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ACADEMIC YEAR 2013/2014

REQUEST FOR ACCOMMODATION IN THE A.DI.S.U. HALLS OF RESIDENCE


Please print in block letters

Surname: ______________________________________________________________________________________
First Name: __________________________________________________________ Sex: _____________________
Current Address: ________________________________________________________________________________
Mobile: ______________________________________________________________________________________________________________
E-mail address: ______________________________________________________________________________________________________
Home University: ___________________________________________________________________________________________________
(example: Universitatea Politechnica din Bucuresti)

Date of Arrival in Perugia:

_______________________________Date

of Departure from Perugia: _____________________

Students Italian faculty in Perugia: __________________________________________________________________________________


Period of study in Perugia:

all year

1st semester

2nd semester

Student Signature: ____________________________________________________________________________________________________


Date: _______________________

Please complete and return by post on or before July 15th, 2013 for the 1st Semester and for the full
year and December 15th, 2013 for the 2nd Semester, together with Student Application and Learning
Agreement forms to the following:
Universit degli Studi di Perugia
Incoming Student Mobility Office
Piazza dellUniversit, 1
06123 Perugia
Italy
e-mail:studenti.incoming@unipg.it

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