Annex 1
Scholarship application
Scholarship programme to support long-term mobility abroad
Surname and first name .......................................................................................................
University identification number (UIN)....................................................................................
Field of study…………………………………………………Programme (Bachelor’s, Master’s)
Destination country .................................................................................................................
Name of the university/institution ............................................................................................
Start date of the study period/internship .................................................................................
Date of return ..........................................................................................................................
Date................................... Student’s signature......................................................
Decision of the Vice-Dean: