UNIVERSITY OF PATRAS

STUDENT HOUSING APPLICATION FORM

FOR THE LLP / ERASMUS STUDENTS

ACADEMIC YEAR 201..../........

First name(s) : Surname :

Nationality : Male Female Date of birth :

Home address :

ID Number / Passport Number:

Telephone: Fax:

E-mail:

Sending University:

Country :

Name of the Contact Person at the University of Patras :

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

Title :………………………………………………………………………………………..

Department: …………………………………………………………………………………..

Name of the Contact Person of the Sending University :

…………………………………………………………………………………………….

Title :………………………………………………………………………………………

Department: ……………………………………………………………………………….

I would like to stay preferably in:

Student Residence Hall (outside Campus) ……. (Sychaina Residence)

Student Residence Hall (outside Campus) ……. (new Residence- Kastellokampos)

I would like accommodation from ……./……../……….. to ……./……../……….

Date: ...................................... Student’s signature: ...........................................

This Application Form should be sent to the International Relations Office (University of Patras,University Campus, 265 04 Patras, Greece, Tel. +30 2610-969028, Fax +30 2610 994441, email:

llp.incoming@upatras.gr )no later than: October 30th for Spring semester and June 15th for Autumn semester

Passed the above dates no guarantee for accommodation is provided