Nominations for Participation in the Academic Mobility Program at Lomonosov Moscow State University

1. University/Institution

1

Name of the University/Institution *

2

Country, City of the University/Institution *

2. Mobility Coordinator

3

Last Name *

4

First Name *

5

Other Names

6

E-mail *

7

Contact Telephone Number *

Mailing Address

8

Country *

9

Street *

10

House, Apt. Number *

11

ZIP (CAP, Postal) Code *

3. Nominations

12

Academic mobility period for which you nominate students *

13

Number of nominated students *

14

Please, upload here the Excel-file with nominations *

Please, name the file as follows: University Name_Nominations