Master of Science

Information and Communications Engineering (ICE)

APPLICATION FORM ICE Master Course 14/15 starting in October 2014
Please TYPE your entries in the form and then print it or use CAPITAL LETTERS if you hand-write
Last (family) name
(as written on your passport):


First Name:

Document1 Page 1 / 2
Photograph on p. 1
( ) Male ( ) Female Marital status:
Date of birth City/Country of birth
Country of citizenship
Correspondence address Permanent address if different
Street / number







City/State


Postal code
Country
email address
ACADEMIC BACKGROUND
Name of your
University
City, Country (
The information in this section has to be very precise (exactly as indicated on your university documents)
Name of your College
City / State / Country

Dates of attendance
From (MM/YY) To (MM/YY)

Type of degree
obtained
Write the title of your degree in the original language on the degree certificates. For languages which are not with the Latin alphabet,
please write the title phonetically (for example Karshenasi mohandesi, bakalavr, Idjaza 5, etc.)



Grades
(e.g. 3.82/4 or 2.0)
Semester 1 Semester 2 Semester 3 Semester 4

Semester 5 Semester 6 Semester 7 Semester 8

Semester 9 (if applicable) Semester 10 (if applicable OVERALL GRADE of Bachelors degree

Explanation of grading
system:
Highest grade possible:
Minimum passing mark:
Further details if applicable:
If degree is pending:
Name of degree pursued
+ Expected date of completion:
+ Complete list of outstanding
subjects:

Other university degree
you have completed
Please add all details: Name of university, college, dates of attendance (MM/YY)



Details about previous
incomplete or failed
program of study
Please add all details: Name of university, college, dates of attendance (MM/YY)




Name and date of your
high school completion
certificate

Write the title of your high school completion certificate in the original language on the degree certificates. For languages which are not
with the Latin alphabet, please write the title phonetically



Master of Science
Information and Communications Engineering (ICE)
APPLICATION FORM ICE Master Course 14/15 starting in October 2014
Please TYPE your entries in the form and then print it or use CAPITAL LETTERS if you hand-write
Last (family) name
(as written on your passport):


First Name:

Document1 Page 2 / 2
Photograph on p. 1
LANGUAGE SKILLS / COMPETENCE
ENGLISH
An examination for
English is absolutely
necessary

( ) TOEFL Score obtained:
Date:
( ) IELTS Score obtained:
Date:

If your examination for English is pending: Which examination is pending?:

Date of availability of your final score?

GERMAN
Compulsory section
1- ( ) I am attaching the results of my examination for level A1
Language Institute:...
Number of hours: .
2- ( ) I am in the process of learning German (please download the document called
German on our website and fill it out, add it to your application documents. German is a
requirement for our program and the applications can only be processed with valid and
complete information about your situation regarding a language course.

Compulsory section ( ) I am aware that my application can only be processed if I already have an examination
for level A1 or if I can provide all details about the German course I am attending (Date of
examination for level A1, latest September 15, 2014)

PROFESSIONAL EXPERIENCE (Optional - please list the work experience with a duration > 1year)

Employer 1

Name and address of employer /Position / Start and Enddate (MM/YY)
Employer 2

Name and address of employer /Position / Start and Enddate (MM/YY)

HOW DID YOU FIND US? (..) DAAD (..) Internet (..) Flyer (..) others

FINANCIAL ARRANGEMENTS
Do you need a visa?
If yes, what is the amount of money required for per year of studies by the German Consulate nearest to you?
Amount in EURO:______

To which other universities have you applied?


Declaration
I declare that the information submitted in my application is correct and complete. I authorise the University to obtain information
from any educational institution previously or currently attended by me. If any information supplied by me is considered to be
untrue, incomplete or misleading in any respect, I understand the University may take such action as it believes necessary,
including the disclosure of the information to any person or body the University considers has a legitimate interest in receiving it,
and I consent to such disclosure. I understand the University reserves the right to vary or reverse any decision made on the
basis of untrue, incomplete or misleading information.

Signature: Date:


Our postal address:
Technische Hochschule Mittelhessen
Ms. Anton Master ICE
Wilhelm-Leuschner Str. 13
61169 Friedberg
Germany