Exchange Minor Faculty of Health

Application form exchange minor Faculty of Health

Please fill in this online form and upload the required documents. Fields marked with * are mandatory
Details of home institution
Name of Home institution*
Home institution Faculty/Department*
Country*
Home institution contact person*
Phone number contact person*

Country CodePhone Number
Email contact person*
example@example.com
Personal details student
Student name*

First NameMiddle NameLast Name
Student date of birth*

DayMonthYear
Student place of birth*
Student country of birth*
Student nationality*
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Student phone number*

Area CodePhone Number
Student e-mail address*
example@example.com
Contact in case of emergency
Name*

First NameLast Name
Relation (e.g. mother)*
Phone number*

Country CodePhone Number
Email
example@example.com
Study programme
Study programme home university*
Your current study year*

Year 1Year 2Year 3Year 4
Minor
Which minor are you applying for?*
Semester of choice – first (fall) semester/ second (spring) semester*

First (fall) semesterSecond (spring) semester
Would you like to rent a student room via the AUAS (only for one semester)?*

YesNo
Required documents
Transcript of records (including all grades you have received so far at your home institution)*

Door Bestanden Bladeren
Upload Cancelof
Motivation letter*

Door Bestanden Bladeren
Upload Cancelof
Learning Agreement*

Door Bestanden Bladeren
Upload Cancelof
What do we do with your data?
We store your data for up to 1 year after registration, after which it will be automatically deleted. Read more about how we handle your data in our privacy statement.
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Application form exchange minor Faculty of Health

Details of home institution

Personal details student

Contact in case of emergency

Study programme

Minor

Required documents

What do we do with your data?