Application form for admission to studies for foreign applicants

Applicant number: 1438223

Semester: winter semester 2015 (beginning of studies in september/october 2015)

Higher Education Institute:

Hamburg, Studienkolleg

Application form for course of study:

Studienkolleg alle Studienkolleg-Kurse

1. Information on the desired degree course
1.1. Course 1. choice (not submitted)
Target degree in Germany : Studienkolleg
Course number

Course name

Course semester

1. course

alle Studienkolleg-Kurse

2. Personal details
Surname/Family name Khadka
First/Given name(s) Ajit
Sex male

Date of birth 20.3.1994

Place of birth Lalitpur

Nationality/Nationalities Nepal

3. Correspondence address
c/o Herrn Prakash Neupane
House number/Street/Road Nollendorfstr. 21 A
etc.
Postcode/Zip code 10777

Town/City/Postal Berlin
district

Country Germany
E-Mail ajit.khadka47@yahoo.com
Telephone
Mobile phone +49 17686169365

4. School leaving certificate

Date 2013-12-26
Original name Academic Transcript (Grade XI und XII)
Country Nepal

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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 with your
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).

I confirm that to the best of my knowledge and belief all the information I have given on this form is true,
complete and accurate. Beyond that I assure that my specifications about my academic background are
complete and that I did not conceal any studies done at a university. I have enclosed the required documents
(certificates, supporting documents, etc.). I am aware that intentionally or negligently giving false information
constitutes an administrative offense and may lead to exclusion from the admissions procedure or if
discovered at a later date to the cancellation of my admission or enrollment. I confirm that I have read the
admissions information.
All entries completed? Please print out form and sign it. Please enclose all documents.

Place

Date

Signature

The above information will be stored and processed by the higher education institutions. They are fully
subject to the data protection regulations currently in force.

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