Università degli Studi di Ferrara

RIPARTIZIONE SERVIZI AGLI STUDENTI

Unità Operativa Mobilità Internazionale

ACCOMMODATIO FORM
ACADEMIC YEAR 2009/2010

FIELD OF STUDY_____________

STUDENT PERSONAL DATA

Family Name Name

Gender M F
Permanent address:

Telephone: E-Mail:

HOME UNIVERSITY

Name and address:

Departmental Coordinator (name, telephone, fax and e-mail):

I will look for a room myself

I undersigned ___________________________________________ declare my will

to book a bed in a double room in a ARDSU residence starting from the month of
_______________ for No. ______ months.

I will communicate to the International Mobility Service the exact date of arrival.

Date Signature

_______________ ______________________