Université Lille 1
Exchange students - Application for accomodation

 

 1. SENDING INSTITUTION (To be completed by the Coordinator in your home institution)

 Name of the institution  
 Country  



  2. PERSONAL INFORMATION

 Surname  
 Forenames  
 Sex  
 Nationality  
 Email address                                          @



  3. STAY IN LILLE

 Departmental co-ordinator  
 Period of stay  from :        /         /
  to :           /         /
 Kind of accommodation       Hall of residence
      Private
 Date of arrival (very
  important)		                   /         /
 Disabilities or special
  requirements		  

To be returned not later than 15 June for the first term
and 15 November for the second term to :

Université des Sciences et Technologies de Lille
Mrs Fabienne DERNONCOURT
Cellule des Relations internationales – Bâtiment A3
F - 59655 Villeneuve d'Ascq
Fax : + 33 3 20 43 40 03
fabienne.dernoncourt@univ-lille1.fr

Students can ask for their address by email 15 days before arrival.