Application

Personal data

Student Status

Erasmus

Other

First name(s)

Family name(s) (as it appears in the passport)

Date of birth

Town & Country of Birth

Nationality

Gender

female

male

diverse

Permanent address

Mobile phone

E-Mail

Copy of your passport

Emergency contact

First name(s) of contact person

Family name(s) of contact person

Telephone number of contact person

E-Mail address of contact person

Relationship with contact person

Home university

Country of the home university

Home university

Enrolment certificate of your home university

Current semester

Field of study

Other personal information

Do you have any disabilities, special requirements?

Do you have any dietary restrictions?

Which type of accommodation do you prefer for your stay in Mosbach?

Double room in shared flat

Single room in shared flat

Which type of accommodation do you prefer for your stay in Bad Mergentheim?

Double room in student dorm

Single room in student dorm

Double room in shared flat

Single room in shared flat

Twin room in hotel (optional breakfast)

Single studio in hotel (optional breakfast)

Please note that there are only a limited number of rooms available in each category. If your preferred room category is no longer available, we will suggest the closest available alternative.

Additional Comments

Agreement

Confirmation

1) I confirm that all information provided in the application form is correct and complete. 2) I confirm that I have sufficient financial resources to cover all costs associated with my stay at the DHBW Mosbach and Bad Mergentheim (accommodation, travel, entry fees and food). 3) I will confirm that I will participate in the Summer School at my own risk. I will obtain adequate insurance coverage and comply with all entry and visa requirements for my stay at DHBW Mosbach.

Declaration of consent

I agree to the storage, disclosure and processing of my personal data as part of the overall application process.

Application

Anmeldung Summer Schools