Application for exchange students

Contact

First name(s)*:
Last name*:
Gender*:	female male
Date of birth:*		(format: YYYY-MM-DD)
E-mail*:
Mobile phone (home):	+
Mobile phone (CZ):	+	(format: +yyy xxxxxxxxx)

Login:*
Password:*
Password once more:*

Home address

Street:
Town/City:
ZIP code:
Country*:

Study - Masaryk University

Faculty*:
Field of study:
Semester applied*:

Study - other university

If MU is not your home university:
Home university:
Home faculty:
Field of study:
Town/City:
Country:

* Highlighted items are obligatory.

According to the Personal Data Protection Act (law no. 101/2000 Sb.), I hereby confirm that the data mentioned above are complete and correct and I agree with their use by ISC MU Brno during the period of my membership for its internal purpose, especially for communication with its members and for promotion of its activities. I take due note of the possibility to withdraw this agreement in writing.