Erasmus+ Office

Avram Iancu street, no. 68

Tel.: 0264-42.97.62
cci@ubbcluj.ro
www.cci.ubbcluj.ro
Cluj-Napoca, RO-400083

STUDENT ACCOMMODATION REQUEST FORM

Academic year 2016/2017

This application should be completed in CAPITAL LETTERS.

Please send the Accommodation Request Form by mail, no later than the deadline indicated
below.

Do not modify the form; just fill in the requested information!

All fields compulsory!

STATUS

Erasmus+ EU Erasmus+ non-UE Erasmus Mundus

PERSONAL DATA

Name:______________________________________________________________________________________
____________________________

Date of birth: ________________________________ Citizenship

_________________________________ Sex:___________

Permanent Address:
_____________________________________________________________________________________________
_____

_____________________________________________________________________________________________
_____________________________

Phone number (with international code):

__________________________________________________________________________

E-mail address:
_____________________________________________________________________________________________
___________

CURRENT ENROLMENT HOME UNIVERSITY

 Erasmus+ Office
Avram Iancu street, no. 68
Tel.: 0264-42.97.62
cci@ubbcluj.ro
www.cci.ubbcluj.ro
Cluj-Napoca, RO-400083

Name of institution:
_____________________________________________________________________________________________
_____

Country: ____________________________________________ City:

____________________________________________________________

Phone: _______________________________________________E-mail:
_________________________________________________________

PERIOD OF STAY

_____________________________________________________________________________________________
_____________________________

DEADLINE FOR SENDING THE ACCOMMODATION REQUEST FORM

1. Academic year 2016/2017:.....

July 15, 2016
2. Academic year 2016/2017 first semester: ..
.. July 15, 2016
3. Academic year 2016/2017 second semester: .....
November 15, 2016

NOTES

(These are some indications, please read and respect the accommodation
contract!)

If you have a disability that requires special accommodation, please

advise us immediately and we will assist you in working with the host
institution to determine how such accommodation can be arranged.
You are requested to respect the deadlines, since there are many
students applying.
No pets are allowed in any area of the dormitory.
 Erasmus+ Office
Avram Iancu street, no. 68
Tel.: 0264-42.97.62
cci@ubbcluj.ro
www.cci.ubbcluj.ro
Cluj-Napoca, RO-400083

We do not offer single rooms or mixed rooms.

You cannot change your room or dormitory once it has been assigned to you
upon arrival.
You cannot ask for a prolongation of stay from the first semester to one
year.
You cannot move into the dormitory after the start of your mobility. Once
you quit the dormitory, you cannot ask to be accommodated again at a later
time.

Your keeping the commitment would be a great help for the Center and
for all the others students who need accommodation.

Date: Signature: