2015 16 International Students application form

2015/16 International Exchange Students
Application Form
Etudiants Internationaux en Echange 2015/16
Dossier de Candidature
1. PERSONAL DATA/ COORDONNEES PERSONNELLES (block letters only / en majuscule)
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Family Name /Nom de famille: ____________________________
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First Name /Prénom: ____________________________
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Date of Birth/Date de Naissance: __/__/____
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Citizenship/ Nationalité : ____________________________
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Current Address/ Adresse Actuelle: (Valid until/ Valide jusqu’au ___/___/___)
_________________________________________________________________________________
_________________________________________________________________________________
____________________
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Permanent Home Address/ Adresse Permanente:
_________________________________________________________________________________
_________________________________________________________________________________
____________________
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Phone Number (incl. country and area code)/ Numéro de téléphone (inclure l’indicatif du pays et de la ville) :
___________________________________
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Fax (incl. Country and area code/ Inclure l’indicatif du pays et de la ville)
_______________________________________________
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E-mail Address :
_________________________________________________________________________________
Please note: Addresses and e-mail given in these boxes will be used in future communication/Remarque: ces adresses
postales et e-mail seront utilisés pour notre communication future.
2. ACADEMIC DATA/COORDONNEES DE L’UNIVERSITE D’ORIGINE
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Complete Home University Address/ Adresse complète de l’Université d’Origine:
_________________________________________________________________________________
_________________________________________________________________________________
____________________
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Precise Coordinator Contact/ Nom et adresse précise du Coordinateur :
_________________________________________________________________________________
_________________________________________________________________________________
_________________________________________________________________________________
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Phone Numbers/ Numéros de téléphone :
□ Of the University : ___________________________
□ Of the Coordinator : ___________________________
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Fax:
□ Of the University: ___________________________
□ Of the Coordinator: ___________________________
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E-mails/ Adresses électroniques :
□ Of the University: _______________________________________________________________
□ Of the Coordinator: ______________________________________________________________
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Studied Program :
Undergraduate Study
Post-Graduate Study
□ Major/ Principal: _____________________________
□ Minor/ Secondaire: ___________________________
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Choose a period of studies:
Academic year (From Mid-September 2015 to June 2016) / Année universitaire (De mi-septembre
2015 à mi- juin 2016)
Winter Semester (From Mid-September 2015 to December 2015) / Semestre d’hiver (De miseptembre 2015 à décembre 2015)
Spring Semester (From January 2016 to June 2016) / Semestre de printemps (De janvier 2016 à
juin 2016)
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If you stay during the whole academic year, will you apply for the C.E.P1 or not? / Allez-vous
participer au C.E.P pendant l’année scolaire?
Yes/Oui
No/Non
1
C.E.P = Certificat d’Etudes Politiques, is a certificate tailor-made for Exchange students at Sciences PO Lille during the whole academic year.
Students wishing to apply have to be able to attend courses taught in French (60ECTS).
3. LANGUAGE SKILLS/COMPETENCES LINGUISTIQUES
To be able to write essays, attend lectures and interact socially with other students, it is better to start
courses of French as foreign language before your arrival / Pour pouvoir écrire et assister aux cours,
discuter avec les autres étudiants, il est préférable de prendre des cours de français avant votre arrivée.
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Which level of French language do you have? / Quel est votre niveau de langue en français ?
Beginning/Débutant:
Intermediate/Moyen:
Advanced/Avancé:
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How many hours of French language did you attend? A combien d’heures de cours avez-vous
assisté ?
50 hours or less
between 50 and 250
250 hours and more
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Do you plan to choose only courses taught in English?
Yes/Oui
No/Non
Note that:
Sciences Po Lille can provide free courses of French Language during the academic year / Des cours de
français gratuits durant toute l’année sont possibles pour les étudiants.
It is strongly recommended for students to attend the integration seminar at the beginning of the
semesters. Il est fortement conseillé aux étudiants de participer au séminaire d’intégration en début de
semestre
4. REQUIRED DOCUMENTS/DOCUMENTS A FOURNIR
Please upload the following documents:
your resume/CV
your transcripts of records
a nomination letter from your home university
5. APPLICATIONS/CANDIDATURES
Applications should be submitted to Sciences Po Lille no later than:
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ACADEMIC YEAR AND/OR 1st SEMESTER:
o applications should be submitted to Sciences Po Lille no later than the 15th of April 2015 for
non EU students (coming in the framework of bilateral agreements)/ 15 Avril 2015 pour les
étudiants hors UE
o
•
2nd of June 2015 for EU-Erasmus students/ 2nd juin 2015 pour les étudiants Erasmus
2nd SEMESTER: applications should be submitted to sciences Po Lille no later than 13th of November
2015 for all students-13 novembre 2015 pour tous les étudiants
Please send application documents to/Veuillez envoyer les documents de candidature à
SCIENCES PO LILLE
Relations Internationales/International Prog
Emmanuel Buteau
84 Rue de Trévise
59000 Lille
France
Tel : +33-3 20 90 42 85
Fax: +33-3 20 90 48 68
E-mail: [email protected]
Student’s signature: Date: __/__/____
Coordinator Signature/ University Stamp: Date:__/__/______