International Office - University of Vienna

Joint Study Programs with English-speaking, non-European universities:
USA: Georgetown University, New York University, Wellesley College, University of Chicago,
University of Illinois at Urbana-Champaign, Washington and Jefferson College, University of Washington, University of South Carolina / Please attach
passport sized
Photograph
AUSTRALIA: Macquarie University, Monash University, University of Sydney, UniversityUniversity of Melbourne,
University of Queensland, The Australian National University, University of Western Australia
Student Application Form
(Please print and write in black to facilitate the copying and/or faxing procedures!)
Field of Study: ......

Students Personal Data

(to be completed by the student applying)

Family name: ...... / First name: ......
Date of birth: ...... / Gender: ......
Nationality: ...... / Place of birth: ......
mailing address: / Permanent address:
...... / ......
...... / ......
...... / ......
...... / ......
Tel.: ...... / Tel.: ......
Email: ...... / Email: ......
Ranking of institutions / Period of attendance:
(Please number 1 - 3 in the order of your preference) / (Please put a tick according to your preference)
·  Georgetown University: ...... / fall term 2012 ...... or spring term 2013 ......
·  New York University: ...... / fall term 2012 ...... or spring term 2013 ......
·  University of Illinois: ...... / fall term 2012 ...... or spring term 2013 ......
·  University of Chicago / winter & spring quarter 2013......
·  Washington and Jefferson College: ...... / Fall term 2012 ...... or spring term 2013
·  University of Washington: ….. / academic year 2012/13 .....
·  University of South Carolina: ….. / Fall term 2012 ...... or spring term 2013
·  University of Sydney: ...... / second semester 2012 ...... or first semester 2013 ......
·  Macquarie University: ...... / second semester 2012 ...... or first semester 2013 ......
·  Monash University: ….. / second semester 2012 ...... or first semester 2013
·  The Australian National University: ...... / second semester 2012 ...... or first semester 2013 ......
·  The University of Western Australia: ….. / second semester 2012 ...... or first semester 2013 ......
·  The University of Queensland:…… / second semester 2012 ...... or first semester 2013 ......
·  The University of Melbourne:……. / second semester 2012 ...... or first semester 2013 ......
Have you passed the TOEFL or IELTS test?
If yes, please indicate date and score: / Date: ...... Score: ......
If no, for which date did you register? ...... / When do you expect to receive your score? ......
Other language skills: ......
......
Education abroad: ......
......
......
Occupational experience abroad: ......
......
......
Occupational experience in Austria: ......
......
......
Hobbies: ......
......

D e c l a r a t i o n

I have read the information on Joint Study Program available at the International Office of the University of Vienna. I wish to apply for the program(s) that I indicated on the first page of this application form. I certify that the statements I have made on this application are true and correct. I understand that the application process may include supplementary materials which I agree to complete promptly. I understand that in case of nomination I will be studying on a non-fee/non-degree-status. I hereby authorize my application to be distributed to other participants in the program. I further agree that neither the University of Vienna nor a Partner University will be held responsible for any liability whatsoever; furthermore, neither the University of Vienna nor a Partner University shall be required to purchase any insurance against loss or damage to any personal property to which this application relates. Due to the limited number of places and the fact that nominated students must be distributed on fall or spring term (respectively 1st or 2nd Semester), I understand that in case of nomination the period of attendance can be different than the one I indicated on the first page of this application form.
Applicant's signature: ...... Date: ......

INTERNATIONAL OFFICE USE ONLY

Required approval:

Joint Study Coordinator: ...... Date: ......