Application Form AMERTA X
NOTICE: Students from AUN Member Universities MUST apply via AUN-ACTS website as well.

INSTRUCTIONS
1. This Application Form is to be duly completed based on the required format.
2. Please indicate “NA” if an item is not applicable.
3. Please send the scanned supporting documents to our office email : inbound@global.unair.ac.id
with the following format of subject : NAME/HOME INSTITUTION/AMERTA X

Required Supporting Documents
1. A copy of Passport (colored front page)
2. Most recent passport photo (red background)
3. Official academic transcript in English (issued by the applicant’s home institution)
4. One (1) Professional Letter of Recommendation signed by the referee (Preferably from a Professor, Invalid if recommendations are made by family members or friends)
5. Scanned English Proficiency Certificate
6. A Health Certificate (as attached in the AMERTA X Information Package)


*NOTE: You will have to choose your courses in this application. Please do check REGULARLY the most recent list of courses beforehand.

**NOTE: The application will only be processed if applicants have sent all required
supporting documents to our office email. Should there be any other inquiries, please do
not hesitate to contact our email : inbound@global.unair.ac.id. Please check your email regularly.

Email address *
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