Application for admission Exchange
Academic year 2015 – 2016
Summer Programme
Faculty of Health and Social Studies
photograph (1)
Deadline registration for studying at HAN : April 15, 2016
1.
Personal Identification (only complete digital)
Student name
Last name:
First name(s):
Place of birth:
Date of birth:
Gender:
Scroll Menu
Nationality:
Email address:
2.
Student Address (only complete digital)
Permanent address:
Postal Code
City:
Country:
Telephone number (incl. country code):
Cell phone number (incl. country code):
Application for admission Exchange, Summer Programme
Faculty of Health and Social Studies 2015-2016
3.
To be warned in case of an emergency: (only complete digital)
Name:
Email address:
Address:
Postal Code
City
Country:
Telephone number incl. country code :
Cell phone number incl. country code:
4.
Details of your home University (only complete digital)
Name of your home University :
Address of your home University :
Name of the contact person at your home University:
Telephone of the contact person at your home University
Email address of the International Office of your home University:
Title of your degree course at your home University:
Name of the person who is supporting your application:
Date
:
Position
:
Stamp
:
Signature
:
Application for admission Exchange, Summer Programme
Faculty of Health and Social Studies 2015-2016
5. Course at HAN University of Applied Sciences
Exchange course
Faculty of Health and Social Studies:
Scroll Menu
Period of Study:
From July, 1 until July, 15 2016
6. Language Ability
Native language:
English language ability:
B1
B2
C1
C2
Every program has their own language standard, more information can be
found on https://www.han.nl/international/english/about-han/internationaloffice/erasmus+/
7. Motivation:
Attach your motivation letter including your resume
Application for admission Exchange, Summer Programme
Faculty of Health and Social Studies 2015-2016
8. Study Costs
I am aware that the basic cost of living (transport, meals) etc in the
Netherlands will be around € 550 per month, accommodation NOT
included.
9. Insurance
I am aware that I need to have health insurance, covering urgent
medical costs In the Netherlands.
Name of my International Health Insurance Company :
(Attach a copy of your International Health Insurance card,)
Please note: Students for whom HAN UAS had applied for a visa, will have
insurance through the HAN and do not need to hand in a copy.
I am aware that I must have a liability insurance that will cover claims if
I am to blame for an accident that injures someone or damages another
person`s property
10. Accommodation
HAN Campus Nijmegen:
I want to reserve a room
In order to reserve a room you need to respect our deadline for admission:
which is April, 15 2016
The information that I have filled in is correct and I am aware that only after the
selection procedure is completed I will receive an official confirmation of admission
Date:
Place:
Signature:
Application for admission Exchange, Summer Programme
Faculty of Health and Social Studies 2015-2016
Please attach the following:
 Copy of passport or European Identity Card
 1 passport photograph
 Copy of International Health Insurance card
 A Transcript of Records from your home university
 Motivation Letter and resume
Send the application for admission to:
Faculty of Education and Health and Social Studies
HAN University of Applied Sciences
International Office
Mrs. Agnes van Kalleveen
Postal address
PO Box 6960
6503 GL Nijmegen
Netherlands
Application for admission Exchange, Summer Programme
Faculty of Health and Social Studies 2015-2016
Courier address
Kapittelweg 33
6525 EN Nijmegen
Netherlands