Erasmus+ student
non-Erasmus+ student

studies
traineeship

Surname/Family name: *

First name(s): *

Gender: Male
Female
Undefined

Passport numer/ID Card number: *

Expiry date of passport/ID Card *

Nationality: *

Place of birth – town or city and country: *

Date of birth: *

Correspondence address

Street: *

House number: *

Postcode/Zip code: *

Town/city: *

Country: *

Phone number: *

E-mail: *

Sending Insitution

Sending Insitution name *

Address: *

Faculty/Department: *

Field of study: *

Level of study:*

Please select Bachelor degree Master degree Long-cycle Programme PhD Programme

Year of study:*

Please select 1 2 3 4 5 6

Mode of study:*

Please select full-time part-time

Contact Person/Coordinator

Name and surname: *

Phone number: *

E-mail: *

Exchange period:*

Please select winter semester summer semester whole year

Academic Year:*

Please select 2021/2022 2022/2023 2023/2024 2024/2025 2025/2026 2026/2027

Polish language course*
I would like to participate in the Polish language course – elementary level, 30 hours, free of charge.
Please select Yes No

Accommodation*
I would like to stay at the UJK dormitory.
Please select Yes No

Room preferences:*
single room
2-bed room
3-bed room

*Currently only 2-bed rooms are available.

Attachments (ZIP file, maximum size 2 MB): scan of ID/passport, photo (jpg file), scan of visa (if applicable)*

I confirm that to the best of my knowledge and belief all the information I have given on this form is true, complete and accurate. I am aware that intentionally or negligently given false information constitutes an administrative offence and may lead to exclusions from the admissions procedure or - if discovered at a later date – to the cancellation of my administration or enrolment.
I confirm to have read the information.

Please read the information clause on personal data processing of an applicant before you continue.
Please confirm to have read the information. Otherwise, the form cannot be submitted. I confirm to have read the information.