To the

University of Osnabrück

c/o ASSIST e.V.

Helmholzstr.2-9

10587 Berlin

Germany

I hereby apply for admission to the

International Master Programme in «Cognitive Science» (M.Sc.)

Application deadlines:

summer term: 15th January

winter term: 15th July

I received a Bachelor degree (or equivalent) from a non-German university[1].

Personal details (as written in your passport):

Family name

First name

Corresponding address

Street and house number

Postcode, Town, Country

Telephone number

E-mail address

Home address

Street and house number

Postcode, Town, Country

Telephone number

Date of Birth, Place of Birth

Nationality

Details of secondary school education

List of secondary school qualifications attained (0+A-Level, Baccalaureat, etc.) ______

______

Name of town and country where certificates were attained ______

______

Further details of your school education

Country / town / Name of high school / Month/Year courses started / Month/Year courses finished / Degree awarded / Grade

Total duration of schooling

Primary/Elementary school

to the end of your schooling

Date / Original name, e.g. baccalauréat, Lise diplomasi… / Country

Details of university education

Information concerning university entrance examination in home country (if this applies to you)

______

Which universities have you attended to date?

Country / Name of university / Subjects / Year course started / Year course finished / Details of examinations / Dates of examina-tions / Examina-tion results

University grades obtained to date (B.A., B.Sc., M.A., M.Sc. etc.) ______

______

Please enclose officially authenticated photocopies of school and university certificates (incl. transcripts of academic records) along with officially authenticated translations into the German or English language.

Proficiency in German and English

My mother tongue is

□ German □ English □ ______

□ I enclose the TOEFL-test certificate (with a score of at least 550 points or computer based test with a score of at least 213 points)

□ I enclose an equivalent certificate proving my proficiency in English

□ I enclose certificates proving that I have studied English for at least 6 years at school

Proficiency in German is not mandatory, nevertheless it helps in daily life:

□ I enclose the following certificate proving my proficiency in German: ______

□ I have already studied ______hours of German language lessons

□ I would like to attend German language lessons at the University of Osnabrück

All documents must be submitted in the form of officially authenticated photocopies: Please enclose officially authenticated photocopies of school and university certificates (incl. transcripts of academic records) along with officially authenticated translations into the German or English language.

Students who do not have a Bachelor's degree in Cognitive Science must include in their application materials a statement explaining why they wish to change their previous field of study and obtain an MSc in Cognitive Science. Please be as specific as possible.

Apart from the documents required in this form, make sure that you enclose all documents required by ASSIST (cf. www.uni-assist.de)

I confirm that the above information is correct and complete to the best of my knowledge.

I hereby declare that I have taken note of the matriculation regulations.

______

Place, Date Signature

[1]If not applicable this is not the correct application form. Please, use the correct application form!