KU Leuven Study Abroad Programme
in European Culture & Society
Academic and financial information
Name:
Home University:
Academic year:
Period:
20
/ 20
(Fall, Spring or Year)
1. ACADEMIC INFORMATION
In what year did you obtain your high school degree? .............................................................................................
Present year: 1 - 2 - 3 - 4 – 5
I plan to graduate in the year: ...................................................................................................................................
Field of study
Major(s): . .............................................................
.............................................................
Minor(s):
..........................................................................
..........................................................................
Overall academic result and scale: ...........................................................................................................................
(for example US: GPA 3.0 / 4.0, Canada: 70% ...)
List all courses in which you are currently enrolled at your home university (title and expected grade)
1. ...............................................................................................................................................................................
2. ...............................................................................................................................................................................
3. ...............................................................................................................................................................................
4. ...............................................................................................................................................................................
5. ...............................................................................................................................................................................
6. ...............................................................................................................................................................................
Include the transcripts of your university education so far. Please list the colleges or universities from which you
have included transcripts:
...................................................................................................................................................................................
...................................................................................................................................................................................
...................................................................................................................................................................................
...................................................................................................................................................................................
KU Leuven, Study Abroad Programme in European Culture & Society
Blijde-Inkomststraat 21/3312, B-3000 Leuven (BELGIUM)
2. STUDY PROGRAMME AT KU LEUVEN
List at least 30 ECTS credits worth of courses per semester that you would seriously consider taking and that
meet with the approval of your advisor. Check our website to make sure that your courses do not overlap.
First Semester (September – December/January):
Course code
Course title
1. .......... : .................................................................................................................................................................
2. .......... : .................................................................................................................................................................
3. .......... : .................................................................................................................................................................
4. .......... : .................................................................................................................................................................
5. .......... : .................................................................................................................................................................
6. .......... : .................................................................................................................................................................
Second Semester (February – June):
Course code
Course title
1. .......... : .................................................................................................................................................................
2. .......... : .................................................................................................................................................................
3. .......... : .................................................................................................................................................................
4. .......... : .................................................................................................................................................................
5. .......... : .................................................................................................................................................................
6. .......... : .................................................................................................................................................................
KU Leuven, Study Abroad Programme in European Culture & Society
Blijde-Inkomststraat 21/3312, B-3000 Leuven (BELGIUM)
3. SECTION FOR THE STUDY ABROAD ADVISOR / EXCHANGE COORDINATOR
Advisor’s statement:
I have discussed both the programme and the conditions for study abroad at KU Leuven
with ..............................................................................................................
and hereby
❍ Unconditionally approve of this student’s participation in the programme.
❍ Conditionally approve of this student’s participation, with the reservation(s) listed below:
...................................................................................................................................................................................
...................................................................................................................................................................................
...................................................................................................................................................................................
...................................................................................................................................................................................
Will your institution grant credit for the courses taken at KU Leuven towards this student’s degree?
(please use an additional sheet if necessary)
❍ Yes
❍ Yes, provided that the student’s programme meets the conditions below:
❍ No, for the reasons below:
...................................................................................................................................................................................
...................................................................................................................................................................................
Is this student currently in violation of any code of student conduct?
❍ No
❍ Yes (please explain)
...................................................................................................................................................................................
...................................................................................................................................................................................
Advisor's signature
Name (capitals)
Date
4. SIGNATURE OF APPLICANT
I declare, upon my honor, that this information is correct and complete, and that I have sufficient funds to cover
my expenses resulting from enrolment at KU Leuven. I acknowledge that I claim no financial or material aid
whatever from KU Leuven during my studies. I agree that any false statement I make in this application shall
result in immediate cancellation of my application.
I also certify that all responses made on my health information form are true and accurate, and that I will notify
PECS hereafter of any relevant changes in my health that occur prior to the start of my study abroad period at
KU Leuven.
Applicant's signature
Name (capitals)
KU Leuven, Study Abroad Programme in European Culture & Society
Blijde-Inkomststraat 21/3312, B-3000 Leuven (BELGIUM)
Date