Immediate support for BFH students and staff who have fled Ukraine as a

result of the war

*with ‘protection status S’

Please fill in this form to apply for hardship support.

1. Once complete, save the form and add a manual or digital signature.
2. Email it to your Head of Degree Programme (for students) or to your department’s
International Office (for staff).
3. If you name a reference person, you can also email the signed form to your reference
person, who will forward it to the relevant office at BFH.

Personal details

I hereby confirm that I qualify for and have already registered for ‘protection status S’

Last name
First name
Date of birth
Street
Postcode and town
Tel.
Email

Please describe your financial hardship. (max. 600 characters including spaces)

Berner Fachhochschule | Haute école spécialisée bernoise | Bern University of Applied Sciences Seite 1
Details of payment account
Please indicate the amount of the support payment you would like to apply for (max. CHF 500.-)

Please tell us your Swiss bank account number (IBAN)

You will find the IBAN number on your bank card or bank statement. Any support payment will be
transferred to this account.

I hereby confirm that the information I have given is correct and consent to payment of the
requested funds into the above Swiss bank account. If any information is found to be
incorrect, the money must be repaid.

*If you do not yet have a bank account in Switzerland, you can name a reference person at
BFH. The reference person must declare that they are willing to have the funds transferred
to their account and to pay these funds to the applicant in cash (see page 3 of the
application).
I would like to name a reference person
The reference person must complete and sign page 3 of this application.

Privacy statement regarding the use of personal data (applicant)

By granting immediate financial support, Bern University of Applied Sciences is fulfilling its duty
to offer social provisions and measures to support its members (Art. 16 FaG, Art. 45 FaSt). In
order to assess financial hardship, BFH requires the applicant to submit personal data and details
of personal circumstances. This data is processed and, more particularly, stored by BFH. Personal
data is entered into an electronic form. The gathered data is only processed by BFH once the form
has been submitted. The application will only be seen and processed by BFH staff members
entrusted with the application procedure. Confidentiality is assured. BFH will use Microsoft
applications, in particular Microsoft Outlook; the data will also be stored on a BFH server. The
personal details gathered will be deleted once they are no longer needed, generally once the
financial accountability no longer exists or the statutory maximum retention period of 10 years
has elapsed.

Declaration of consent

I hereby give my consent for BFH to process and store the personal data I have provided,
including any particularly sensitive personal data gathered in the context of an application for
immediate financial support, as defined above.

Yes, I consent

Place, date, signature

*we also accept digital signatures

Berner Fachhochschule | Haute école spécialisée bernoise | Bern University of Applied Sciences Seite 2
Details of reference person

The applicant (to be completed by applicant)

Name
Vorname

has nominated you to handle their support payment (immediate support for BFH students
and staff who have fled Ukraine as a result of the war). Please provide us with the
following information so that we can process the application and action the payment:

Last name
First name
Address, postcode, town
Name of bank
IBAN

Consent of reference person

I consent to having the sum requested by the applicant paid into my Swiss bank account (detailed
above) and to pay this sum in cash to the applicant.

Privacy statement regarding the use of personal data (reference person)

By granting immediate financial support, Bern University of Applied Sciences is fulfilling its duty
to offer social provisions and measures to support its members (Art. 16 FaG, Art. 45 FaSt). The
personal details that you, as the reference person, provide in the context of the application and
that BFH requires in order to make the requested support payment, will be processed and, more
particularly, stored by BFH. Personal data is entered into an electronic form. The gathered data
is only processed by BFH once the form has been submitted. The application will only be seen
and processed by BFH staff members entrusted with the application procedure. Confidentiality is
assured. BFH will use Microsoft applications, in particular Microsoft Outlook; the data will also be
stored on a BFH server. The personal details gathered will be deleted once they are no longer
needed, generally once the financial accountability no longer exists or the statutory maximum
retention period of 10 years has elapsed.

Declaration of consent

I hereby give my consent for BFH to process and store the personal data I have provided as
reference person, gathered in the context of an application for immediate financial support, as
defined above.

 Yes, I consent

Place, date, signature

*we also accept digital signatures

Berner Fachhochschule | Haute école spécialisée bernoise | Bern University of Applied Sciences Seite 3