Uniwersytet Opolski

Ap p l i c a t i o n f o r Ac c o m m o d a t i o n
Application Deadline:
for Winter Semester 15 June
for Summer Semester 15 December
Opole University can offer a limited number of places for international students in dormitories - Niechcic and
Kmicic (www.campus.uni.opole.pl). The monthly cost of one place is about PLN 350 (about 85 EUR). There
are only double and triple rooms (no single rooms!). The complete application form must be returned to:
Opole University
Biuro ds. Bada Naukowych i Wsppracy z Zagranic
Pl. Kopernika 11a
45-040 Opole, Poland
Fax.: +48/ (0) 77 54 15 969
e-mail: agnieszka.kondziela@uni.opole.pl
PLEASE PRINT ALL DATA BELOW IN CAPITAL LETTERS

1.

Family name

2.

First name(s)

3. Sex (F/M)

4. ID Number

Home University and field of studies:

_______________________________________________________________________________________
_

Correspondence address:

5. Postal code

6. City

7. Street

9. Country

10. Phone No.

11. E-mail address

Period of stay:
from (______/______/______) to (______/______/______)
Arrival date: ________________________

8. Number

Date

Student's signature