Application for a Scholarship in theSummer Semester 2016

(Please note: only digital applications are accepted)

To the attention of the funding committee of BTK

Scholarship Application

I, (name, first name), born on in

hereby apply to be granted a scholarship.

Current address:

Street, post code, city: ______

Tel. (incl. area code): ______/______Mobile: ______/______

E-Mail: ______

(binding for any correspondence, please write legibly!)

Home address:

Street, post code, city: ______

Tel. (incl. area code): ______/______Mobil: ______/______

Degree program:

Bachelor:______

Master:______

Number of semesters: ______in SS 20______or WS 20______

1. Name a tutor or professor to act as your contact/reference

Please name one tutor or head of program as a contact/reference for the funding committee. This person should be able to affirm your eligibility for a scholarship. The funding committee can contact the listed referee directly to obtain information about your eligibility for funding.A special written assessment from the tutor is not required.

Name oftutor:______

2. Proof of completed module examinations at BTK

All necessary information about studies and courses completed at BTK is available tothe funding committee. No further performance record is required.

3. Social Commitment at BTK

Verify your eligibility for a scholarship by demonstrating your commitment for the university (in a specific student’s department, at info events etc.). A document with activities of the last two semesters listed in note form is sufficient.

a)______

b)______

c)______

4. Social Commitment outside of BTK

When awarding scholarships at BTK we also look to acknowledge above-average commitment outside of BTK (e.g. in a sports club, in social, ecclesiastical, charitable or other establishments and/or in creative areas). Please include relevant certificates in your application.

a)______

b)______

c)______

5. other funding

I have applied for other scholarshipsYes□No□

If yes, which scholarships: ______

This information is not a criteria for decision about scholarship but we want to use it to improve our funding efforts.

6. Tuitionfees

I havepaydtutionfeesregularelyand I therearenooutstandingclaimsagainstme.

Ort, Datum______Unterschrift ______

7.Affirmation on completeandaccurateinformation, dataprotection

I have read the guidelines concerning the allocation of scholarships. I affirm that all the information provided by me in this form, including the attachments to this form, is complete and correct.

Data protection

The Student agreestothecollection, storageandprocessingofhis/her personal dataconsistingofidentificationandcontactdata (e.g. nameandsurname, government ID/passport, birthdate, address, email, phone), socialandlifestyledata (e.g. maritalstatus), economicandfinancialdata, professional data (e.g. internships, workstudyexperiences, employmentinformation), educationrecordsandtranscripts, etc. (hereinafter collectively “Personal Data” bytheBTKasfarastheselectionprocessforthescholarshipinvolvescentralizedservicesof Laurate Education Inc. whichrequiretheprocessingof Personal Data forfollowingpurposes:

  • Managing the student experience, providing education support and educational resources, enrollment into Laureate owned or operated institutions, enrollment in specific courses, recording and reporting grades, and course material delivery and communications;
  • Managing the process for scholarships;
  • Marketing purposes as permitted under applicable local law; and
  • Managing the alumni experience by providing development services and contacting alumni and generating continued interest in our institutions and programs as permitted under local law.

The Students Personal Data maybedisclosedandtransferredonlytothefollowingrecipientsorcategoriesofrecipients:

  • Public sector bodies that receive the data because of legal provisions (e.g. education authorities, Social Security, tax and financial authorities).
  • Internal departments involved in the execution of the respective business processes (e.g. personnel administration, bookkeeping, accounting, enrollment).
  • Laureate Education Inc. or affiliated / group companies as far as necessary for the purposes above
  • External contractors (auditors, service companies for the IT-support).
  • Financial institutions with regard to the administration and funding of scholarships;

The Students Personal Data transferredmaybestoredfornomorethan 3 years after theterminationofthecontractualrelationshipwiththestudent. Personal Data may not betransferredtothirdpartiesforadvertisingormarketingpurposes.

I confirmthat I haveunderstoodandvoluntarilyagreetotheconsentsconcerningmy Personal Data contained in thisSection. I am entitledtowithdrawtheconsentscontained herein at any time bydeletingthe same orbygiving separate noticewitheffectforthefutureandwithoutanyimpact on thegrantingorcontinuanceof a scholarshipbyBTK

______

Place, Date, Signature

The BTK funding committee has obliged itself to consider all applications submitted on time and as required and to deliberate them in the next meeting oft he funding committee following the deadline. Application deadlines will be announced internally for each semester. The applicant will be informed of the results of this deliberation promptly. Repeat applications of previously unsuccessful applicants will be treated like first time applications.As a matter of course we will treat your response as confidential.