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					                                      Application file for admission
                                                              for
                                                   Double-Degree
                                                   Erasmus Exchange
                                                   Visiting student




        Paris site                                                                        Passport size

        Eurecom site                                                                          photo


Study Period:               Semester1                  Semester2 




Personal details (Please write in block letters)



Title: Ms.       Miss  Mr


Last or Family Name:


First or Given Name(s):


Gender:  Female                     Male


Date of Birth:


Nationality:


Permanent postal Address:
(your admission notification will be sent to this address)


_______________________________________________________________________________________


Phone number:


Email address:


Name of your home University:




                         TELECOM ParisTech – Direction des Relations Internationales

     46, rue Barrault – 75634 Paris Cedex 13 France – + 33 (0)1 45 81 77 12 – Fax + 33 (0)1 45 88 11 14
                                   Email : international@telecom-paristech.fr
                                 Application Checklist



Complete the application form and submit it through your home university’s coordinator
for Double Degree Programme to the following address:

TELECOM ParisTech
Att’n: Ana Balavoine – Direction des Relations Internationales
46, rue Barrault - 75634 Paris Cedex 13 - FRANCE
: + 33 (0)1 45 81 77 12 Fax : + 33 (0)1 45 88 11 14
e-mail : ana.balavoine@telecom-paristech.fr

All applications must reach TELECOM ParisTech by the following deadlines:


      Before May 16, 2012 (for September intake)

      Before November 16, 2012 (for February intake) only for exchange students




Please remember to include the following documents in your application:



 Application Form (+ Learning Agreement for Eramus students)

 Resume

 Letters of recommendation

 Passport-size photograph

 One copy of the identity card or your passport (in legal validity)

 Certified true copy of your transcripts (English or French version)

 2 unstamped envelopes (size 16x23) with your right personal address




Important Note:

The students outside the European Community cannot come to the school if they are not in order with
the French authorities. For more information, please read this link:
http://www.telecom-paristech.fr/eng/practical-information/before-you-leave.html




                       TELECOM ParisTech – Direction des Relations Internationales

    46, rue Barrault – 75634 Paris Cedex 13 France – + 33 (0)1 45 81 77 12 – Fax + 33 (0)1 45 88 11 14
                                  Email : international@telecom-paristech.fr
Post secondary school studies:

  Dates               Institutions              Degrees, certificates       Distinction          Administration

2011/2012



2010/2011



2009/2010



2008/2009



2007/2008




Languages:
If you passed any language test please send us your score report:


Francophone                        Yes           No

Could you evaluate your level if you have not taken a French language test:


      French                 Beginner                  Low              Intermediate                Advanced
                                                    intermediate
                             A1      A2                  B1                      B2                      B2+




     English                Beginner           Low intermediate          Intermediate               Advanced
                                                       B1
                            A1       A2                                          B2                      B2+

If you have taken an English test (TOEFL, TOEIC etc.) please indicate your score and send us
your score report:



I certify that the statements made by me on this form are correct:




            (Date)                                                            (Student’s signature)




                       TELECOM ParisTech – Direction des Relations Internationales

    46, rue Barrault – 75634 Paris Cedex 13 France – + 33 (0)1 45 81 77 12 – Fax + 33 (0)1 45 88 11 14
                                  Email : international@telecom-paristech.fr
                                  HOUSING IN PARIS

Our students’house called «Maisel » (Maisons des Elèves de TELECOM ParisTech)
offers 527 beds in our quarter in Paris city available on
http://www.telecom-paristech.fr/eng/life-at-telecom-paristech/accommodation.html
(English version)
and : http://www.telecom-paristech.fr/vivre-ecole/logement.html for French version.


Individual requests from Telecom ParisTech students who do not meet the accommodation
priority criteria may still apply to Maisel. Places will be allocated if and when they become
available.

                                   HOUSING IN NICE
Please consult this link:

http://www.eurecom.fr/studentlife/studentguide/housing.en.htm (English version)




                       TELECOM ParisTech – Direction des Relations Internationales

    46, rue Barrault – 75634 Paris Cedex 13 France – + 33 (0)1 45 81 77 12 – Fax + 33 (0)1 45 88 11 14
                                  Email : international@telecom-paristech.fr
                                   ECTS – EUROPEAN CREDIT TRANSFER SYSTEM
                                          LEARNING AGREEMENT

Academic year 2012 – 2013                               FIELD OF STUDY: …......................……………………..


Name of student:…………………………………………………………………………………………………………………………………………………

Sending institution:............................................................................................................................

Country:………………………………………………………………………………………………………………………………………………………………..


             DETAILS OF THE PROPOSED STUDY PROGRAMME ABROAD/LEARNING AGREEMENT


Receiving institution:….. …………………………………………………………………………………...............................................

Country:………………………………. ………………………………...................................................................................


Course unit code (if any) and page                  Course unit title (as indicated in the                     Number of ECTS credits
 No, of the information package                           information package)

……………………………………………                                 ………………………………………………                                    ……………………………………………
…………………………………………..                                ………………………………………..                                     ……………………………………………
…………………………………………..                                …………………………………………..                                    …………………………………………..
…………………………………………..                                …………………………………………..                                    …………………………………………..
…………………………………………..                                …………………………………………..                                    …………………………………………..
…………………………………………..                                …………………………………………..                                    …………………………………………..
…………………………………………..                                …………………………………………..                                    …………………………………………..
…………………………………………..                                …………………………………………..                                    …………………………………………..
…………………………………………..                                …………………………………………..                                    …………………………………………..
…………………………………………..                                …………………………………………..                                    …………………………………………..

If necessary, continue the list on a separate sheet

Double Degree student
In the program for double degree student, all studies and internship must be carried out in the country of
destination

Student’s signature

                                                                                         Date:


RECEIVING INSTITUTION

We confirm that the proposal programme of study/learning agreement is approved.

Head of studies’ signature                                            Director for International Relations’ signature
Dominique KREMMER                                                     Jean-François NAVINER


Date:                                                                 Date:


SENDING INSTITUTION

We confirm that the proposal programme of study/learning agreement is approved.

Departmental coordinator’s signature                                  International coordinator’s signature


Date:                                                                 Date:


                                 TELECOM ParisTech – Direction des Relations Internationales

       46, rue Barrault – 75634 Paris Cedex 13 France – + 33 (0)1 45 81 77 12 – Fax + 33 (0)1 45 88 11 14
                                     Email : international@telecom-paristech.fr
                      CHANGES TO ORIGINAL PROPOSED STUDY
                        PROGRAMME/LEARNING AGREEMENT
                                       (to be filled in ONLY if appropriate)


Course unit code (if any)     Course unit title (as       Delete                Added          Number of
and page number of the          indicated in the          course               course         ECTS credits
  information package        information package)         unit                    unit
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
………………………………                ………………………………..                                               ………………………………..
                                                                              
……………………………….               ………………………………..                                               ………………………………..
                                                                              
              If necessary, continue this list on a separate sheet

Student’s signature

                                                                        Date:

RECEIVING INSTITUTION

We confirm that the above-list changes to the initially agreed programme of study/learning agreement are
approved.

Departmental coordinator’s signature                                    International coordinator’s signature



Date:                                                                   Date:


SENDING INSTITUTION

We confirm that the above-list changes to the initially agreed programme of study/learning agreement are
approved.

Departmental coordinator’s signature                                    International coordinator’s signature



Date:                                                                   Date:




                        TELECOM ParisTech – Direction des Relations Internationales

     46, rue Barrault – 75634 Paris Cedex 13 France – + 33 (0)1 45 81 77 12 – Fax + 33 (0)1 45 88 11 14
                                   Email : international@telecom-paristech.fr

				
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