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F-nummer Versie Eigenaar

: OWADMIN003 : 1.0/2012-12-31 : Onderwijsadministratie :

Title

: Admission for students with a foreign diploma

Reserved for the admission office IN VW CT


Datum aanvraag: Behandeld op: Opmerking:

Instructions for the applicant


Complete and print this form and send it with all the required documents (see http://www.ua.ac.be/ENGLISH&n=33427) through regular mail to: Mrs. Carla Dinnewet, Universiteit Antwerpen, Central student administration, City campus, building S, Lange St. Annastraat 7, B-2000 Antwerp Belgium.
Electronic files will not be accepted.

Personal data of the applicant


Surname: Place of birth (city, country): Date of birth (DD-MM-YYYY): Nationality: Male / Female First name:

Official residence of the applicant


Street: Postal code: Country: Telephone: Address in Belgium (if applicable): E-mail: City, Province: Number:

Information regarding the requested study programme


Please consult the website of the university regarding the programmes offered: http://www.ua.ac.be/ENGLISH&n=42712 I wish to enroll in the following programme during the academic year Select : O Bachelor programme:

O Master or Advanced Master programme (only for holders of a Bachelor or Master degree):

Date:

Signature applicant,