<p>APPLICATION FORM 2017/2018 for INTERNATIONAL EXCHANGE STUDENTS Application deadlines: 15 May 2017: nomination deadline 1 June 2017: deadline for e-mailing application files for admission to the full academic year 2017/2018 </p><p>15 May 2017: nomination deadline 1 June 2017: deadline for e-mailing application files for admission to the Autumn semester 2017/2018 15 October 2017: nomination deadline 1 November 2017: deadline for e-mailing application files for admission to the Spring semester 2017/2018 Please complete this form on your computer, then print and sign it. Note that incomplete applications will not be processed! 1. Personal details student Surname: First name(s): Sex: Male Female Place of birth: Date of birth: Passport/ID-number: Nationality: Street + house number: City/town: Postal/Zip code: Country: E-mail address 1: E-mail address 2: Cell phone number (incl. country code): Phone number (incl. country code): </p><p>2. Contact details home university Full name home university: Erasmus code (if applicable): Country: Website: Contact person at your home university (International Office): Ms. Mrs. Mr.: Full Name: Function: Telephone number: Fax number: E-mail address: </p><p>3. Visa If you are a non-EU student, please check if and what kind of visa you need on: http://www.studyinholland.nl/practical-matters/visa-wizard Please tick: I do not need a visa to study in the Netherlands</p><p>I need a visa to study in the Netherlands. I will fill out the Visa Service Application Form on www.windesheiminternational.nl and send it to Windesheim International office.</p><p>4 . Motivation Why do you want to study at Windesheim University of Applied Sciences? (Max. 300 words)</p><p>5. Field of study Please tick which study area you are applying for: Business</p><p>Education</p><p>Engineering</p><p>Health and Welfare</p><p>ICT</p><p>Journalism and Communication</p><p>Sport and Therapy</p><p>6. Study period Please tick and then specify the begin and end dates of your stay: Full academic year 2017/2018 I expect to stay from until Autumn semester 2017/2018 I expect to stay from until Spring semester 2017/2018 I expect to stay from until </p><p>7. Type of programme Please tick the appropriate option(s): I want to participate as an Erasmus student I want to participate in a Double Degree programme. Please note: Double Degree-students also have to apply through www.studielink.nl I am a participant of the Science Without Borders Programme</p><p>Other, namely: </p><p>8. Learning difficulties Do you have any learning difficulties (such as dyslexia, dyscalculia) or other disabilities that we should know of? No Yes If yes, do you need any specific facilities/support? No Yes. Please specify: </p><p>9. Accommodation Note, that our student housing cannot be booked before 1 July/1 December 2017 (for Autumn/Spring semester)! Please tick: Yes, I would like to apply for a room from SSH offered by Windesheim UAS, location Zwolle If you wish to apply for a room in one of our student dormitories please refer to our website. No, I do not want to apply for a room from SSH offered by Windesheim UAS, as I want to find (other) housing myself 10 . Checklist I have attached to my application e-mail (obligatory, please tick): A fully completed and signed scan of my Learning Agreement </p><p>A scan of my Language Proficiency Statement (signed and stamped), native speakers of English excepted</p><p>A photocopy of my academic records to date in Dutch or English</p><p>A clearly readable scan of my passport / ID-card</p><p>A scan of my original passport photo, format: jpg (not a copy of my passport)</p><p>A scan of my health insurance papers or European Health Insurance Card, valid throughout my study period in the Netherlands. A scan of my travel and liability insurance papers (including compensation of theft), valid throughout my study period in the Netherlands.</p><p>Full year students only: 1 photocopy of my birth certificate, with an apostille or double legalisation </p><p>Note: Your original birth certificate is needed in order to register with the municipality. Please click this link for more information regarding legalising documents: legalising documents Nursing students only: the result of my hepatitis B titre test + copy of MRSA result</p><p>Design students only: portfolio </p><p>Students who need a residence permit for Study in the Netherlands: </p><p>Visa Service Application Form + appendices </p><p>11 . Signatures Student: Coordinator of sending institution: I hereby certify that I have provided all the I hereby certify that this student is eligible required information and that all the for exchange at Windesheim, and that the information that I have provided is correct. proposed study programme can be incorporated in the student’s regular study programme. Name: Name: Mr Ms Mrs Place: Date: Place: Date: Signature: Signature: </p><p>Stamp: </p><p>12. Submitting your application Please send your application documents as separate files (not in 1 file) to the following e-mail address: [email protected] </p><p>INCOMPLETE, UNSIGNED OR NON-COMPLIANT APPLICATION PACKAGES WILL NOT BE ACCEPTED! English Language Proficiency Statement (Only to be filled out by the International Office or a professor from the student’s home university. Native speakers of English do not have to hand in this form.) </p><p>I hereby declare that [full name student]: born on [date of birth]: registered at [name sending university]: meets the English language requirements for participation in exchange programmes at Windesheim University of Applied Sciences. </p><p>His/her English language proficiency is comparable to at least: </p><p>IELTS overall band 6.0</p><p>TOEFL computer based 213</p><p>TOEFL internet based 80</p><p>TOEFL paper based 550</p><p>CEFR (Common European Framework of References for Languages) B2</p><p>Date: …………………………………………..</p><p>Name: …………………………………………………………………………………</p><p>Position: ……………………………………………………………………………..</p><p>Signature and stamp: </p>