Hessen-Wisconsin Student Exchange

HESSEN-WISCONSIN STUDENT EXCHANGE Program Application for Study in Hessen (NOTE: For full functionality, Macros MUST be enabled!)

This is a Program Application. If accepted by the Hessen Ministry, you may receive additional paperwork/application materials from the specific host institution. Personal Information Currently registered at (Name of institution): Year in School (fr, soph, jr, sr, grad): UW–

Name: (Family Name, First Name, Middle Name) Sex: , , Male Female Birthplace Citizenship: Date of Birth: City: / / Country: Month / Day / Year Mailing Address (valid until): Street and number: Phone:

City, Postal Code: Email:

Country:

Permanent Home Address Phone: Street and number: Email: City, Postal code:

Country:

Contact in case of Emergency Phone: Name: Street and number: Email: City, Postal code: Country: Relationship:

Study In Hessen List the Hessen Institutions at which you would like to study in order of priority (MUST provide a course list for each school listed below):

This application is for the (pick only ONE):

Winter (Fall) Semester only of 20______

Summer (Spring) Semester only of 20______

Academic Year of: 20______/ 20______

IUSP Marburg of (Semester only) 20_____

IUSP Marburg of (Academic Year) 20______/ 20______

1 Academic Information Number of Semesters studied prior to this Application

Hessen-Wisconsin Contact at your International Office (Name, Email: Campus Address)

Academic Advisor (Name, Campus Address): Email:

Major: Minor:

Level: undergraduate graduate

German Language Proficiency How many years did you study German in High School? How many years have you studied German at University level? Highest German class taken before going abroad? Have you visited Germany previously? For which purpose? (e.g. family, travel, school exchange, study, language course, etc.)

Certifications We have met to discuss the Wisconsin-Hessen exchange program and the information provided is correct and complete.

------(Signature of Applicant) **NOT Typed (Date: dd/mm/yy)

------(Signature of Study Abroad Advisor) (Date: dd/mm/yy)

PLEASE ATTACH THE FOLLOWING WITH THIS APPLICATION:

 Typed Student Statement This must be in German if you plan to study in German or plan to study intensive German beyond the beginner level. This may be in English if you plan to study in English and your intensive German course is at the beginning level.

 Resume This must be in German if you plan to study in German or plan to study intensive German beyond the beginner level. This may be in English if you plan to study in English and your intensive German course is at the beginning level. Use this resume template regardless of the language you use to complete your resume.

 Unofficial transcript from your current institution (an official transcript may be requested at a later date).

2 HESSEN-WISCONSIN STUDENT EXCHANGE

NAME: DATE:

HOME CAMPUS: UW–

(NOTE: This section must be typed!) Statement of Purpose Briefly state your reasons why you wish to study abroad: