STUDENT DETAILS. Surname: Student ID (UWA): Student ID ([Partner institution]) Given Names: Title (Dr/Mr/Ms/Mrs): Title of research topic: UWA supervisors: Names and Qualifications of the proposed supervisors at the partner institution: Please attach CVs.
STUDENT DETAILS. New Student Returning Student Student No.
STUDENT DETAILS. Full name & Surname: Date of Birth: Cell Number: Form: House: Highest practical examination(s) passed: Instrument 1: Grade: Institution:
STUDENT DETAILS day(s) prior to the workshop The minimum # of students per Workshop is , and the maximum # of students is . I, the Instructor, will provide tools or supplies for purchase by students No I, the Instructor, will only sell tools and supplies in the workshop if it is noted above. (if YES, attach a detailed description, cost information, and whether the tools are optional)
STUDENT DETAILS. Full Name: UC Student ID Number: Date of enrolment (dd/mm/yy): Department/School/Centre: Course Code (e.g., HIST790): Name of any scholarships held: Enrolment Status Full-time Part-time Thesis Working Title
STUDENT DETAILS. Student Name: Present Address: Telephone (Home): (Work): (Mobile): Date of Birth: / / 19 E-mail: TERMS & CONDITIONS* * Must be read in conjunction with Teach International’s usual Terms and Conditions for all courses.
STUDENT DETAILS. Last name : .............................................................. First name :........................................................................... Date of birth : ........................................................... Nationality : ........................................................................... EHL e-mail: .............................................................. Private e-mail:....................................................................... Mobile phone (with country code) : .......................................................................................................................................... Programme : ☐ AP ☐ BOSC Your departure ☐ I confirm and understand that my Swiss residence permit ( B, C, L permit) will be cancelled if I leave Switzerland for my internship. In case I live out of EHL campus, I will have to communicate my departure and/or change of address to the Swiss authorities, in the town I live in. When back from internship, I will declare my arrival to the Swiss authorities in the town I choose to live in. Should I need a Visa to re-enter Switzerland for study purpose, I have to start my Permanent address application at least 3 months before the start date of my retakes / intake. In order to facilitate this process, Service Centre can provide me with the necessary documents. ☐ My internship is in Switzerland, I understood the above information and will inform Swiss authorities of my changes of address. ☐ Not concerned Address : .................................................................. ZIP code : ............................................................................. Town : ...................................................................... Country : ............................................................................... Emergency contact Last name : .............................................................. First name :........................................................................... Relation to intern :.................................................... Tel. (with country code) :................................................................... E-mail : ..................................................................... Health/accident insurance ☐ I am insured through EHL package : Allianz Policy number : ................................................................................................... ☐ I am covered by my own insuranc...
STUDENT DETAILS. Last name :............................................................... First name :........................................................................... Date of birth : .......................................................... Nationality : .......................................................................... EHL e-mail:............................................................... Private e-mail: ...................................................................... Mobile phone (with country code) :........................................................................................................................................ Permanent address Address : .................................................................. ZIP code : .............................................................................. Town : ...................................................................... Country :............................................................................... Emergency contact Last name :............................................................... First name :........................................................................... Relation to student .................................................. Tel. (with country code) : ................................................................. E-mail : ..................................................................... Health/accident insurance Name of insurance:...................................................................................................................................................... Card number or policy number : .................................................................................................................................
STUDENT DETAILS. Surname: Given Names: Date of Birth: Phone: Emergency Contact (name & Phone):
