DAUGAVPILS UNIVERSITY APPLICATION FORM

For studies of foreigners at Daugavpils University in the framework of inter-universities exchange programmes
Please fill in the form on the computer or with block letters
Study programme you are applying to

The list of documents to be added to the application form:

1. Scanned passport.

2. 2 photos, sized 3 cm x 4 cm

3. Approval letter from home university.

The application form and documents are to be submitted to your local representative or:

both by e-mail and mail

International and Public Relations Office
Daugavpils University
Vienibas street 13-215a
Daugavpils, LV-5401
Latvia

For inquiries:

Phone: +371 654 25564

PERSONAL DATA / PERSONAS DATI
Name / Vārds *

First name(s) / Vārds Family name / Uzvārds
Gender / Dzimums *
Date of birth (dd.mm.yyyy) / Dzimšanas datums *
Place of birth (city, country) / Dzimšanas vieta *
Citizenship / Pilsonība *
Nationality / Tautība *
Passport No. / Pases Nr. *
Date of issue / Izdošanas datums *

Day Month Year
Date of expiry / Derīguma termiņš *

Day Month Year
PERMANENT ADDRESS / PASTĀVĪGĀ DZĪVESVIETAS ADRESE
No., Street / Nr., iela *
City/Town / Pilsēta *
Postal code / Pasta indekss *
Country / Valsts *
Phone / Tālrunis *
E-mail / E-pasts *
REGISTERED ADDRESS OF LIVING (if different) / REĢISTRĒTĀ DZĪVESVIETAS ADRESE (JA ATŠĶIRĪGA)
No., Street / Nr., iela
City/Town / Pilsēta
Postal code / Pasta indekss
Country / Valsts
PERSON TO NOTIFY IN CASE OF EMERGENCY / PERSONA, AR KURU SAZINĀTIES ĀRKĀRTAS GADĪJUMOS
Name *

Name /Vārds Family name / Uzvārds
Relationship: (e.g. mother) / Radniecība *
Phone / Tālrunis *
Address (No., Street, City, Postal Code, Country) / Adrese *
E-mail / E-pasts *
HOME UNIVERSITY / MĀJAS UNIVERSITĀTE
Name of university / Universitātes nosaukums *
Location / address / Adrese *
Study programme / field / Studiju programma / joma *
Degree to be obtained / Iegūstamais grāds *
Planned date of graduation / Plānotais absolvēšanas laiks *
LANGUAGE KNOWLEDGE / VALODU ZINĀŠANAS

	Beginner / Iesācēja l.	Intermediate / Vidējs l.	Advanced / Augstākais l.	Mother tongue / Dzimtā valoda	Certificate/Level (if applies) / Sertifikāts/līmenis (ja piemērojams)
English
French
Russian
Turkish

ACOMMODATION / DZĪVESVIETA
I will arrange my own placement / Pats/-i organizēs sev dzīvesvietu
DECLARATION *

With my signature I confirm that I have given complete and accurate answers to all the questions in this application form. I certify that my English knowledge is sufficient to follow the lectures in English. I understand that any omission or misinformation may render my admission void or result in dismissal.
Date: (dd.mm.yyyy) / Datums

Day Month Year
Signature of the applicant / Paraksts
Should be Empty:

PERSONAL DATA / PERSONAS DATI