Global Learning Application Form
Fill out the form carefully and send it with the required attachments.
University you apply to
*
Université libre de Bruxelles
Prince of Songkla University
KU Leuven
Udayana University
Pannasastra University
(full names for all four universities)
Type of program you apply to
*
Short summer/winter program
Semester program
Study semester(s) you apply to
*
Autumn
Spring
Autumn & Spring
Spring & 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. 2016 or 2016-2017)
*
English language proficiency
native speaker
near native/fluent
excellent command
very good command
good command
basic communication skills
Please choose the option that best describes your command of spoken and written English language
PERSONAL INFORMATION
Your Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Female
Male
E-mail address
*
Confirmation Email
example@example.com
Phone Number
*
-
Country Code
-
Area Code
Phone Number
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nationality
*
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Arctic Ocean
Argentina
Armenia
Aruba
Ashmore and Cartier Islands
Atlantic Ocean
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Baker Island
Bangladesh
Barbados
Bassas da India
Belarus
Belgian Congo
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Borneo
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Guiana
British Virgin Islands
Brunei
Bulgaria
Burkina Faso
Burma
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Clipperton Island
Cocos Islands
Colombia
Comoros
Cook Islands
Coral Sea Islands
Costa Rica
Cote d’Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Czechoslovakia
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Europa Island
Falkland Islands (Islas Malvinas)
Faroe Islands
Fiji
Finland
Former Yugoslav Republic of Macedonia
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Gaza Strip
Georgia
Germany
Ghana
Gibraltar
Glorioso Islands
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong
Howland Island
Hungary
Iceland
India
Indian Ocean
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Jan Mayen
Japan
Jarvis Island
Jersey
Johnston Atoll
Jordan
Juan de Nova Island
Kazakhstan
Kenya
Kerguelen Archipelago
Kingman Reef
Kiribati
Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mediterranean Sea
Mexico
Micronesia
Midway Islands
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Navassa Island
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
North Sea
Northern Mariana Islands
Norway
Oman
Pacific Ocean
Pakistan
Palau
Palmyra Atoll
Panama
Papua New Guinea
Paracel Islands
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Reunion
Romania
Ross Sea
Russia
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro
Seychelles
Siam
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Korea
Southern Ocean
Spain
Spratly Islands
Sri Lanka
Sudan
Suriname
Svalbard
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Tasman Sea
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tromelin Island
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
USA
USSR
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands
Wake Island
Wallis and Futuna
West Bank
Western Sahara
Yemen
Yugoslavia
Zaire
Zambia
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
example@example.com
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
*
First Name
Last Name
Contact's phone
*
-
Country Code
-
Area Code
Phone Number
Contact's e-mail
*
Confirmation Email
example@example.com
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 advisor
Email from student organization
Friend or another fellow student told me about it
University's website
Search engine (e.g. Google)
Facebook
Other social media
Printed advertisement
Other
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 aleader?
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
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or a copy of a document that verifies your eligibility for universitylevel studies, if you are not currently a university student (max. 3 MB)
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2) Copy of the first page (identification page) of your passport
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(max. 1 MB)
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3) A color photo
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4x3 cm, without glasses, ears visible (max. 1 MB)
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4) Signature page
5) Any additional attachment
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(max. 5 MB)
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