Online | Summer School of Preventive Medicine

Online format

(open to students from Polish universities and universities abroad)

First name:

Last name:

Gender:

Female

Male

Other...

Date of birth:

Name of the University:

University address:

Faculty (optional):

[Name of faculty, if applicable]

Level of education

1st year of undergraduate studies

2nd year of undergraduate studies

3rd year of undergraduate studies

Second-cycle (Master’s) studies

1st year (or later) of unified Master’s studies

Index number

[Your index/student number]

Home address

City/Town

ZIP/Postal Code

Country

E-mail address:

Phone number:

[Your phone number with country code]

Foreign language skills

I confirm that I have knowledge of the English language at the language proficiency level of at least B2.

Source of information about the SPINAKER programme in the frames of NAWA

NAWA website

Faculty website

Information received by email

Friends / Colleagues

Other [Specify]:

Confirmation of student status

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Limit 10 MB.
Dozwolone rozszerzenia: pdf, doc, docx.

English language certificate or an equivalent document e.g. certificate issued by your language school, proof of passing an English course at your University

Tylko jeden plik.
Limit 10 MB.
Dozwolone rozszerzenia: pdf, doc, docx.

PARTICIPATION DECLARATION FOR THE SPINAKER PROGRAMME (Annex No. 1)

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Limit 10 MB.
Dozwolone rozszerzenia: pdf, doc, docx.

INFORMATION CLAUSE REGARDING THE PROCESSING OF PERSONAL DATA (Annex No. 2)

Tylko jeden plik.
Limit 10 MB.
Dozwolone rozszerzenia: pdf, doc, docx.