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Application form: special facilities for international students 2018-2019 - Second semester

Surname * 
First name * 
Student number * 
Faculty * 
Course (e.g. Applied Economics) * 
Programme (e.g. Bachelor) * 
Email address *   
Phone * 

I would like to make a request for special facilities because of (multiple impairments are possible) * 

*  required fields
The University of Antwerp ( is collecting these personal details for registration purposes only. By completing the application, you also grant permission to transmit limited information to essential staff members. Without this consent, special facilities are not possible. For more information or if you wish to change your personal details or have them removed from our database, please inform us using the address above. Further information about our privacy policy: