INTERNATIONAL WINTER UNIVERSITY University of Applied Science Fulda, Germany January 4 – 23, 2016 Application for the International Winter University (IWU) Fulda 2016 January 4-23, 2016 Wisconsin-Hessen IWU Fulda Application I would like to enroll in the IWU Fulda 2016 program. The program includes one academic seminar (45 contact hours), a language course (30 contact hours), workshops, a cultural program, accommodation in a hotel from January 4 – 23, 2016 (with breakfast), health, liability and accident insurance for the duration of the program and study material. Please send the completed form to the International Office of your home university (via mail or email). This information is for application purposes only and will not be passed on to third parties. Please TYPE 1 INTERNATIONAL WINTER UNIVERSITY University of Applied Science Fulda, Germany January 4 – 23, 2016 PLEASE TYPE!!! Personal Information Family name: First name(s): Date of birth (DD.MM.YY): Place of birth: Gender: Nationality (as stated in your passport): Passport number (if already available): Do you need a visa to enter Germany? Contact Information Street: City: Zip code: Country: Phone: E-Mail: Emergency Contact Name: Email: Phone: Academic Information Home institution: Subject, year: Level of English: Have you studied German before? Level of German: City: male US Citizen State: female No USA 1 (country code) + 1 (country code) + (area code) + (area code) + UW Major: First Yr/Soph/Jr/SR Beginner Intermediate Advanced Native Speaker No Yes, I studied it by myself Yes, I studied it at the university / a language institute / via online course. Please name the institute and city: and how long (please mention in hours, days, weeks or months) Beginner Intermediate Advanced Native Speaker Miscellaneous 2 INTERNATIONAL WINTER UNIVERSITY University of Applied Science Fulda, Germany January 4 – 23, 2016 Do you suffer from any health problems (chronic illness, allergies, etc.)? Yes No If yes, please specify: How did you find out about IWU 2016? Internet Advertising material (flyer, poster, etc.) DAAD Friends, family or former IWU/ISU participants Faculty / Member of your home university International Office / Study Abroad Advisor Study Abroad Fair on my home campus Other: Please choose one IWU module (45 contact hours): Business: International Management in an Intercultural Environment German Cultural Studies Please choose one IWU German language course level (30 hours): Beginner Intermediate Advanced Optional Frankfurt Tour (EXTRA Fee of 50€) Yes (I understand this will incur an extra fee) No, thank you Please briefly state your motivation to participate in the International Winter University (IWU) Fulda: _____________________________________________________________________________ __ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ __________________________________________________ Please attach a CV (template provided by the home international office, specifically for Hessen programs) and an academic transcript to your application (may be unofficial transcript). 3 INTERNATIONAL WINTER UNIVERSITY University of Applied Science Fulda, Germany January 4 – 23, 2016 Terms and Conditions Registration Upon receipt of an application, the IWU Fulda will review the documents and confirm or reject acceptance. In the event that there is not a sufficient number of students enrolled, the International Winter University may cancel seminars or may cancel the entire IWU 2016 program. Disclaimer The IWU Fulda, its organizers, staff, lecturers, and teachers shall not be held accountable for any damage to personal property or for any injuries suffered by participants during the Winter University program, except where the damage or injuries suffered are caused by acts of willful intent or gross negligence. The IWU Fulda shall not be held accountable for any damage to property or injury to people caused by participants. Important Minimum age for participation in the IWU program is 18 years. In case of misbehavior, the organizers of the IWU Fulda reserve the right to dismiss a participant from the IWU Kassel program. Misbehavior constitutes e.g. attacks and insults on other participants, staff, or other third people, drug abuse, excessive alcohol abuse. The dismissal of a participant from the course is solely at the discretion of the organizers, i.e. the academic organizers and the program manager. Should a person be dismissed from the International Winter University program, no fees will be refunded. Governing Law, Jurisdiction The laws of the Federal Republic of Germany shall govern this contract. The place of jurisdiction for all disputes arising hereunder shall be the courts of ordinary jurisdiction in Fulda. (initials) Herewith, I am registering for the International Winter University (IWU) Fulda 2016 at the Fulda University of Applied Science with the components marked above. I carefully read the information concerning registration and hereby accept the terms and conditions of IWU 2016. City Date (DD/MM/YYYY) **Signature **Please use your handwritten signature when signing the application form. 4