Global Learning Application Form Fill out the form carefully and send it with the required attachments. University you apply to (*) Université libre de BruxellesPrince of Songkla UniversityKU LeuvenUdayana UniversityPannasastra University Type of program you apply to (*) Short summer/winter programSemester program Study semester(s) you apply to (*) AutumnSpringAutumn & SpringSpring & Autumn Choose one of the options depending on the semester(s) you will bestudying at the selected university. Study abroad year(s) you apply to (e.g. 2019 or 2019-2020) (*) English language proficiency native speakernear native/fluentexcellent commandvery good commandgood commandbasic communication skills PERSONAL INFORMATION Full Name (*) Date of Birth (*) Gender (*) MaleFemale E-mail address (*) Phone Number (*) Address (*) Nationality (*) AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArctic OceanArgentinaArmeniaArubaAshmore and Cartier IslandsAtlantic OceanAustraliaAustriaAzerbaijanBahamasBahrainBaker IslandBangladeshBarbadosBassas da IndiaBelarusBelgian CongoBelgiumBelizeBeninBermudaBhutanBoliviaBorneoBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish GuianaBritish Virgin IslandsBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandClipperton IslandCocos IslandsColombiaComorosCook IslandsCoral Sea IslandsCosta RicaCote d’IvoireCroatiaCubaCyprusCzech RepublicCzechoslovakiaDemocratic Republic of the CongoDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaEuropa IslandFalkland Islands (Islas Malvinas)Faroe IslandsFijiFinlandFormer Yugoslav Republic of MacedoniaFranceFrench GuianaFrench PolynesiaFrench Southern and Antarctic LandsGabonGambiaGaza StripGeorgiaGermanyGhanaGibraltarGlorioso IslandsGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHowland IslandHungaryIcelandIndiaIndian OceanIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJan MayenJapanJarvis IslandJerseyJohnston AtollJordanJuan de Nova IslandKazakhstanKenyaKerguelen ArchipelagoKingman ReefKiribatiKoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMediterranean SeaMexicoMicronesiaMidway IslandsMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNavassa IslandNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth SeaNorthern Mariana IslandsNorwayOmanPacific OceanPakistanPalauPalmyra AtollPanamaPapua New GuineaParacel IslandsParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRepublic of the CongoReunionRomaniaRoss SeaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSerbia and MontenegroSeychellesSiamSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouthern OceanSpainSpratly IslandsSri LankaSudanSurinameSvalbardSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaTasman SeaThailandTogoTokelauTongaTrinidad and TobagoTromelin IslandTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUSAUSSRUzbekistanVanuatuVenezuelaViet NamVirgin IslandsWake IslandWallis and FutunaWest BankWestern SaharaYemenYugoslaviaZaireZambia Passport Number (*) CURRENT HOME INSTITUTION (if applicable) Institution name (*) Please use the official English name if available Department/faculty you are studying in Contact (eg. study abroad advisor) Your contact person at your home university for studying abroad. University contact person's email Your study year PREVIOUS EDUCATIONAL BACKGROUND School, degree/major subject (*) WORK EXPERIENCE Employer, position/job description (if applicable) CONTACT PERSON AT HOME Full name of contact person (*) Contact's phone (*) Contact's e-mail (*) Relationship to you (*) (e.g. mother or father) INFORMATION FOR GLOBAL LEADERS Where did you hear about Global Learning and the study program you are applying for? From a university lecturer or a study abroad advisorEmail from student organizationFriend or another fellow student told me about itUniversity's websiteSearch engine (e.g. Google)FacebookOther social mediaPrinted advertisement (e.g. mother or father) We would very much appreciate if you could be more specific how you found out about Global Learning and the study program you are interested in. Please tell us how will this Study Abroad Program shape you as a leader? Please tell us why you have chosen this study destination? REQUIRED ATTACHMENTS Instructions for the attachments Please upload the below mentioned documents to your application as attachments. The documents could be scanned and saved to the applicant's computer or you can also take a digital picture of the required document. Try to keep the file sizes of your attachments minimal, whenever possible (max. few megabytes per attachment), and preferably send them in PDF format. If you are unable to send the attachments at the same time as the application, you can send the required attachments to us later by emailing them to info@studyabroadalliance.com 1) Transcript of records from your university in English (max. 500kb) 2) Copy of the first page (identification page) of your passport (max. 500kb) 3) A color photo (max. 500kb) 4) Any additional attachment (max. 2 MB)
