__/__/______

dd/mm/yyyy

To
The Assistant Director,
Division of International Affairs,
Lovely Professional University,
Phagwara-Punjab

Subject: Application for applying to Study Abroad Program

Respected Sir,

With due respect, I would like to state that I ________________________ want to apply for
an International Partner University through your good office for Study Aborad Option. I am
furnishing some required details as following;

General Information
Name:_____________________________ S/D/o __________________________________
University Registration No. ____________ Program _________________________
Program code _________Term ________ CGPA till now ________ Batch _______________

Qualificational Details
1.Present Qualification’s details: Name of Program
_______________________________________________

S.No Sem. Year of CGPA Marks Any If Yes,

Passing obtained/ Backlog Cleared or not.
Total Marks

2.Last Qualification’s details

S.No Class Board Year of Marks %age
Passing obtained/ Total
Marks

Residential Information
Resident of _________________________________________________________________
__________________________________________________________________________
Contact details (Resi.) __________________________ (PP)__________________________
Parents/ Guardians Contact details are (Resi.) _________________(PP)_________________
English Proficiency Score
English Language Test taken (Yes/No) _______ if yes, which test IELTS/TOEFL _________
Bands/Score _________ Valid or Not _________ If yes, valid till ______________________

Passport Information
Passport No.______________ Issued from __________________Date of Issue ___________
Date of Expiry _____________ Date of Birth ____________ Place of Birth _____________

University Preference Chart : How to fill it? - Instructions

1. State only prefered three Universities out of below mentioned by putting 1, 2 and 3 no. in two brackets.
2. N.A states not Applicable or the course is not available for Study Abroad Program option in said University.

To be Filled by Candidate:
Course BBA B.Tech BHMCT & MBA Others
University (CSE, ME B.Sc Hotel
& ECE) Mgt.
University of North Carolina at Yes ( ) Yes ( ) NA Yes ( ) NA
Charlotte, USA
North Dakota State University, USA NA Yes ( ) NA Yes ( ) NA
Northern Illinois University, USA NA Yes ( ) NA NA
Binghamton University, USA Yes ( ) Yes ( ) NA Yes ( ) NA
Washburn University, USA Yes ( ) NA NA NA
Troy University, USA Yes ( ) Yes ( ) NA Yes ( ) NA
San Francisco State University, USA NA Yes ( ) NA Yes ( ) NA
University of Sunderland, UK Yes ( ) Yes ( ) Yes ( ) Yes ( ) NA
Thames Valley University, UK NA NA Yes ( ) NA NA
Roehampton University, UK Yes ( ) NA NA NA BCA Yes ( )
University of Wolverhampton, UK Yes ( ) Yes ( ) Yes ( ) Yes ( ) NA
University of East London, UK NA NA NA NA M.Sc Yes ( )
Phsiotherapy
Northampton University, UK Yes ( ) NA NA Yes ( ) NA
Murdoch University, Australia Yes ( ) Yes ( ) Yes ( ) Yes ( ) NA
Central Queensland University, Yes ( ) Yes ( ) Yes ( ) Yes ( ) NA
Australia
University of South Australia, Yes ( ) NA NA NA NA
Australia
Mount Allison University, Canada Yes ( ) NA NA NA NA
University Canada West, Canada Yes ( ) NA NA Yes ( ) NA
Management Development Institute of Yes ( ) NA NA Yes ( ) NA
Singapore, Singapore
Verification & Declration by student
I declares and verify that all the above furnished information is true, correct and complete.

_________________________________
Name of Student
_________________________________
Signature of Student
Contact: __________________________

Verification & Declration by Parents

I _________________________ s/d/w of ________________________ hereby declares that:
1. I shall be responsible for my ward/son/daughter's acts and all the expenses incurred
by him/her during the period of study abroad program in foreign partner University,
2. I also affirm that neither Lovely Professional University nor any of its official will be
responsible for any loss/expense/unlawful act of my son/daughter/ward.

_________________________________
Relationship with the Student
_________________________________
Signature of Parent/Guardian
Contact: __________________________