PUEDES - Erasmus Mundus Action 2

Travel Form
Please note: The ticket will be only purchased upon evidence of VISA Issuing

PLEASE TYPE OR COMPLETE IN CAPITAL LETTERS

FAMILY NAME/S (as stated in your passport) Haga clic aqu para escribir texto.
GIVEN NAME/S (as stated in your passport) Haga clic aqu para escribir texto.
GENDER MALE FEMALE
EMERGENCIES PERSON TO BE CONTACTED
TEL NUMBER
EMAIL

Information
DO YOU NEED A VISA? YES NO
CITIZENSHIP / NATIONALITY
Haga clic aqu para escribir texto.
DATE AND PLACE OF BIRTH DATE:
PLACE:
PASSPORT NUMBER AND EXPIRY DATE NUMBER:
(PLEASE ADD A SCANNED COPY OF THE PASSPORT) EXPIRY DATE:
TELEPHONE NUMBER (WITH INTERNATIONAL CODE) AND E- TEL:
MAIL ADDRESS EMAIL:
PERMANENT ADDRESS Haga clic aqu para escribir texto.
(IN YOUR HOME COUNTRY)
EUROPEAN EMBASSY/ GENERAL CONSULATE Haga clic aqu para escribir texto.
(THAT WILL ISSUE YOUR VISA)
WILL YOU BE REQUESTING YOUR VISA AND TRAVELLING YES NO
WITH FAMILY MEMBERS? IF YES:
NAME:
NATIONALITY:
RELATIONSHIP TO YOU:
DO YOU NEED TO SHOW A RESERVATION OF THE FLIGHT YES NO
TICKET AT THE EMBASSY?

Flight details (Round trip ticket)

HOST UNIVERSITY Haga clic aqu para escribir texto.
MOBILITY DATES (AS AGREED WITH HOST UNIVERSITY) START:
END:
DATE OF DEPARTURE: DATE OF RETURN:

CITY OF DEPARTURE: CITY OF DESTINATION:

SPECIAL REQUESTS RELATED TO THE FLIGHT: Haga clic aqu para escribir texto.