Madrid 2014
		
First Name/ Last Name

Address
		
Nationality:	Telephone number :  
                   	 E-mail:
	
ID or passeport number:		  Mss 	  Mr	Age:	
University:	
	
Degree Course (name of the master or doctorate, level)	
	
Student Number: 
		
Have you participate in any other Erasmus Program?
When and where? 	

Your Master program  in	  Arts	  Literatures	  Computing Sciences  __________	Other:	
Speak about your competences or knowledges
(even if you have user competencies)	On Art:

	
	On Literature:

	
	On Computing:

	
	other:

	
Languages	 Mother langage:
	Other:

	
English competence

Certificates	  novice

	  usual talk 	  very fluent	

This application must be sent to the local referent of the Intensive Erasmus Program  of your University before January 22th 2013

Pieces to join to this form:
-	a CV
-	a grade sheet of last year
-	a covering letter explaining your interest for the program 
-	a both sides photocopy of your Student Id
-	a photocopy of your passeport or of your national Id
-	if your are not European: the photocopy of a resident permis valid for the Schengen area until Jully 5th 2014

Information :
Fill entirely the form. Notably give information about your competences and knowledge in the domains of arts, literature, computing

Concerning the credits:
The program delivers 8 credits (ECTS) but the possibility to use them in your cursus depends on your master. To know exactly if you can use them or a part of them and how, contact the director of your master or the local referent of this intensive Erasmus program of your University

Local referents of the Intensive Erasmus Program:
University Paris 8 : Philippe Bootz (philippe.bootz@univ-paris8.fr)
University Complutense: Amelia Sanz (amsanz@filol.ucm.es)
Falmouth College: Jerome Fletcher (Jerome.Fletcher@falmouth.ac.uk)
University Fernando Pesoa: Rui Torres (rtorres@ufp.pt)
University of Ljubljana: Janez Strehovec (Janez.Strehovec@guest.arnes.si)