Holland Scholarship Programme

Application form for incoming Master students 2019/2020

Personal details

Family name*)
Given name *)
Gender Male/female
Date of birth: (dd-mm-yyyy)
Place and country of birth
Nationality
Permanent postal address
Zip code and town
Country
E-mail address
Telephone/mobile phone
Starting date □ first semester 2019/2020 (September)

*) as in passport

Higher education institution where you are currently enrolled or got

your last degree
Name
City
Country
Name of programme/degree

Please add your motivation letter for the Holland Scholarship Programme.

I herewith apply for the Holland Scholarship and declare that I have completed this form
to the best of my knowledge.

Holland Alumni Network

o Yes, I agree to share my contact details with the Holland Alumni network. I have
read the Holland Alumni Privacy Policy.

Date ................................................ Place ................................................

Signature ...................................................................