MASARYKOVA UNIVERZITA

OFFICE FOR INTERNATIONAL STUDIES

Application for extension of Erasmus stay from the autumn to the spring
semester of the academic year 2009/2010
(! Please note that it is not possible to extend the Erasmus stay from the spring to the autumn semester!)

Hereby, I ... from

(name of student)

(name of home university)

apply for an extension of my exchange period abroad. I am currently studying at the Masaryk
University (Brno, Czech Republic) within the Erasmus exchange programme.
Original exchange period (autumn semester):
........ ( months)
New exchange period (spring semester):
( months)

From . /. / ........ until . / . /

From . / . / ........ until . / . / .......

..
Date, Signature (of the student)

Name of HOST UNIVERSITY :

Departmental Coordinator:
Department/Faculty:
..

Masaryk university
..........................................................................
........................................................................

..
Date, Signature (of the departmental co-ordinator)
Erasmus Coordinator:
Marcela Dibelkov
The Institution agrees
Yes
No
Phone:
+ 420 549 49 3264

Fax:

+ 420 549 49 1113

..
Date, Signature, Stamp (of the receiving institution)

Departmental Coordinator:

Name of the HOME UNIVERSITY:

..........................................................................
..........................................................................
Erasmus Coordinator:
..........................................................................
The Institution agrees
Yes
No
Phone:
Fax:

..
Date, Signature, Stamp (of the sending institution)