Polish-European School of Law

Intensive International Curriculum

Polish National Agency for Academic Exchange
SPINAKER PROGRAM
Agreement No. BPI/SPI/2021/1/00034/U/00001
Project entitled "Supporting the institutional capacity of Polish universities
through creation and implementation of international study programs "
(no. POWR.03.03.00-00-PN16 / 18), implemented under Measure:
3.3 Internationalization of Polish higher education,
Operational Program Knowledge Education Development

FOREIGN STUDENT APPLICATION FORM

2nd edition – from 8.05.2023 till 02.06.2023

This application must be completed on the COMPUTER.

Please return this form to the following address.
UNIVERSITY OF BIALYSTOK
International Cooperation Office
Swierkowa 20B
15-328 Bialystok, Poland
tel./fax: +48 85 745 70 19; e-mail: p.bialas@uwb.edu.pl

STUDENT`S DATA
Last name (s) ............................................................... First name
(s) .....................................................
Place and date of birth ............................................. Sex M F Nationality ...................................
Document number: IDcard……………..…………/Passport...................................................................
Current
address..........................................................................................................................................
Postal code ..................................... Town .....................................
Country ............................................
Tel ..+............................................................... e-
mail ...............................................................................
Permanent address (if
ifferent) ....................................................................................................................
Home
university .......................................................................................................................................
Field of study ................................................................. Current year of study:………………………...
Level of studies: Bachelor / Masters / Ph.D.*

Mother language ................................................................................................................................

Language of instruction at home institution (if different than mother language): ............................................

Other I have an international language

English language
languages certificate
I am currently studying proficiency level
knowledge
this language If YES, please add a photocopy

to the application form

yes no B1 B2 C1-C2 yes no

English       

ADDITIONAL PERSONAL DATA

Polish PESEL number Applicant’s Current Education

Please select one of the following answers:
Please select the appropriate answer:

 I do not have  lower than primary (ISCED 0)

 I have - please enter PESEL:  primary (ISCED 1)
 lower secondary education (ISCED 2)
 upper secondary (ISCED 3)
 post-secondary (ISCED 4)
 higher (ISCED 5-8)

Applicant’s status at the time of joining the Project

Please select the appropriate answer:
A person belonging to a national or ethnic minority, No - I don't belong to that group
a migrant, a person of foreign origin I refuse to provide information
Yes - I belong to this group

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 Please select the appropriate answer:
A homeless person or affected by exclusion from access No - I don't belong to that group
to housing I refuse to provide information
Yes - I belong to this group
Please select the appropriate answer:
No - I don't belong to that group
A person with disabilities I refuse to provide information
Yes - I belong to this group
Please select the appropriate answer:
No - I don't belong to that group
A person in a different social disadvantage I refuse to provide information
Yes - I belong to this group

Briefly state the reasons why you wish to participate at the IIC Polish-European School of Law,
organised by the University of Bialystok. (In English. Please use another page if more space is needed.)
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I have the experience in participation at the international projects:  NO  YES
If YES, please describe it
shortly:.......................................................................................................................................................

I hereby acknowledge that I have read and understood the information about Data Protection and
I consent to the processing of my personal data by the University of Bialystok for the needs as
described below.

Place, date.................................................. Applicant's

signature.........................................................

HOME INSTITUTION -………….................................. DISCIPLINE OF STUDIES ..........................

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COUNTRY AND ADDRESS:................................................................................................
Average grade for the previous year of study.....................................
Departmental/faculty coordinator or institutional coordinator (name, telephone, fax, e-mail)
.............................................................................................................................................................
.............................................................................................................................................................
.............................................................................................................................................................
.....................
I hereby certify that the above-mentioned person is a student of our university and the information
provided on this application form is correct.

Date: ......................................................
Signature: ...............................................................................

Official stamp of the

Institution:..............................................................................................................

Information duty resulting from Art. 13 par. 1 and par. 2 of the Regulation (EU) 2016/679 of the European
Parliament and of the Council of 27 April 2016 on the protection of natural persons with regard to the
processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC
(General Data Protection Regulation):
1. Data controller of candidates’ personal data is University of Bialystok, Świerkowa 20B,
15-328 Bialystok, Poland.
2. Data controller has designated Data Protection Officer responsible for the proper processing of
personal data who can be contacted via email: iod@uwb.edu.pl.
3. Personal data will be processed for the purpose of staff and students exchange under the Polish-
European School of Law Intensive International Curriculum and under other agreements concerning
interinstitutional cooperation at the University of Bialystok and for the purpose of contact.
4. A legal basis to process candidates’ personal data is:
Art. 6 par. 1 item a of General Data Protection Regulation, i.e. – explicit, unambiguous and voluntary
consent of a candidate to process his personal data for the needs of the recruitment procedure;
Art. 6 par. 1 item b of General Data Protection Regulation, i.e. - processing is necessary for the performance
of a contract to which the data subject is party or in order to take steps at the request of the data subject
prior to entering into a contract;
Art. 6 par. 1 item c of General Data Protection Regulation, i.e. - processing is necessary for compliance with
a legal obligation to which the controller is subject;
Art. 6 par. 1 item f of General Data Protection Regulation, i.e. - processing is necessary for the purposes of
the legitimate interests pursued by the controller.

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5. Providing personal data is voluntary but necessary to be hosted at University of Bialystok.
6. Data may only be disclosed to your home institution or other external entities in cases envisaged by
the provisions of law.
7. Data will be stored for the period necessary for the purposes of processing, and for the period
required by the Polish-European School of Law Intensive International Curriculum regulations or by
other agreements concerning interinstitutional cooperation regulations.
8. You have the right of access to and rectification or erasure of your personal data as well as restriction
of data processing and portability and objection to data processing and revoke your consent.
9. Whenever data processing infringes the provisions of the law in force, you have the right to lodge a
complaint with supervisory authority.
10. Personal data submitted will neither be processed automatically nor profiled in any way.