SWFR 2 =~ Studierendenwerk Freiburg-Schwarzwald Studlerendenverk Freiburg Ms, Renate Litterst ‘Aulfenstelle Offenburg Phone: +49 781 205 328, ‘Badstr. 24 Fax: +49 781 205 330 77652 Offenburg 3 Email literst@swt.de Germany Application for accommodation (Please type the required information (do nt fil out by hand). "Note that we cannot guarantee you a room inthe student residence!) Moverindate (2)01March or (Q)01 Sept or Oot oct © _twiltonly stayin Offenburg for the language course @ _ | preter private accommodation ‘Admission code (Graduate schoo! students ony) Deparmentistudy rogram at Offenburg Universi: Master's in Process Engineering (MPE) Family name(s): _Karde First name(s): _ Amey Date of bith: 1991-05-04 Nationality: _ Indien Gender. GQ male —_C) female ‘Are you motorized:()yes no Correspondence address: Home address: (ifitferent from correspondence address}: Postal code and cy: 415605 Chiplun Country: India Phone: +491-9028208046 Ema: kardeameya4591@gmall.com Chiplun, india 10/05/2018 de Place, Date Signature