ACCOMMODATION FORM 20__/20__

To be filled in electronically
Family name: First name:

Gender: F M

Date of birth (dd/mm/yy):

Place of birth:

Nationality:

Passport/ID card number and date of expiry:

Phone: E-mail:

Home institution:

Host institution
(Faculty at the University of Split):

Arrival date: Departure date:

Dorm:  Hostel Spinut  Campus  Any

(tick appropriate)
Preferences:
Room to share with:
(if yes state student’s full name and if spouse or brother/sister a
valid confirmation is to be attached)

YES  €/month:
Do you have an ERASMUS+ mobility grant?
NO 

YES  €/month:
Do you have any national grants or
scholarship?
NO 

Do you have a severe disability? If yes, describe your need special requirements.

Date: Signature:

NOTE:
Accommodation Form has to be sent to erasmus@unist.hr or by fax to +385 21 440 344
by June 01 for the winter semester and whole academic year and by November 01 for the summer semester.
By submitting this application form, all applicants agree that the University of Split publishes their personal data on their web page
within the selection procedures.