Student Application Form

EUROPEAN MASTER IN COMPUTER VISION AND ROBOTICS

Academic year 20. . /20. .
This application should be completed in black in order to be easily copied and/or faxed
Student Personnal Data

FAMILY NAME ........................................... First Name ........................................

Date of Birth ............................................ Nationality ......................................

Place of Birth ...........................................

Sex  M /  F (check off your choice)

Current address Permanent address (if different)

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Dept/Floor :.............................................................
City :..........................................................................
State/Province:.......................................................
Zip/Postal Code:…………………………………………...
Country:....................................................................
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Dept/Floor:…...........................................................
City:...........................................................................
State/Province:.......................................................
Zip/Postal Code:…………………………………………...
Country:....................................................................

Phone ....................................................... Phone ........................................................................

E-mail ........................................................ E-mail ........................................................................

Current address is valid until :

Cursus and Experiences

Last degree/Diploma awarded, mention and year
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Name of Institution .......................................................................................................................................................
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Actual ECTS Credits ........................................................................................................................................................
Precedent universitary degrees awarded (Please fill the board)

Name of degree Year Institution Mention/Rank

Have you received prices or awards during your cursus?

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Professionnal experience (year, job, firm, country, dates)

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 More experiences (see the CV attached)

Other (if you want to add something)

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Have you already studied abroad?  Yes ;  No (check off your choice)
If yes, please indicate the country, context and dates
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Language Competence
Mother tongue ..........................................................
Other languages, level (written, read, spoken), results of language’s test(s)

1.
2.
3.

Erasmus Mundus GRANTS

- I wish to be considered for EU funding under the Erasmus Mundus scheme:  Yes ;  No

Other GRANTS (non EM students)

You will be eligible for a grant of 300 Euros per month, however you will still have to pay the fees (8000 Euros for
European Students and 14800 Euros for non EU students)
- Should you not be selected for the Erasmus Mundus grant, are you still interested in being candidate?
 Yes ;  No

I attest on my honour that all information given here are true.

Place and date :
Signature of the applicant :
The Procedure to apply:

1. Please fill this application form online and valid it.

2. Please print this application, sign and submit it online:

3. Documents requested to submit with the application paper are:

- a letter of application outlining rationale for wanting to undertake the programme

- a CV
- a certified copy of the university Bachelors Degree (equivalent to a UK 1st class Honor Bachelor Degree)
or equivalent with records transcript (English translation)
- a proof of your English level (TOEFL or other)
- an evaluation form from two referees of the University or Institute that awarded the first degree
(available online or under request)
- 2 letters of recommendation
- a valid ID document and passport
- 2 current passport-size photographies

If you are selected to join the masters VIBOT, please submit online:
- an original of your certificate of birth and the translation in French
- a translation in French of your Bachelor's or Masters Degree certified copy by your University. (If your
University will not provide such documents, but only the original English transcripts, in that case, it
could be translated and attested by French Centre or French embassy in your country, a notary or a
lawyer)

An application paper submitted without all documents requested will be automatically refused