Student Exchange Form 2020/2021

This Form is for UMY Student who want to apply Exchange Program.

Name*
First Last
NIM*
Department*
Faculty*
Host University*

Your university destination
Host Country*

Your country destination
Date of Birth*
DD slash MM slash YYYY
Gender*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Passport Number*
Date of Issue*
MM slash DD slash YYYY
Expired Date of Issue*
MM slash DD slash YYYY
Issued Country*
Email*
Phone*
Application Form (If you apply to UUM)
Max. file size: 3 MB.
English Proficiency
TOEFL
Max. file size: 3 MB.
GPA*
Academic Transcript in English*
Max. file size: 3 MB.
Recomendation Letter from your department*
Max. file size: 3 MB.
Motivation Letter*
Max. file size: 3 MB.
Max 250 words
Curriculum Vitae*
Max. file size: 3 MB.
Passport Biodata Page Only*
Max. file size: 3 MB.
Photo 3x4*
Max. file size: 3 MB.
Last taken within 6 months