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Personal Information
Title
Mrs.
Ms.
Mr.
Last Name
*
Name
*
Nationality
Gender
Female
Male
Date of Birth
Month
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
Year
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
Current home address
Street
*
City
*
ZIP code
*
Country
*
Phone number (eg. 0041123456789)
E-mail
*
Type of lease agreement
*
Autumn Semester (approximately September - January)
Spring Semester (approximately February - June)
Type of student
*
Mobility student
Student – no mobiliy program
Choose your program
*
Swiss mobility
Swiss mobility PMP
SEMP
International bilateral agreement
Freemover
ESKAS scholarship holder
ICE (Hanken School of Economics)
Other...
Choose type
*
USI student
Master in Cognitive Psychology in Health Communication (MPHC)
SUPSI
Conservatorio
Other...
Please specify
*
Home university (name of the university and the country)
*
USI faculty
*
Faculty of Biomedical Sciences
Faculty of Communication, Culture and Society
Faculty of Economics
Faculty of Informatics
My contact person at USI is
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