Information Form for Exchanges:
| Name: | _____________________________ | ||
| Affiliaton: | _____________________________________ | ||
| Address: | _____________________________________ | ||
| City: | _______________ | ZIP: | _________ |
| Country: | ______________________ | ||
| Tel: | ________________ | Fax: | ________________ |
| Email: | _______________________________ | URL: | _______________________________ |
| Facilities you can provide freely: |
O Accomodation O Meals O Travel Tickets |
O Local Transportations O Courses O Other: __________ |
| Could you Provide | O Sponsorship | O Grants |
| Best Stage/Module Duration: |
O 2 weeks O 3 weeks O 1 Month O 2 Month2 |
O 3 Months O 6 Months O 1 Year O Other: _______ |
| Languages: |
O Italian O English O Mandarin |
O French O Spanish O Other:_________ |
| Are you interested in exchanging Teachers/Professors | O Yes | O No |
| Are you interested in exchanging Students | O Yes | O No |
| How many teachers could you host ? | ____________ |
| How many teachers could you send ? | ____________ |
| How many students could you host ? | ____________ |
| How many students could you send ? | ____________ |
| What kind of students would you like to receive? |
O BS O Master O PhD |
| What kind of students are you sending ? |
O BS O Master O PhD |
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