Application form 2012-2013

Fontys University ICT College

Telephone secretariat: +31 8850 78347 / 78127

e-mail :

Please fill in this form digitally

Personal data

Familyname + initials______

(maiden name)

First names in full______

Male/female 0 M 0 F Civil status 0 married 0 single

Date of birth______Place of birth______

Native country______Nationality ______

Home address

Address______

Postal code______Town______Country______

Telephone number______

E-mail address ______

E-mail address country-representative (if applicable) ______

Embassy where you want to pick up your VISA (if applicable) ______

Information regarding your diploma

What is the exact name of your diploma? ______

If you do not possess a diploma yet; what is the expected date of your diploma? ______

Please note: for non-EU students application requirements need to be fulfilled before 1 June 2012

Together with this form please send us:

  • A copy of your valid passport;
  • (if already achieved) Certified (*) copy of your diploma; in the original language and in English (an official English translation);
  • (if already achieved) Certified copy of the final gradelist;
  • (if applicable) proof of your command of the English language;
  • (if applicable) please check our website for documents needed for your VISA application.

(*) Photocopy of the original diploma and gradelist; these copies needs to be originally signed and stamped.

Your school, townhall, police or another official body can do the certification / validation of your papers.

The course will start on 20 August 2012

Course of choice

Application is for(tick one box)

0 ICT & Software (Information Technology / Software Engineering)

0 ICT & Business (Business Information Systems)

0 ICT & Technology

0 Joint Program TU/e

Application is for(tick one box)

0 Propedeutic Phase (1st year)

0 Core Phase (2nd or 3rd year; application is only possible in consultation with the course coordinator)

0 Final Year Programme (4th year; application is only possible for students coming from a partner University)

General information

Do you want Fontys to reserve accommodation on your behalf?

I would like Fontys to arrange accommodation in the Netherlands on my behalf. I have read and I agree with the terms and conditions mentioned on the Accommodation form, academic year 2012-2013. Please send the accomodation form together with this application.

Upon arrival in the Netherlands, I will have a legal address to live. Therefore, I do not need Fontys to arrange accommodation for me.

Attention!

  • If the information is not complete we can not process your application.
  • Per academic year you need approximately € 8.000 for complete costs (excluding Tuition Fees).

Filled out truthfully

I hereby declare that I am in agreement with the registration conditions of Fontys University of Applied Sciences

(see: )

DateSignature studentSignature parent or legal guardian

(if student is a minor)

______

For updated information, please visit our website : www.fontys.edu/ICTandEngineering