MSc Medical Technology Application Form 2002



MSc Candidate Application Form

Master’s Program Biomedical Engineering

TO BE FILLED IN BY APPLICANT (INTERNATIONAL STUDENTS)

A. Personal Data

|1. Surname Family Name: |      |

|2. Birth Name Maiden |      |

|Name: | |

|3. First Name(s) |      |

|4. Date of Birth | |5. Sex: male = m female = f |

| |           | |

| |(day) (month) (year) | |

|6. Place of Birth |      |

|7. Correspondence | |

|Address |      |

| |Street and House Number |

| | |

| | |

| |      |      |

| |Postcode |Place of Residence (city) |

| |      |

| |Country |

|8. Citizenship |      |

|9. Telephone |      |

|(incl. Int. Code) | |

|10. E-Mail | |

| |      |

You must have an international English language certificate or you fulfill one of the issues listed below. (Detailed information: )

Proof of English proficiency

Internationally accepted language test in English

(e. g. TOEFL ; IELTS ; CAE)

English was the official language in school

At least ½ year of working or studying

in an English-speaking country

English was the official language of

Bachelor/Master’s studies

MSc Candidate Application Form

Master’s Program Biomedical Engineering

B. Curriculum Vitae

Academic Qualifications

|Name and Location of Universities, Colleges or Polytechnics where you acquired your degrees |Best grade |Worst grade |

| |(theoretic best grade)|(to pass the course |

| | |of study) |

| | | |

|1.       |      |      |

| | | |

|2.       |      |      |

Please fill in the general margins of the grade system of the university, where you acquired your degree

|Correct term of the degree and the field of study (e.g. Bachelor of |From |To |Standard length |Your final grade|

|engineering in Biomedical Engineering) |mm/yyyy |mm/yyyy |of your |(GPA) |

| | | |Bachelor’s | |

| | | |program | |

| | | | | |

|1.       |      |      |      |      |

| | | | | |

|2.       |      |      |      |      |

Previous/Current Employment

|Name/Address of Employer |From |To |Position |

| | | | |

|      |      |      |      |

| | | |      |

| | | | |

|      |      |      |      |

| | | |      |

Level of German knowledge A1 A2 B1 B2 other

(only for International applicants)

MSc Candidate Application Form

Master’s Program Biomedical Engineering

Other Experiences/Skills

|Please submit further information relevant for your application |

| |

|      |

| |

I confirm that the information given in my application is true, complete and accurate. No information requested has been omitted. I know that incorrect statements may lead to a cancellation of my application.

Please take into account: The studies are free of tuition fees. Only a charge of approximately 75 Euros has to be paid once for the application, if you have to apply with Uni-Assist in Berlin. Additionally, all students have to pay a semester fee of about 120 Euros after their arrival in Lübeck and a registration fee of 50 Euro only once. Please do not pay anything to mediating persons. Such payments do not increase your chances for admission to the studies in any way. Please send your application documents directly to the address given below.

           

Place/Date Signature of Applicant

(1) Applicants from China, Vietnam and Mongolia have to apply at “Akademische Prüfstelle - APS”

of the German embassy in Beijing.

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