Application for scholarship


I would like to apply for a financial contribution regarding the travel expenses associated
with participation in the program ........………………………….………………………………..


Name and surname


UČO


Study programme


Year of study


Permanent address


Contact address


Place of stay abroad


Academic year

                        20 …  /  20 …

Time period of the stay

                        from …

                               to …


Travel expenses from your residence ……………………….……………… to the place of stay

abroad …………………………………………………………………………………………………

Number of tickets


Prices of tickets in relevant currency (EURO / CZK)



Travel expenses from the place of stay abroad ……………………….……………… to your

residence ………………………………………………………………………………………………..

Number of tickets


Prices of tickets in relevant currency (EURO / CZK)



Total amount for refund of travel expenses:


Turn the page!




Note:  Glue the tickets on a separate piece of paper so that their dates and prices are clearly
visible. The refund can be applied only to the way there and back (tickets have to have a date in
compliance with the beginning and end of the stay abroad). Seat reservations, baggage, and journey
by private car are not refunded. Your account number must be submitted in the Information System of
MU (IS). Hand in this application to Bc. Zuzana Pilatova from International Studies Office.






In Brno, on .……………………..                                       ………………………………..…   Date
                                                                       Student´s signature










..…………………………………………………………..

Dean’s Office responsible person’s signature, stamp













..………………………

Vice-dean´s decision