Application for exchange students 2016-2017

Application

Btrnu, Ctlin
Application number: 2016EI0732
Application date: 2016-06-30 17:26:56
Programme: Erasmus+ Studies
Home institution: Universitatea de Vest din Timioara
Period: Winter semester 2016/2017
Faculty: Faculty of Fine Arts
Field of study: School of Visual and Applied Arts
Signature of the student
I confirm that all details given in the application form are correct and complete.
Date, Place:
Signature:
Confirmation of the coordinator
Institution: Universitatea de Vest din Timioara
Name: ________________________________________________
Function: ________________________________________________
Department: ________________________________________________
Phone: ________________________________________________
Fax: ________________________________________________
Email: ________________________________________________
To be completed by the international coordinator
Date, Place:
Signature:

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Application for exchange students 2016-2017

Personal data
Personal data
Family name Btrnu
First name Ctlin
Sex Male
Date of birth 1990-01-12
Country of birth Romania
Place of birth Drobeta Turnu- Severin
Country of nationality Romania
Second country of nationality Romania
Identity document
Type Identity card
Number MH337577
Issued by SPCLEP Drobeta Turnu- Severin
Issue date 2010-11-12
Expiration date 2017-01-12
Current address
c/o
Street veterani 7
Postcode 220202
City Drobeta Turnu- Severin
Country Romania
Phone 0724668212
Address valid until 2016-08-01
Mobile phone 0724668212
Email cata_batranu@yahoo.com
Permanent address (if different)
c/o
Street
Postcode
City
Country
Phone
Person to notify in case of emergency
Name Batranu Ana-Maria
E-mail batranu.anamaria@gmail.com
Phone +447341212762
Previous and Current Studies
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Application for exchange students 2016-2017

Home institution
Country Romania
Institution Universitatea de Vest din Timioara
Faculty/School/Department Arts and Design, School of Art, department of
Sculpture
Begin of studies at this institution 2014-10-01
Current studies/status
Degree/Qualification pursued Bachelor s degrgee in Sculpture
Study level First Cycle / Undergraduate / Bachelor
Subject area 021 - Arts
Number of years studied prior to
mobility
Contact details of your Coordinator at home institution
Family name Serban
First name Ana- Maria
Phone 0723093605
Email serbanan@yahoo.com
Street Calimanesti 14
Postcode 168300
City Arad
Country Romania
Contact details of person responsible for your Transcript of Records at home institution
Family name Toma
First name Dan- Iulian
Phone 0723920898
Email dan.tomax@yahoo.com
Street Timotei Cipariu 6
Postcode 3000523
City Timisoara
Country Romania
Previous studies period Nr. 1
Country
Name and place of institution
Field of study
Start
End
Preferred mobility
Details of mobility

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Application for exchange students 2016-2017

Mobility programme Erasmus+ Studies

Faculty Faculty of Fine Arts
Field of study School of Visual and Applied Arts
Subject area 0218 - Inter-disciplinary programmes and
qualifications involving arts
Departmental Coordinator Sachinis Xenofon
Study level First Cycle / Undergraduate / Bachelor
Mobility period
Start semester Winter semester 2016/2017
Duration (semesters) 1
Duration (months) 5
Start of mobility 2016-10-01
End of mobility 2017-02-28
Planned date of arrival 2016-09-30
Language skills
Greek language skills
Understanding - listening X - No competence
Understanding - reading X - No competence
Speaking - spoken interaction X - No competence
Speaking - spoken production X - No competence
Writing X - No competence
Certificate(s) (name and results) no certificate, nor level
English language skills
Understanding - listening C2 - Mastery
Understanding - reading C2 - Mastery
Speaking - spoken interaction C2 - Mastery
Speaking - spoken production C2 - Mastery
Writing C2 - Mastery
Certificate(s) (name and results) English Language Certificate, level B2
Further language skills
Further languages
Miscellaneous information
Disability and special needs
Do you have any disability or No
special needs?
If yes, please specify
Please mention if you are taking
any special medication that the
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Application for exchange students 2016-2017

Host Institution should know

about it, in case of emergency.
Useful Information
Please do not forget to enclose the needed documents with your application.

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