Application form for incoming students

This application is for incoming students on Health Science courses

Need help?

If you have questions regarding the application for incoming students on Health Science courses, please contact us at sund-international@ucn.dk

Fields marked with are required.

Personal information

Given name  
Family name  
Date of birth  
Gender  
Citizenship  
Email  
Mobile phone (incl. country code)  
Upload 
Please insert a photo of yourself

Address

C/O 
The field C/O refers to the name on the door. Please fill out if it differs from your own name.
Address  
Postal code  
City  
Country  
Valid from  
Valid to  
Permanent address
Fill out these fields if your permanent address differs from your current address. The permanent address should be a permanent one - for example your parents' address.
Name on the door 
Address 
Postal code 
City 
Country 

Academic data

Sending institution  
Study programme  
If other, please specify:
Study programme 
Years of study prior to studying abroad  
Period you apply for at UCN  
Module type  
First day of study at UCN  
Last day of study at UCN  
Exchange programme  
If other, please specify:
Exchange programme 

Information about sending institution

Contact person/ coordinator  
Coordinator phone  
Coordinator e-mail  
Contact information in case of emergency
This information will be used by UCN in case an emergency situation takes place once you are in Denmark. Please fill out the contact information for your emergency contact person.
Relation  
Relation refers to whether it is your mother, father, brother, sister, etc.
Full name  
Address  
Telephone number (incl. country code)  

Agreement

Do you agree to UCN making your contact information (full name, e-mail, and telephone number.) available to other exchange students on a list of exchange students?

I agree  
Current date  
Please check the information carefully before clicking on "Send" to continue. A copy of your application will be send to your e-mail.