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(Student’s) Personal Data
First Name(s) *
Family Name(s) *
Date of Birth *	(In format: day/month/year)
Place of Birth *
Sex *
Type of travel document *
Identification number of travel document *
Travel document valid until *	(In format: day/month/year)
State Citizenship *	(see State Citizenship in Travel Document)
Address of permanent residence (please fill in your COMPLETE address - important documents will be sent to this address)
Street and house number *
Town *
ZIP code *	Postal code
State *
Contact
E-mail 1 *
E-mail 2
Telephone
Person to notify in case of emergency
Full name *
E-mail *
Telephone *
Street and house number *
Town *
ZIP code *
State *
Information on studies
Sending institution *
Studying for degree *
Years of study to date *
Have you already studied abroad? *
Institution
Institution	If you have studied abroad, at which institution?
Have you already studied abroad as part of the Erasmus Programme? *
Co-ordinator at your (home) university
Full name *
E-mail *
Telephone *
Fax
Receiving institution (Charles University)
Faculty *
Department
Faculty co-ordinator or contact person *
Faculty co-ordinator or contact person *	See list of co-ordinators (in case of need)
Information about Erasmus
Reasons *
Type of stay
Type of stay	Only for stays shorter than 31 days
Field of study *
I require accommodation at a Charles University Hall of Residence *
Special requirements for accommodation
Special requirements for accommodation	Accommodation will be provided for the duration of your study stay at Charles University. It will be available starting one working day before the beginning of the semester or study period. You will receive details about your accommodation in an accommodation voucher. Students are housed in double rooms. Single rooms are not available.
There are limited capacities for accommodation in Charles University Halls of Residences. When booking the accommodation in Charles University Halls of Residences I understand that the booking is binding
I understand that there are only double rooms available (= rooms shared with one more student)
The length of rent of a Hall of Residence place must correspondate with the length of your study stay at Charles University. The cancellation of the Hall of Residence place is requested the latest until 1 month before the start of semester, so that the halls of residence have sufficient time to find a substitute for your place
A booking fee 1800 CZK is to be paid the latest until beginning of August in the case of winter semester and full year arrivals and the latest until middle of January in the case of summer semester arrivals. You will receive an email with instructions to the payment of the deposit from the European Office of Charles University
Academic year *
Date from *	(In format: day/month/year)
Date to *	(In format: day/month/year)
I am a student with special needs
Special needs
Special needs	Hold Ctrl to select multiple items.
Special needs (other)
Special needs (other)	Please specify if not in the list. For more information please visit: https://inclusivemobility.eu/countries/cz/institutions/2558. To discuss your special requirements, please contact: erasmus.incoming@ruk.cuni.cz

NOTE THAT THE APPLICATION WILL ONLY BE SAVED WHEN YOU ADD ALSO LANGUAGE COMPETENCE(S) AND A LIST OF SUBJECTS ON THE NEXT SITE. YOU NEED TO COMPLETE THE REGISTRATION PROCESS WHILE CLICKING ON “SUBMIT APPLICATION” WHEN THIS IS COMPLETED

Erasmus

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