Ver/Abrir - Biblioteca Digital do IPG - Instituto Politécnico da Guarda
Ver/Abrir - Biblioteca Digital do IPG - Instituto Politécnico da Guarda
Ver/Abrir - Biblioteca Digital do IPG - Instituto Politécnico da Guarda
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STUDENT FORMFicha de InscriçãoFile nº: _________/___________(Registration number – Year)Processo nº:___________/______(nº de Registo – ano)PhotoFotografiaPERSONAL DATA / DADOS PESSOAISGender /Sexo: M F ID Number/Nº <strong>do</strong> BI: ________________Birth Date/Data de Nascimento : _____________________ Telephone/Telefone:__________________Address/ Mora<strong>da</strong>:_________________________________________________________________________________________________________________________________________________________Zip Code/ Código Postal: _______________________________________________________________Country/ País: ________________________________________________________________________INSTITUCIONAL INFORMATION/ INFORMAÇÕES INSTITUCIONAISHome Institution/Universi<strong>da</strong>de de Origem:__________________________________________________School/Facul<strong>da</strong>de:_____________________________________________________________________Course/ Curso:_________________________________________________________________________Institutional Coordinator/Coodena<strong>do</strong>r Institucional:___________________________________________Contact/ Contacto:__________________________________ Email:_____________________________HOST SCHOOL/ESCOLA DE ACOLHIMENTOHost School/ Escola de Acolhimento:______________________________________________________Academic Year/Ano Lectivo:____________________________________________________________Course/Curso:________________________________________________________________________Study Period/ Perío<strong>do</strong> de Estu<strong>do</strong>s: ___________ months/mesesFrom/De:______ To/A:______Address and contact during Erasmus Period/ Mora<strong>da</strong> e contacto em perío<strong>do</strong> Erasmus:__________________________________________________________________________________________________Telephone/Telefone:___________________________________________________________________Arrival <strong>da</strong>te/ Data de Chega<strong>da</strong>:__________________________________________________________