Application for a BIP at a university abroad

Please complete the application form below to apply for your participation in a BIP (Blended Intensive Programme) at a university abroad. We look forward to receiving your application.

Fields marked with an asterisk are mandatory fields.

Application data

Application for the following BIP

Have you already been nominated for the BIP by your university?

Yes.

No.

Please briefly explain your motivation for participating in this BIP.

What existing knowledge/experience do you have in this field?

Personal data

First name

Last name

Gender

Date of birth (DD.MM.YYYY)

Nationality

Email address

Repeat email address to verify

Current home address / mobile number

Street and house number

Postal code

City

Country

Mobile number (incl. country code, for example +41)

Emergency contact

First name of your emergency contact

Last name of your emergency contact

How are you related to the emergency contact (e.g. mother, father, partner)?

Email address

Phone number

Home address

Information about your studies

At what level are you studying?

Matriculation/student number

Name of your study programme

In which semester are you currently studying? (e.g. 3rd semester out of 6)

Additional information

Is your host university, where the BIP is taking place, a partner of the EELISA alliance?

Yes.

No.

Not sure.

Is there anything you would like to share with us regarding your application?

Completion of application

I confirm

that before my departure, I will ensure with my insurance provider that my insurance coverage is sufficient during my stay abroad (accident and health insurance, liability insurance).

I confirm

that I have made all statements truthfully.

Data protection at ZHAW: See data protection notice https://www.zhaw.ch/en/data-protection

I confirm

that I have taken note of the data protection information.