Not to be completed by the applicant.
(name of the Higher Education Institution )
1. INFORMATION ON THE DESIRED DEGREE COURSE
1.1 1st choice degree course
Eingang Registrier-Nr. Matrikel-Nr. Datum der HZB: Note:
Major subject 2nd Major or 1stminor subject 2nd minor subject * Which study semester are you applying for? (Enter only if you have a transfer of credit notice) Target degree in Germany for the 1st choice degree course Diplom Magister Staatsexamen Doctorate Bachelor's Master's
r Direkte HZB - r DSH erforderlich - r DSH nicht erforderlich r Feststellungsprüfung r erforderlich - r Besuch des Studienkollegs -___________________________ - in den Kurs _________________ - r externe Feststellungsprüfung - r Ergänzungsprüfung r Zulassungsbesonderheiten nach Studienplatzvergabeordnung Art. 12 ___________________________ r Fachbindung ___________________________ r Ablehnung Weitere Bearbeitungsvermerke: ___________________________
No formal degree
Teaching degree (Lehramt) for 1.2 2nd choicedegree course Which degree course do you wish to apply for if you cannot be admitted to the 1st choice degree course?
Major subject 2nd Major or 1st minor subject 2nd minor subject * Which study semester are you applying for? (Enter only if you have a transfer of credit notice) Target degree in Germany for the 2nd choice degree course Diplom Magister Staatsexamen DoctorateBachelor's Master's
No formal degree
Teaching degree (Lehramt) for
2. PERSONAL DETAILS (enter exactly as contained in your passport)
Surname/Family name First/Given name(s) Sex / Date of birth Place of birth Nationality/Nationalities Male Female
(dd, mm, 19yy)
___________________________ ___________________________ ___________________________
c/o House number/Street/Road etc. Postcode/Zip code Town/City/Postal district Telefon/Fax - E-Mail
___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________ ___________________________
4. HOME ADRESS (if different from 3.)
c/o Housenumber/Street/Road etc. Town/City/Postal district Town/City/Postal district Telefon/Fax - E-Mail
5. YOUR EDUCATIONAL BACKGROUND All details must be proven by enclosing officially certified/attested certificates/supporting documents and officially certified/attested German or English translations. It is essential that you include these withyour application. Important Note. Some higher education institutions (HEIs) do accept certificates/supporting documents in other languages (please observe the detailed information provided by the HEI in question). (Please write in block capitals)
CURRICULUM VITAE Education/Training School education (enter study details below ) Length of schooling Primary/Elementary school to the end of yourschooling from - to Details
School leaving certificate
Original name: e.g. baccalaureat, Lise diplomasi, Maturität Country
Did you take a higher education entrance qualification in the country in which you did your schooling?
Date Yes No If yes, please enter date and name Name
Studienkolleg (preparatory/foundation course) If you attended a Studienkolleg in the Federal Republic ofGermany or took the Feststellungsprüfung (assessment test), please enter the name and place of that Studienkolleg and when and how often you took or attempted the Feststellungsprüfung. Higher education, further education and training, practical training, vocational training in and outside Germany Name of the institution(s), country/-ies, details of the study subject(s), which examinations did...