Erasmus+ Application Form 2016-17

Outgoing Study / Work Placement Application Form

Please complete this Application Form if you wish to apply for Erasmus+ Grant during your Year Abroad in Europe during the 2016-17 academic year. If you intend to participate on two or more separate study / work placements (minimum of 3 / 2 months respectively), then please complete two separate forms. The deadline for completing this Application Form is Friday 26th February 2016 at 3pm. Please note that once you successfully submit your information you will be taken to a 'thank you' page and so if you DO NOT see this page, then please resubmit your form and then email us so that we can check safe receipt. Please note completion of this form is NOT a guarantee of an Erasmus Grant.

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PLACEMENT DETAILS

Study placement students only:

Study placement students only, please go direct to the Language section

Work placement students - Details of work placement:

All students - Language section:

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You declare that the information you have given in this application is accurate and complete to the best of your knowledge, you understand the obligations of the Erasmus grant and that you will not receive any grant you may be eligible for, or will be required to reimburse UEA, if you fail to provide the required paperwork and you undertake to inform the Erasmus Officer at UEA of any changes to your details during your placement. By submitting this form you are accepting the above terms. Your information will be passed to your School's Erasmus Academic Co-ordinator for approval and your Erasmus grant will not be confirmed until such time.

The University of East Anglia is a registered data controller and will collect and use the information you submit on this form to help select your Erasmus foreign institution or enterprise and to administer your participation in the Erasmus programme. We will, at all times, process your personal data in accordance with the data protection principles within the Data Protection Act 1998. If you are studying at one of UEA's partner university (namely institutions that UEA has an exchange partnership to enable students to undertake their year abroad to students), data may be shared between UEA and the partner university, or host enterprise, in connection with the administration of your course and studies.