UNIVERSITE DE REIMS CHAMPAGNE- ARDENNE

Transcription

1 UNIVERSITE DE REIMS CHAMPAGNE- ARDENNE PROGRAMME D ÉCHANGES FORMULAIRE DE CANDIDATURE ÉTUDIANT EXCHANGE PROGRAMME STUDENT APPLICATION FORM ANNEE ACADEMIQUE:.../.. DOMAINE D ETUDES:... ACADEMIC YEAR FIELD OF STUDY IDENTITE DE L ETUDIANT(E) STUDENT S PERSONAL DATA Nom/Family name:... Prénom/First name:... Date de naissance/date of birth:... Sexe/gender: F M Nationalité/nationality:... Numéro de passeport / Passport number:.... Adresse permanente/permanent address: Tel : UNIVERSITE D ORIGINE HOME UNIVERSITY Nom et adresse complète : Name and full address nom, téléphone, télécopie et - name, telephone and fax numbers, Coordinateur de département nom, téléphone, télécopie et Department coordinator name, telephone and fax numbers, SEJOUR A L UNIVERSITE DE REIMS CHAMPAGNE-ARDENNE STUDY PERIOD AT THE UNIVERSITY OF REIMS CHAMPAGNE-ARDENNE Vous souhaitez venir pour un semestre ou une année? Are you applying for one or two semesters? Semestre 1 Semestre 2 Année Semester 1 Semester 2 Year

2 Contrat d études / Details of the proposed study programme abroad Learning agreement Notre offre de formations / Check our training offer: Les étudiants d échanges paient leurs droits d inscription dans l Université d origine / Exchange students pay tuition fees to their home University. ECTS / Crédits à valider pour un semestre : 30 / Requested ECTS / credits to be valided for one semester : 30 ECTS / Crédits à valider pour une année : 60 / Requested ECTS / credits to be valided for one year : 60 UNIVERSITÉ D ORIGINE HOME UNIVERSITY UNIVERSITE D ACCUEIL Discipline Nombre Discipline choisie Nombre prévue Course unit title Crédits ou ECTS Number of Credits/ ECTS Course unit title Crédits ou ECTS à valider Required credits / ECTS Signature de l étudiant / Signature of the student Date: Nous confirmons que ce contrat d études est approuvé. We confirm that this proposed learning agreement is approved.

3 HOME UNIVERSITY Department coordinator Department coordinator Date signature :

4 Modifications du contrat d études proposé / Changes to original proposed learning agreement (à compléter uniquement le cas échéant / to be filled in only if appropriate) UNIVERSITE D ACCUEIL Cours inchangés / Unchanged courses Nombre Crédits ou ECTS à valider Required credits / ECTS Nouveaux cours / New courses Signature de l étudiant / Signature of the student Date : Nous confirmons que les modifications du contrat d études proposées ci-dessus sont approuvés / We confirm that the above-listed changes to the initially agreed learning agreement are approved.

5 HOME UNIVERSITY Departement coordinator Department coordinator Date signature : Compétences linguistiques en français / Skills in French Niveau débutant / Beginner (A1) Niveau intermédiaire / Intermediate level (A2) Niveau avancé / Advanced level (B2) Besoin de cours intensifs en français? Vous pouvez suivre les cours du Centre international d études françaises / In need of French courses? Try our intensive programmes at the Centre international d études françaises Notre site internet / Our website : Déclaration de l étudiant / Student Declaration (please sign below) J accepte que l Université modifie ou révoque toute décision prise sur la foi d informations incorrectes ou incomplètes / I understand that the University may vary or reverse any decision made on the basis of incorrect or incomplete information J accepte que l Université obtienne les relevés de notes de tout établissement fréquenté antérieurement / I understand that the University may obtain official records from any educational institution I have previously attended J accepte de respecter les procédures de sélection et d inscription de l Université de Reims Champagne-Ardenne / I agree to comply with the rules of admission and enrolment of the University of Reims Champagne-Ardenne J accepte de me soumettre au règlement intérieur de l Université d accueil, aux lois et procédures de l État où cette Université est sise / I agree to comply with all the rules and regulations of the host University, and the laws and procedures of the State in which the University is located J accepte d informer immédiatement l Université de Reims Champagne-Ardenne de toute modification apportée à ma candidature / I agree to inform the University of Reims

6 Champagne-Ardenne immediately if there is any change to the information I have given in this application Je suis pleinement conscient que tous les frais personnels liés au séjour d études sont à ma charge (hébergement, restauration, transport, livres, santé) / I understand that I am fully responsible for all my living and personal expenses, including transportation, text books and health insurance while I am studying at the University of Reims Champagne-Ardenne J accepte les termes et conditions de cette candidature / I agree to be bound by the terms and conditions stated on this form Je déclare que toutes les informations délivrées dans ce dossier sont exactes et sincères / I declare that all the information I have given is true and correct J accepte de communiquer mon mèl et mon n de téléphone portés dans ce dossier de candidature à tout autre étudiant d échange aux fins de constituer un réseau d entraide et de partage d informations / I agree to allow my contact details ( and phone number) specified on page 1 of this form to be released to other exchange students to aid networking and the sharing of exchange related information : OUI NON YES NO Je joins les pièces suivantes à mon dossier de candidature / I have attached the following documents in support of my application - Lettre de motivation / motivation letter - Lettre de recommandation du directeur de département / Letter of support from department director - Copie du passeport / Copy of passport - 2 photos - Relevé de notes (en français ou en anglais) / Certified copies of academic transcripts in French or English - Attestation de langue / A copy of French tests Signature : Date : L examen du dossier de candidature sera retardé s il est incomplet / Failure to provide all necessary information and documentation will result in delays in considering your application. Date limite de candidature / Closing dates for application 30 mars 2010 Dossier à envoyer / This application and attachments should be forwarded to : Adresse postale / Postal address : Service des relations internationales, 9 boulevard de la Paix, REIMS cedex

7 EXPERIENCE THE U.R.C.A.! THE URCA, A VARIETY OF DISCIPLINES IN A HUMAN SIZE CAMPUS LIFE Our multidisciplinary university offers 5 ranges of study areas: Art, Languages, Philosophy, Psychology, Geography, History Law, Economics, Management, social and political Sciences, public Administration Health sector: Medicine, Pharmacy, Odontology, paramedical Sport: Sciences and Techniques of Sport (STAPS) Sciences and Technology: Mathematics, Computer Science, Physics, Chemistry, Electronics, Mechanics, civil Engineering, Biology, Biochemistry, Oenology, Biotechnology, Geology, etc. Only multidisciplinary University in the region, our institution is recognized by local authorities for its active role in the regional development. AN ATTENTION TO EACH AND EVERY STUDENT As a medium size University, the URCA is close to its students, future students and staff and strives to be as attentive as possible to their needs. Reims can boast its good quality of life, which is a highlight of our university. Together with the wide range of training offer, the campus life is very active, with numerous association and cultural events. Key figures Sections: the University is divided in 8 Faculties, 2 University Institutes of Technology (IUT), 1 postgraduate School of Packaging Engineering, 1 Institute providing higher technical training, 1 Training Center for Secondary Education ; 2 Doctoral Schools (Humanities and Society Studies, Sciences, Technology, Health) Number of students: students Diplomas: our training scheme has implemented the LMD system and offers 19 Bachelor Degrees, 37 Professional Bachelor Degree, 14 Masters with 51 specialities, 17 Technological Degrees (DUT), 2 Engineering Degrees, 3 Academic Degrees for Medical Doctors, 1 Midwifery Degree, 1 ERASMUS MUNDUS (Training of Trainers), 1 Oenology Degree. Research: 36 Research teams working in 5 Research Centers International Relations Open and very active, our university is constantly developing its international network and influence with worldwide and dynamic partners: International mobility of students and teachers: Erasmus Programme (around 265 bilateral agreements signed with 145 Universities of the 31 eligible States), Canada (CREPUQ), Australia, Russia, Taïwan, Peru, Mexico, Brazil, Argentina. Research programmes: Tempus, PCRDT, AUF, co-tutelles of thesis, etc. How to contact the International Relations Office: Université de Reims Champagne-Ardenne Villa Douce - 9 boulevard de la Paix Reims Cedex Dr Laure CASTIN Head of International Relations Tel / laure.castin@univ-reims.fr Priscilla EBAKA In charge of incoming students Tel / priscilla.ebaka@univ-reims.fr