exchange Monash University _____ • China exchange: Tsinghua University _____ • Brazil exchange: Pontifical Catholic University of Rio de Janeiro (PUC Rio) _____ Please describe your reasons for applying for the exchange: Briefly discuss your goals for the year abroad and describe any past experience in living abroad and away from your family. (For non-Anglophone destinations) Give a brief account of your language competency in the host country of your choice: Signature_________________________________________________ Date___________