#-ff%?r\.

tJ

,ffiHfi
T5 chrlc H5 trq Dqi hgc
Vin phdng Hessen Vi$t Thii gi6i, CHLB Drlc
B9 khoa hgc vA Nghe thuet bang Hessen

MM HOSOxIN GAP HQC BONG

ctia BQ khoa hgc vi Nghg thuqt bang Hessen, GHLB Duc
th6ng qua T6 ch&c H6 trq D4i hgc Th6 gi6i Drlc (WUS Germany)
G6c em sinh vi6n thdn m6n!

BQ khoa hgc vd Ngh€ thuat bang Hessen CHLB Drlc (Htr/WK) th6ng qua T6 chtlc H6 trg Dai hqc The
gicri Drlc (World University Service - WUS) lu6n lu6n girip dO vdr hqp t5c vG gi6o dgrc vd ddo tao vdi ViQt
Nam, d{c biet la c6ng t6c h6 trq sinh vi6n th6ng qua cAg chucrng_trinh hec b6ng taiViQt Nam il6 duEc thyc
hi6n li6n tuc 31 ndm nay. Ndm hgc 202112022 ndy, Td chrlc H6 tre Dai hqc ThO gi6i CHLB Dtlc vA Vin
phdng Hessen taiViet Nam thr,rc hi6n chucyng trinh hqc b6ng nhnm h6 trq cho c6c sinh vi6n c6 ket qu6 hgc
tflp loai gi6i vd c6 hodrn cdnh kh6 khin c0a c6c trudng dai hgc vd cao ding tqi ViQt Nam.

DuEc phep cOa B0 Giao duc vdr Ddo tao, Vdn phdng Hessen ViQt Nam hudng ddn c5c em sinh vi6n
ldm don xin cdp hqc b6ng nhu sau:

Dieu kien ldm dcvn xin cdp hgc b6ng:

1. KGt qud hoc tQp trung binh hqc k!' I ndm hgc 2021t2022 dEt tu 7,5 di6m trd l6n
2. Hodn c6nh gia clinh kh6 khdn, hoac ld con thucrng binh, liQt sT, dAn tQc thi6u s6...
3. Hien kh6ng nhan h6 trq hgc b6ng cria t6 ch0c, c5 nh6n ndro kh6c
4. DE co tham gia c6c hoqt dQng xd hQi (ti6u chi uu ti6n) nhu: hi6n mdu nh6n dqo, thanh ni6n tinh
nguy$n, h6 trE CI6ng bio b6o lqt, thi6n tai, phdng ch6ng dich Covid, v.v...

H6 scv xin cdp hqc b6ng theo m6u in s5n g6m c6c gi5y to dudi d6y (de nghi srl dung bdn h6 so song
ng0 ViQt Drlc grli kdm theo, kh6ng cluqc srl dqng m6u khdc):

1. To khai th6ng tin c6 nh6n xin c5p hgc b6ng: C6c em CIgc ki hvong d1n ndy vd tt7 khai that ildy
d0 tdt cd cdc muc, vi6t hoa phAn hq vd tdn, ghisti tai khodn c1a chinh bdn thdn em, t1n chI tiri
khodn phdi ld t)n cla chinh em, ddn dnh 4x6, ky vd ghi rd hg tfin. (Luu ,!: cAn vi6t tay vdo hii so
g&i kim theo ndy, kh6ng ddnh mdy vdo bdn mdm riti in ra; cin ghi sO tne sinh vi6n hoi,c sO
gi6y chung minh thu n6u nhu chua c6 th6 sinh vi6n; cdn ghi diy di cd s6 diqn thoqi vd (Ific
bi$ h cin ghi cd dia chi email cl nh6n ti6n hG duoc d6 Van phdng Hessen th6ng b6o vd k6t
qud x4t duyQt vd llch trao hgc bdng, cfing nhu g{ri dnh trao hgc b6ng sau ndy cho cdc em.
Hii so thi6u thdng fin s6 kh6ng tfttg.c x6t duyQt).
2. GiSy chr?ng, nh4n kiit qui hgc tfp: Cdc em tq khai thQt dAy d0 cdc mqc dd c6 trong gi6y chtmg
nhQn hoc b6ng vd xin ch? k!, tlong ddu xdc nhQn c1a Ban gi6m hieu hoac phdng-d-ao tao cla
Trtwng.minh vdo mqtc xac nhQn c1a nhd tnrng. NOu thi6u chtr ky, ddu xdc nhQn trong GiSy ch&ng
nhdn k1t qud hgc tap thi sE khong duEc xet duyQt.

Hai m6u h6 so tr6n c5c em nhQn trr,rc ti6p tai truong vA sau khi hodn thdrnh xong thi n6p cho Ban giSm
hi6u nha truong d6 xem xet vd quyet Olnfr. Sau d6 Trudng lAm c6ng vdn ghi t6n nh0ng sinh vi6n clucyc x6t
duyOt vd grli chuy6n- ph6t nhanh h6 scv sinh vi6n xin cdp hoc b6ng vC Van phdng Helsen Vi6t Nam, dia
chi: s6.34D, phiS Trin Phri, qufn Ba Dinh, Ha NOi, Tel: 024.62i51'lzo, trudc ngay ts.os.2oi2, grli bdn
scan hd so qua email d6n: hessenbuero.vn@qmail.com vd htqt@moet.qov.vn. Trudng hop cAn huong d5n
hoic c6n h6i th6m th6ng tin, cdc em li6n h€ vdi anh Phqm ViCt Ctfd'ng, VP HJssen, s6 di6n lhoai:
0982.088115 d6 dugc huong d6n. Sau khi x6t duyet h6 scy vd co k6t qud,-th6ng qua nhd truong vd qua
email, sinh vi6n sE clugc mdi CI6n nhQn hgc b6ng, thoi gian vd dia di6m cu thr5 s6 co th6ng b6o sau.
He N}| ngdy 22.02.2022 Vdn phdng Hessen taiVi6t Nam
tlqidiQn

Vdn phdng Hessen lai Viet Nam, 34D TrAn Phl, Ba Dinh, Hd NQi,
Tel/Fax: 024.627 341 20, Email : hessenbuero.vn@gmail.com
tho k h u ye n ho c@y a h oo. co m.v n
TS. Bii C6ng Tho
 cgNG HOA XA Hor CHU NGHTA VlEr NAM
Dec re p -_r_q,$""_:_1i n on o"

cnY cHl./NG NHAN

BESCHEINIGUNG
Sinh vi6n / Student:
Ngdy sinh / Geburtsdatum: ..

Gi0i tinh / Geschlecht: (anh

S5 the sinh vi6n / tmm.-Nr.: 4x6) .
d6ng ddu
L6p / Klasse:
giap lai
Nginh / Fachbereichi ."

Trudng / Hochschule: ..

1. K6tqud hqctdp hqc k!,t n5m hqc2021-2022

des 1. Semesters vom 2021-2022
STT M6n hoc Di6m TB Ghi chti
Nr. Fdcher Durchschnittsnote Bemerkunq
1

3
4

5
6
7

8
I
10
Di6m trung binh cQng / Durchschnittsnote:

2. HiQn nay t6i kh6ng nh6n hoc b6ng cria cdrc t6 chuc, c6 nh6n ndo khdc
lch geh6re gerade zu keinem anderen Stipendiumsprogramm tr
3. T6i thuOc CI6i tuqng chinh s6ch x5 h6i (con thucrng binh, li6t sI, gia dinh nghdo, ddn tOc thi6u s6)
lch geh6re zu einer sozial benachteiligten Familie tr
4. TOi da tham gia c6c hoqt dQng xd hQi nhu:
Mein soziales Engagement:

n94y....... th5ng ...... ndm 2022

OrUDatum
X6c nhin cia BGH Trudng Chu kli c0a sinh vi6n
(k!,t)n vd d6ng ddu) Unterschrift des Studenten
Bestatigt durch die Hochschule
 *..mnf V'C*57,?'4
H-,Hr,y",*
ex-,{w-ryar]**b*€,$-*.r T6 ch&c H5 tro 9qi hgc
Vin phong Hessen Vigt Nam Thii gi6i CHLB D&c

Ghuong trinh Hgc b6ng

cria BQ khoa hgc vd Ngh€ thuft bang Hessen, CHLB Dtlc
Sur-Place Stipend ienprogram m
des Hessischen Ministeriums fiir Wissenschaft und Kunst
der BR. Deutschland
(dnh 4x6)
TO KHAI THONG TIN CA NHAN
Bewerbungsformular

Hq Ten Gioi tinh * Ngdy sinh

Familienname Vomame Geschlecht Geburtsdatum

Noisinh Qu6 qu5n

Geburtsort Wohnort

Dien thoai Email 56 tai tnodn

Tel-Nr. Konto-Nr.

T6n Tdi khoAn Tai ngdn hdng

Kontoinhaber Bei der Bank

Dia chi hign na

Adresse

Ho vd t6n b6 Ndm sinh Ngh6 nghiQp

Name des Vaters Geburtsjahr Beruf

Hg vd t6n mg Nim sinh NghB nghi6p

Name der Mutter Geburtsjahr Beruf

QUA rRiNH HgC rAP

BILDUNGSWEG

TrudngTHPT_-__ -* Tai
Oberschule Ort

T6t nghiQp loai vd ndm t6t nghiQp

AbschluR und Jahr des Abschlusses

HIEN LA srNH V|EN

GEGENWARTIG STUDENT/STUDENTIN

T6n vir dla di6m Trucrng

Hochschule (Name/Ort)

Ngdnh hgc 56 tha SV Hqc ky thO

lm Fachbereich lmmatrikulations-Nr. im Semester

LV Do xrN cAP H-gc BONG:

STIPENDIENVORSCHLAG UBER:

ngay ...... th5ng......n5m 2022

OrUDatum
Tru&ng dqi di6n VP Hessen ViQt Nam Nguoi vi6t don (kf vd ghi ro h9 t€n)
Unterschrift vom Leiter des Hessen Buros Vietnam Unterschrift vom Bewerber

TS. Bti C6ng Thg