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ANTRAGSFORMULAR FÜR AUSTAUSCHSTUDIERENDE / EXCHANGE STUDENT APPLICATION FORM Erasmus+ / European Credit Transfer and Accumulation System (ECTS) Akademisches Jahr / Academic Year 2020 / 2021

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ANTRAGSFORMULAR FÜR AUSTAUSCHSTUDIERENDE / EXCHANGE STUDENT APPLICATION FORM

Erasmus+ / European Credit Transfer and Accumulation System (ECTS) Akademisches Jahr / Academic Year 2020 / 2021

(Bitte Foto einfügen / Please add photograph)

ANGABEN ZUM/ZUR STUDIERENDEN / PERSONAL DETAILS

Bitte am Computer ausfuellen und als Word-Datei schicken an:

Please fill in this form on the computer and return it as a Word-file to:

Selsela Arya, Academic Exchange Coordinator. E-Mail: arya@rheinahrcampus.de

Name / Surname / Last Name:

Vorname / First Name:

Geburtsdatum / Date of Birth:

Geburtsort / Place of Birth Geschlecht / Gender:

Staatsangehoerigkeit / Nationality:

Heimatadresse / Home Address:

...

...

E-Mail:

Handy-Nr (mit Laendervorwahl) / Mobile Phone (with country code):

Heimathochschule / Home University:

Austauschkoordinator / Exchange Coordinator Name:

Austauschkoordinator / Exchange Coordinator E-mail:

Austauschkoordinator / Exchange Coordinator Tel:

Dauer des Auslandsaufenthalts / Length of Intended Stay at RheinAhrCampus

 Winter Semester 2020/2021... (September - February)

 Summer Semester 2021... (March - August)

Bewerbung für Studentenwohnheim / Application for Room at Student Residences:

Ich bewerbe mich um ein Zimmer im Studentenwohnheim / I would like to apply for a room at the student residences:

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Ja / Yes  Nein / No  SPRACHKENNTNISSE / LANGUAGE PROFICIENCY

Deutsch / Level of German: Beginner  Basic  Intermediate  Advanced  Englisch / Non-Native Speakers of English:

Level of English: Basic  Intermediate  Advanced  Excellent 

If possible, please attach a certificate of English proficiency (TOEFL, IELTS)

ANGABEN ZUM STUDIUM / DETAILS ABOUT CURRENT STUDIES

 Angestrebter Abschluss / Degree for which you are currently studying:

 BA in ...

 Anzahl der Semester vor Beginn des Auslandsstudiums / Number of semesters prior to departure abroad:...

 Haben Sie bereits im Ausland studiert? / Have you already studied abroad?

JA / YES NEIN / NO

Falls ja, wann und an welcher Hochschule? / If yes, when and at which institution?

...

Warum moechten Sie Ihr Auslandsstudium am RheinAhrCampus absolvieren? / Please state the reasons for your study abroad application at RheinAhrCampus:

...

...

...

...

...

...

...

...

...

HEIMATHOCHSCHULE / HOME INSTITUTION

Wir bestätigen hiermit, dass der Studierende für ein Semester / ein Jahr als Austausch- studierender am RheinAhrCampus nominiert ist. Die Datenabschrift enthält alle wichtigen Angaben zum bisherigen Studium. Weitere Angaben, die zum Zeitpunkt der Antragstellung noch nicht vorlagen, werden nachgereicht.

We hereby confirm that the student has been selected as an exchange student for an exchange semester/year (please underline) at RheinAhrCampus Remagen. The enclosed transcript of records contains all details about the student's academic progress up to the point of application. Further details not available at the date of application will be handed in later.

Date: Coordinator´s name:

Coordinator´s signature:

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GASTHOCHSCHULE /

RECEIVING INSTITUTION

We hereby acknowledge the receipt of

 the application

 the proposed Learning Agreement

 the Transcript of Records

The student

 has been provisionally accepted

 is not accepted at our institution

Date: Coordinator´s signature:

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