APPLICATION FOR ACCOMMODATION FOR THE HOLIDAY PERIOD

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APPLICATION FOR ACCOMMODATION FOR THE HOLIDAY PERIOD APPLIES ONLY TO STUDENTS OF THE MEDICAL UNIVERSITY OF LODZ. OTHER PEOPLE, PLEASE USE THE “GUEST” TAB.

Surname and name*
E-mail adress*
Phone numer
Faculty, year of study, degree*
Student of the Medical University of Lodz?*
Student practice*
Activities for the university*
Residents Council, others
Exact address of residence
To be completed only by - interns, residents, graduates, students of other universities, others
Place of accommodation
Dormitory*
Check in date
July from:
July to:
August from:
August to:
September from:
September to:

Up to September 20

APPLICATION FOR ACCOMMODATION FOR THE HOLIDAY PERIOD

Place of accommodation

Check in date