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APPLICATION FORM 2015/2016 for INTERNATIONAL EXCHANGE STUDENTS

Application deadlines:

15 May 2015: nomination deadline
1 June 2015: deadline for e-mailing application files
for admission to the full academic year 2015/2016 (07-09-2015 until 25-06-2016)
15 May 2015: nomination deadline
1 June 2015: deadline for e-mailing application files
for admission to theAutumn semester 2015/2016 (07-09-2015 until 30-01-2016)

15 October 2015: nomination deadline
1 November 2015: deadline for e-mailing application files
for admission to the Spring semester 2015/2016 (01-02-2016 until 25-06-2016)

Please complete this form on your computer, then print and sign it. Note that incomplete applications will not be processed!

1. Personal details student

Surname:

First name(s):

Sex:MaleFemale

Place of birth:

Date of birth:

Passport/ID-number:

Nationality:

Street + house number:

City/town:

Postal/Zip code:

Country:

E-mail address 1:

E-mail address 2:

Cell phone number (incl. country code):

Phone number (incl. country code):

2. Contact details home university

Full name home university:

Erasmus code (if applicable):

Country:

Website:

Contact person at your home university (International Office):

Ms.Mrs.Mr.:

Full Name:

Function:

Telephone number:

Fax number:

E-mail address:

3. Visa

If you are a non-EU student, please check if and what kind of visa you need on:

Please tick:

I do not need a visa to study in the Netherlands

I need a visa to study in the Netherlands. I will fill out the Visa Service Application Form on and send it to Windesheim International office.

4 . Motivation

Why do you want to study at Windesheim University of Applied Sciences? (Max. 300 words)

5. Field of study

Please tick which study area you are applying for:

Business

Education

Engineering

Health and Welfare

ICT

Journalism and Communication

Sport and Therapy

6. Study period

Please tick and then specify the begin and end dates of your stay:

Full academic year 2015/2016

I expect to stay fromuntil

Autumn semester 2015/2016

I expect to stay fromuntil

Spring semester 2015/2016

I expect to stay fromuntil

7. Type of programme

Please tick the appropriate option(s):

I want to participate in a Double Degree programme.
Please note: Double Degree-students also have to apply through

I wantto participate as an Erasmus student

I am a participant of the Science Without Borders Programme

I am a participant of the BRANETEC Programme

Other, namely:

8. Learning difficulties

Do you have any learning difficulties (such as dyslexia, dyscalculia) or other disabilities that we should know of?

No Yes

If yes, do you need any specific facilities/support?NoYes. Please specify:

9. Accommodation

If you wish to apply for a room in one of our student dormitories please refer to our website.

Please tick:

I will be studying at Windesheim UAS, location Zwolle

I will be studying at Windesheim UAS, location Almere

7 . Checklist

I have attached to my application e-mail (obligatory, please tick):

A fully completed and signed scan of my Learning Agreement

A scan of my Language Proficiency Statement (signed and stamped), native speakers of English excepted

A photocopy of my academic records to date in Dutch or English

A clearly readable scan of my passport / ID-card

A scan of myoriginal passport photo, format: jpg (not a copy of my passport)

I have also copied a passport picture onto the first page of this application form

A scan of my health insurance papers or European Health Insurance Card, valid throughout my study period

at Windesheim UAS.

Full year students only: 1 photocopy of my birth certificate, with an apostille or double legalisation

Note: Your original birthcertificate is needed in order to register with the municipality. Please click this link for more information regarding legalising documents: legalising documents

Nursing students only: the result of my hepatitis B titre test

Design studentsonly: portfolio

Students who need a residence permit for Study in the Netherlands:

Visa Service Application Form + appendices

8 . Signatures

Student:
I hereby certify that I have provided all the required information and that all the information that I have provided is correct.
Name:
Place:
Date:
Signature: / Coordinator of sending institution:
I hereby certify that this student is eligible for exchange at Windesheim, and that the proposed study programme can be incorporated in the student’s regular study programme.
Name: MrMsMrs
Place:
Date:
Signature:
Stamp:

9. Submitting your application

Please send your application documents to the following e-mail address:

INCOMPLETE, UNSIGNED OR NON-COMPLIANT APPLICATION PACKAGES WILL NOT BE ACCEPTED!

English Language Proficiency Statement

(Only to be filled out by the International Office or a professor from the student’s home university. Native speakers of English do not have to hand in this form.)

I hereby declare that [full name student]:

born on [date of birth]:

registered at [name sending university]:

meets the English language requirements for participation in exchange programmes at Windesheim University of Applied Sciences.

His/her English language proficiency is comparable to at least:

IELTS overall band 6.0

TOEFL computer based213

TOEFL internet based80

TOEFL paper based 550

CEFR (Common European Framework of References for Languages) B2

Date: …………………………………………..

Name: …………………………………………………………………………………

Position: ……………………………………………………………………………..

Signature and stamp: