STUDENT APPLICATION FORM Photo
EXCHANGE PROGRAM
ACADEMIC YEAR 2022/2023
Exchange program
Erasmus Bilateral agreement
Duration of mobility :
one semester one year
Programs taught in French:
Computer science engineering (taught in French)
Mathematics/Computer engineering (taught in French)
Financial engineering (taught in French)
Programs taught in English:
Bachelor Data Science by Design year 1 Fall Semester
Bachelor Data Science by Design year 1 Spring Semester
Bachelor Data Science by Design year 4 Fall Semester
Semester
Big Data – Master 2 Fall Semester
Big Data – Master 2 Spring Semester
SENDING INSTITUTION
Name and full address:
Kalinga Institute of Industrial Technology (KIIT)
Patia, Bhubaneswar, Odisha, India 751024
+910674 2725113 ; kiit@[Link]
................................................................................................................
Institutional coordinator:
Name: Md. Abdullah Al Riaj
Phone number: +8801710697146 ; +918167734247
E-mail: [Link]@[Link]
STUDENT’S PERSONAL DATA
Family name: Riaj
First name: Md. Abdullah Al
Sex: F M
Birthdate (dd/mm/yyyy): 24/12/1998
Place of birth : Old Satkhira, Satkhira, Bangladesh - 9400
Nationality: Bangladeshi
Current address : Permanent Address :
KP 8A, Campus 11, KIIT University Old Satkhira, Satkhira Sadar,
Patia, bhubaneswar, Odisha 751024 Satkhira - 9400 , Khulna
India Bangladesh
Phone number: +8801710697146 ; +918167734247
E mail : [Link]@[Link]
LANGUAGE COMPETENCE
Mother tongue: Bengali
Language of instruction at home institution (if different): English
English Medium
Level in English
A1 A2 B1 B2 C1 C2
LEVEL IN FRENCH LANGUAGE
I’m currently studying French language:
Yes no
If yes, what is your level :
A1 A2 B1 B2 C1 C2
Are you able to follow courses in French?
Yes no
ACCOMMODATION
The International Relations Office can book accommodation for all international
students. Please contact us as soon as possible: Vanessa MEGUELLATI
[Link]@[Link]
This application form has to be fulfilled by the student, validated by the sending
institution and sent to EISTI with documents required.
Before May 31st for the Fall Semester or for the year
and before October 31st for the Spring Semester.
Required documents:
- Copy of identity card/passport
- Copies of official transcripts of grades and degrees at Bachelor and Master
level
- Recent picture to stick on this application form
- Cover letter
- Resume
- Proof of English language level
For further information, feel free to contact us: international@[Link]
For European, Erasmus partners and Russia, please contact Audrey JAMA
[Link]@[Link]
For non-European partners, please contact Vanessa MEGUELLATI
[Link]@[Link]
Date : 15/12/2022 Date : ……/………/………
Student’s signature: STAMP SENDING INSTITUTION:
Institutional Coordinator’s signature :