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Ek 10
T.R.
SIFA UNIVERSITY
The Office of International Affairs
LIFELONG LEARNING PROGRAM / ERASMUS
STUDENT APPLICATION FORM
(Photograph)
ACADEMIC YEAR 20.. / 20..
This application should be completed in BLACK in order to be easily copied, faxed or e-mailed
STUDENT’S PERSONAL DATA
Family name
ID-Passport no.
First name
Applied for
Nationality
Date of birth (day/month/year)
Home address
Male
Female
Place of birth
Street:
City:
Post Code:
Country:
E-mail
Telephone:
ACADEMIC DATA
Name of home university, city and country
Meliksah University
Faculty or School
Department
Diploma/degree for which you are currently
studying (bachelors/masters/doctorate)
Present year of studies (i.e. 1st, 2nd…)
Have you previously studied abroad?
Yes 
No 
If Yes, when and at which institution?
Study period at Host University
1st Semester (September-February)
2nd Semester (February-June)
Languages known
English
Other: ...........................
Adres: Şifa Üniversitesi, Uluslararası İlişkiler Ofisi, Ankara Cad. No:45,35100, Bayraklı/
Izmir/Türkiye
Address: Sifa University, International Office, Ankara Cad. No.45, 35100,
Bayrakli/IZMIR/ TURKEY
Email: [email protected]
Web: http://international.sifa.edu.tr
Tel: +90 (232) 308 00 00
Fax: +90 (232) 308 0 308
Ek 10
T.R.
SIFA UNIVERSITY
The Office of International Affairs
Briefly state the reasons why you would like to
study at abroad?
LLP / ERASMUS DATA
Faculty/School at Host
University
Department
Erasmus Code of Home
University.
TR IZMIR09
Erasmus Department
Coordinator at Home
University (contact info)
Erasmus Institutional
Coordinator at Home
University
Date
Prof.Dr. Halil İbrahim Atabay
Sifa University International Relations Office
Tel: +90 232 308 00 00
Student’s signature
Fax: +90 232 308 0 308
E-mail: [email protected]
Institutional Coordinator Signature and Stamp
RECEIVING INSTITUTION
We hereby acknowledge receipt of the application, the proposed learning agreement and the candidate’s
Transcript of records.
The above-mentioned student is:


provisionally accepted at our institution
not accepted at our institution
Departmental coordinator’s signature:
Institutional coordinator’s signature:
Date:
Date:
Adres: Şifa Üniversitesi, Uluslararası İlişkiler Ofisi, Ankara Cad. No:45,35100, Bayraklı/
Izmir/Türkiye
Address: Sifa University, International Office, Ankara Cad. No.45, 35100,
Bayrakli/IZMIR/ TURKEY
Email: [email protected]
Web: http://international.sifa.edu.tr
Tel: +90 (232) 308 00 00
Fax: +90 (232) 308 0 308
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