1. Personal data
First Name*: Last Name*:
Date of birth*: Citizenship*:
Place of birth (City/State/Country)*:
Address of Correspondence:
Street number*:
ZIP/Postal Code*:
Country*:
Street*:
City*:
This address will be valid until*:
Add. Inf.:
State/Province:
Telephone*:
Email*:
Permanent Address (if different):
Street number:
ZIP/Postal Code:
Country:
Street:
City:
FAX:
Skype name:
Add. Inf.:
State/Province:
Telephone:
2. Education
University/College name* :
FAX:
Dates of Attendance (Month/Year)
Major/Minor Field of Study*:
Language of Instruction*:
From*: To*:
Date of Award*: GPA/Highest score*:
Language of Instruction*: Degree (B.A./M.A./etc.)*:
[Add another university]
Secondary Schooling (high school, grammar school and equivalent):
Dates of Attendance (Month/Year)
Date of Award*:
From*:
GPA/Highest score*:
To*:
Sex*:
All fields marked with an asterisk* are required. 1

Study abroad experience:
University/College name:
City: Country:
Dates of Attendance (Month/Year) From:
Major/Minor Field of Study:
To:
Language of Instruction:
[Add another university]
Would you like to share any other information with us? (Honors, Fellowships, etc.):
3. Employment and Professional qualifications
Name of Employer:
From: To: Dates (Month/Year):
Type of business or sector:
Occupation or position held:
Main activities and responsibilities:
Country: City:
[Add another employer]
Work experience abroad:
Name of Employer:
Dates (Month/Year):
Type of business or sector:
Occupation or position held:
Main activities and responsibilities:
City:
[Add another employer]
From: To:
Country:
All fields marked with an asterisk* are required. 2

4. Language proficiency
Command of English:
Please specify, whether English is your native language*:
If not, please list your native language:
Have you earned a degree from a university in an English speaking country*:
If yes, please indicate the country:
If English is not your native language or if you are not holding a degree from a university in an English speaking country, you must provide recent results of an international, standardized test of English as a foreign language.
Please enclose copies of your test results with your printed application.
If you have not taken a test yet, please indicate the name and expected date of the test.
Name of English Test (TOEFL/IELTS/CPE):
Date of English Test: Result of English Test:
Command of other languages:
Language:
Reading Skills
[Add another language]
5. Finances
Writing Skills
How do you expect to finance your tuition fees?*
Speaking skills
Self Scholarship Other
How do you expect to finance your living expenses?*
Self Scholarship Other
If you plan to apply for a scholarship, please give the name of the institution which offers the scholarship:
6. References
Please name two academic or professional supervisors who will write a reference letter in support of your application.
Name*: Name*:
University*:
Institution*:
Position*:
Telephone*:
Email*:
University*:
Institution*:
Position*:
Telephone*:
Email*:
All fields marked with an asterisk* are required. 3

7. Statement of Purpose Motivation letter/Statement of Study Plans
Statement of Purpose Motivation letter/Statement of Study Plans*: (max. 4000 symbols including spaces)
8. Additional Information
Would you like to share any other information with us?
How did you first learn about the HCA and/or its MAS program?*
Education Fairs
Poster
Flyer
HCA Alumni
DAAD brochure
Heidelberg University Homepage
Friends
Professor
DAAD website
Mastersportal.de
Findamasters.com
Postgraduate.de
Facebook
Other
Are you applying to other universities?
If yes, please list them and state the position of Heidelberg in your order of preference:
2. 3. 1.
All fields marked with an asterisk* are required. 4

9. Scholarship Application
I am applying for the full scholarship offered by the HCA including the tuition fees (2,500
EUR/semester) and the living costs (660 EUR/month).
I am applying for the tuition scholarship offered by the HCA, including the tuition fees (2,500
EUR/semester).
Scholarship Essay: Why should you receive the scholarship? (max. 4000 symbols including spaces)
Please name your academic supervisor who will write a reference letter in support of your scholarship application. The reference letter must be submitted in a sealed and signed envelope.
Name:
University:
Institution:
Position:
Telephone:
Email:
All fields marked with an asterisk* are required. 5