E-mail this form to sco@du.se
Application for an Erasmus+ stipend
Student’s name
Home address
Date of birth/Personal number
Dalarna University e-mail
address
Bank´s name
Clearing no
( including IBAN/SWIFT if
not a Swedish bank)
Bank account number
Receiving university or work
place
Period of stay
Have you previously been on
Erasmus exchange?
From (date)
until
Totally
months
yes □
no□
Date
Date and student´s signature:
1