Ecole Nationale Suprieure de Mcanique et dArotechnique

APPLICATION FORM FOR EXCHANGE STUDENTS

ACADEMIC YEAR 20 /20
PHOTOGRAPH

FIELD OF STUDY:

Please write in block letters

EXCHANGE PERIOD Duration of stay (in months): Date of arrival: Semester 1 Semester 2 Research project Date of departure: HOME INSTITUTION Name and full address: Institutional/Departmental Co-ordinator (Name, Tel., Fax, E-mail): Whole Academic Year

STUDENTS PERSONAL DATA Family name: First name(s): Sex: Female Male Date of birth: Citizenship: IC or Passport: Current address (Street, Postal Code, City, Country): Tel (Country code, area code, number): E-mail: Permanent address (if different): Contact person in case of emergency: Tel (Country code, area code, number):

PREVIOUS AND CURRENT STUDY PROGRAM Current year of study at home institution: Previous study abroad Have you already been studying abroad? In which country? When?

Yes No At which institution? And how long?

LANGUAGE COMPETENCE Language knowledge: Mother Tongue: Other languages: Command in French: Excellent Good Average Insufficient French language examination/ test takes: Yes No (if yes, attach copy of certificate) SUPPORTING DOCUMENTS (to send along with this application) Application form Program of studies

Cover letter (please specify the research topic and the expected laboratory)

CV Copy of your identity card or passport Student card from home university Copy of the last diploma (if any) An up-to-date academic transcript (document with your results at university to this date)

Date:

Students signature:

Please send your application to the following address: ISAE-ENSMA International Relations Office 1 avenue Clment Ader Tlport 2 BP 40109 86961 Futuroscope Chasseneuil Cedex FRANCE