Fachhochschule Osnabrück: Registration form (special)

personal data _________________________________________________________

family name^*:

first name^*:

gender^*:

gender^*:female
male

date of birth^*:

place of birth^*:

nationality^*:

address _________________________________________________________

c/o:

street, house no.^*:

postal code, city^*:

country^*:

phone:

mobile phone:

e-mail^*:

study _________________________________________________________

my home university^*:

my study course^*:

I'm going to study during fall term 2010/2011 at FH Osnabrück^*

I'm going to study during fall term 2010/2011 at FH Osnabrück^*yes
no

working group _________________________________________________________

notice: Your choice is not binding, you may change your decision at the beginning of the course.

I choose the following working group:

I choose the following working group:society and culture (training in general German)
economy (training in economic German)
technology (training in technical German)

excursion _________________________________________________________

please notice: Your choice is binding. Additional fee for the excursion to Berlin: 120.00 €.

I'll join the 4-day excursion to Berlin^*

I'll join the 4-day excursion to Berlin^*yes
no

level of German proficiency _________________________________________________________

I learned German ...

at school

years:

at university

years:

at a language school

years:

I took the following exam:

I've been to Germany before

for:

accommodation _________________________________________________________

attention! Please complete only if you do NOT continue your stay as a (guest) student! If you study at FH Osnabrück as a (guest) student after the language course, our housing officer will arrange accommodation for you.

notice: FH Osnabrück will try to but cannot guarantee to consider your wishes.

I'd like to ...

I'd like to ...live in the International Guest House of the university
live in a flat shared with other students
arrange accommodation by myself

I accept accommodation in a double room in the International Guest House

I accept accommodation in a double room in the International Guest Houseyes
no

I'm a ...

I'm a ...non-smoker
smoker

payment method _________________________________________________________

notice: FH Osnabrück will confirm your registration. The payment is due within 10 days after receipt of this confirmation. Please choose the method of payment you prefer.

I'll pay by ...^*

I'll pay by ...^*cheque
postal money order
bank transfer

remarks _________________________________________________________

I'd like to remark the following:

general conditions _________________________________________________________

· The fees for international students of FH Osnabrück and for students of our partner universities are 250.00 € or 370.00 € (including trip to Berlin). If you cancel your registration after June 30, the fee will be reimbursed apart from a registration fee of 100.00 €.

· Registrations are accepted in order of receipt. Therefore, early registration is recommended.

· Participants are not insured against illness, accidents etc. by FH Osnabrück. We strongly recommend to take out relevant insurances (health insurance, liability insurance, accident insurance).

send form _________________________________________________________

important! I've read the general conditions. By clicking the send button I declare my consent.

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18th International Summer Language School of Fachhochschule Osnabrück

registration form for students of FH Osnabrück or of its partner universities