APPLICATION FORM
Please fill in the form online!
PERSONAL INFORMATION

Family name

Name

Gender Male Female

Date of Birth

Place of Birth

Citezenship

APPLICATION FOR STUDIES AT ATSU
Current Mailing Address
Permanent Mailing Address (e.g. parents)
CONTACT INFORMATION

Home University

Study Level

Major Study Field

No. of Supplements completed in CURRENT
Study level:

INFORMATION ON HOME UNIVERSITY

Planned Study Period:


Exchange Program Type:

Finance:

How do you plan to pay for your studies

Scholarship
Private funds
Other
Message:

Study Plan at ATSU (courses of interest, planned scientific activities)

Known languages:
English German Russian
Other languages:

Use Comma (,) to separate lanaguages

Special needs, if any
Living arrangement you prefer
Please arrange for me a place in a dormitory
I will organize my own accommodation in Kutaisi
Attachments
Transcript of home university records
Certificate proving the sufficient knowledge of English
Passport Copy
Additional photo
Do you agree, your photo might be used for informative materials given to other exchange students at the respective study semester. If you do not wish your photo is used for such purposes.
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