BEWERBUNGSFRAGEBOGEN / APPLICATION FORM

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1 BEWERBUNGSFRAGEBOGEN / APPLICATION FORM (Vor Unterschrift bitte genau durchlesen) (Please check thoroughly before signing) 1 Foto 1 Picture I. ZUR PERSON / PERSONAL DATA Familienname / Surname (as stated on identification document) Vorname(n) / First name(s) (as stated on identification document) Adresse im Heimatland / Home address Adresse im Studienland / Address in the country of study Geburtsdatum / Date of birth Geburtsort / Place of birth Staatsangehörigkeit / Nationality Konfession / Religious Denomination Familienstatus / Family status Konrad-Adenauer-Stiftung Syria/Iraq Office 1

2 II. AUSBILDUNG / EDUCATION i. Schulbildung / Education (Primary and secondary schools, high schools, evening schools, etc. from most to least recent) Schulart / Type of school Certificate or diploma ii. Universitäts- und Hochschulstudium / Higher Education (University studies from most to least recent) Schulart / Type of school Certificate or diploma Konrad-Adenauer-Stiftung Syria/Iraq Office 2

3 iii. Berufs- und Berufsfachschulen / Vocational training (Vocational, technical schools, etc. from the most to the least recent) Art / Type Certificate, diploma iv. Außerschulische Ausbildung / Further education (Skills trainings, IT trainings, security trainings, etc. from the most to the least recent) Art / Type Certificate, diploma Konrad-Adenauer-Stiftung Syria/Iraq Office 3

4 III. BERUFSERFAHRUNG / PROFESSIONAL EXPERIENCE (Please fill in your current and most recent jobs, from the most to the least recent) Firma oder Institution / Company or Institution Tätigkeit / Position IV. SONSTIGES / OTHER i. Sprachkenntnisse / Languages (Please indicate language and degree of your academic and professional proficiency) A = Mother tongue B = Advanced C = Intermediate D = Beginner Sprache / Language Lesen / Reading Schreiben / Writing Konversation / Conversation Speaking Understanding Konrad-Adenauer-Stiftung Syria/Iraq Office 4

5 ii. Ehrenamtliche Tätigkeiten / Volunteer work Institution / Institution Tätigkeit / Position iii. Persönliche Interessen / Personal Interests iv. Persönliche Ziele / Personal Goals (Where do you see yourself professionally in 5 years?) Konrad-Adenauer-Stiftung Syria/Iraq Office 5

6 v. Verwendung des Stipendiums / Use of the Scholarship (Which education program do you intend to support with the scholarship and what benefits, other than financial, do you expect from it?) V. FINANZEN / FINANCES Geschätzte Studienausgaben / How high are the expenses related to your studies expected to be? Monatliche Miete / Rent per month Monatliche Fahrtkosten / Transportation per month Studiengebühren pro Semester / Tuition fees per semester Ihr Einkommen und das Ihres Haushalts (Verwandte, die Sie finanziell unterstützen) / What is the monthly income of your household (relatives who support you financially), including yourself? Konrad-Adenauer-Stiftung Syria/Iraq Office 6

7 I hereby declare that 1. The information in the application form is true 2. I am aware that the lack of veracity of the information will lead to the cancellation of the contract Datum und Unterschrift des Bewerbers / Date and signature of the Applicant Konrad-Adenauer-Stiftung Syria/Iraq Office 7