UNIVERSIDAD POLITECNICA DE VALENCIA (UPV) – E VALENCI02 ESCUELA TECNICA SUPERIOR DE INGENIERIA AGRONOMICA Y DEL MEDIO NATURAL (ETSIAMN) Exchange Student Application Form and Learning Agreement to be completed and sent to interagr@upvnet.upv.es 1. Personal Details Family name: First name: PHOTO ID card number / Passport number: E-mail: @ Mobile phone number: Date of birth: 2. Details of your Home Institution University: Exchange coordinator (name and e-mail): @ Degree and number of credit points: Number of credit points already obtained: 3. Proposed stay at ETSIAMN Date of start: Are you able to follow courses in Spanish? : 4. Motivation: maximum 50 words Date of conclusion: 5. Proposed study programme Please select courses from the attached course catalogues Course Internship: please state the desired domain(s) Semester ECTS Semester ECTS