please attach photo here APPLICATION FORM I want to apply for Ohm-MBA (business background) – Part-time (3 semesters incl. master thesis) Ohm-MBA (business background) – Full-time (2 semesters + master thesis) Ohm-MBA (non-business background) – Part-time (4 semesters incl. master thesis) Ohm-MBA (non-business background) – Full-time (3 semesters + master thesis) Starting Summer Semester 20 …… (March 15th) Winter Semester 20 …… (October 1st) 1. PERSONAL INFORMATION MALE FEMALE LAST NAME ………………………………………………….............................................................................. FIRST NAMES ……………………………………….......….............................................................................. DATE OF BIRTH (day/month/year) ....................................... PLACE OF BIRTH………............………..….. NATIONALITY..........................................………........……………….............................................................. 1.1 PERMANENT MAILING ADDRESS (please inform us of any change) STREET .…………………………………….......….......................................................................................... POST CODE ............ .......... CITY ............................................. ……COUNTRY ……..…............................ PHONE ……………………………………………………… MOBILE …........................................................... E-MAIL………………………........................................................................................................................... 1.2 BUSINESS ADDRESS NAME OF COMPANY ……………………………………….....................……................................................. STREET ………………..…............…...….........……....................................................................................... POST CODE ...................... CITY ............................................. …..COUNTRY ......................…................. PHONE ………………………………………………………FAX ……............................................................... E-MAIL ……………………………........................…….................................................................................... YES CAN WE CONTACT YOU AT THIS ADDRESS? 1/7 NO 2. ACADEMIC BACKGROUND (please attach copies of certificates and transcripts) Starting with the most recent, please list all colleges and universities you attended. INSTITUTION, COUNTRY DEGREE DATES (attended from…to…) FIELD OF STUDY 3. WORK EXPERIENCE TOTAL PROFESSIONAL EXPERIENCE AFTER FIRST UNIVERSITY DEGREE (in years)....................... 3.1 CURRENT POSITION (please attach proof of your professional experience) COMPANY NAME ……….…………............................................................................................................. SECTOR OF ACTIVITY ………………......................................................................................................... TITLE/POSITION ..………….....................…………..................................................................................... FUNCTIONAL AREA ……………………......….…...................EMPLOYED SINCE..................................... NUMBER OF PEOPLE MANAGED ..............BUDGET YOU ARE RESPONSIBLE FOR ......................... 3.2 PROFESSIONAL EXPERIENCE/CAREER (start with the most recent position) COMPANY NAME …….…………………..................…….…......................................................................... SECTOR OF ACTIVITY ……………………………………...…....................................................................... TITLE/POSITION ……………………………...…............................................................................................ EMPLOYED (from…to…) …………………...….............................................................................................. COMPANY NAME ………………………………............................................................................................. SECTOR OF ACTIVITY …………………………………..………..................................................................... TITLE/POSITION .………………………………………………......................................................................... EMPLOYED (from…to…) ……………………………………........................................................................... 2/7 4. LANGUAGE SKILLS LANGUAGES EXCELLENT GOOD FAIR ENGLISH MOTHER TONGUE …………………………................................................................................................. 4.1 PROFICIENCY IN ENGLISH TOEFL (min. 550 points written/ 213 points computer-based/ 85 points internet based required) TOEIC (min. 750 points required) IELTS (min. 6,0) TOTAL SCORE ………………………...……………...DATE ….…………..................................................... 5. EXECUTIVE TRAINING PROGRAMS PROGRAM’S TITLE INSTITUTION DURATION DATES 6. ACTIVITIES AND INTERESTS Please list any activities related to your professional life (publications, associations) ……………………………………………………..................................................................................………... …………………………………………………………………………………………….......................................... Please list any activities other than education and employment in which you are/have been involved ………………………………………………………………………………..…………………….......……………… …...………………………………………….…..……………………………….......…........................................... 7. INTERNATIONAL EXPOSURE Please describe, in order of importance to you, your international exposure (residence abroad, travel, work experience etc.) DATES ACTIVITY 3/7 COUNTRY 8. TUITION FEE AND LEGAL ISSUES This registration is binding. Upon confirmation of your registration, a deposit of € 500 is due. Ohm-MBA (business background) – Part-time: The fee of € 15,000 has to be paid in three instalments: (€ 500 registration fee), € 5,000, € 5,000 and € 4,500 respectively. Ohm-MBA (business background) – Full-time: The fee of € 15,000 has to be paid in two instalments: (€ 500 registration fee), € 7,500 and € 7,000 respectively. Ohm-MBA (non-business background) – Part-time: The fee of € 18,000 has to be paid in four instalments: (€ 500 registration fee), € 5,000, € 5,000, € 4,500 and € 3,000 respectively. Ohm-MBA (non-business background) – Full-time: The fee of € 18,000 has to be paid in three instalments: (€ 500 registration fee), € 6,000, € 6,000 and € 5,500 respectively. The instalments will be invoiced in good time prior to the start of the semester. The total fee includes all courses, documentation and the first examination fee. Repeating an exam costs an additional € 50 per test. The semester fees during the regular period of study are already included in the tuition fees. Utilisation fee of € 300 will be charged for each semester above and beyond the standard period of study (incl. holiday semester). The final registration is not valid until the first instalment has been paid. By signing this registration form, you accept the General Terms and Conditions of the Georg-SimonOhm Management-Institute of Technische Hochschule Nuremberg (please see the reverse of this form). Cancellation of your registration is possible according to these terms. The tuition fee does not cover accommodation and living costs. 9. INVOICE ADDRESS Please send the invoice for the instalments of the total course fee of 15.000 €, respectively 18.000 € to NAME …………………………………………………...................................................................................... SECTION / ADDRESS ..……………..………………..................................................................................... ……………………………………………………………………....………………………………………………..... PLACE/DATE/SIGNATURE ........................................................................................................................................................ 4/7 CHECKLIST Please ensure that you have: completed the entire application form (Don’t forget the signature!) attached a recent photograph attached a copy of your degree certificate attached a verified copy of your academic transcript detailing all subjects undertaken and results attached your curriculum vitae attached original or certified copy of your TOEFL/TOEIC/IELTS results (if test not yet taken, please provide registration details) attached a proof of your professional experience attached a motivation letter HOW DID YOU LEARN ABOUT GSO-MI? Please check all that apply PROFESSORS (please specify).…………………………........................................................................ AGENTS (please specify)……….……………………............................................................................... ALUMNI (please specify)….….…………………………........................................................................... COLLEAGUES (please specify)………………………............................................................................. FAMILY/FRIENDS (please specify)………………………........................................................................ WEB SITE (please specify)……………………………….......................................................................... MBA FAIR (which city?).………………………...….................................................................................. PUBLICATIONS (please specify)………………….................................................................................. OTHER (please specify)…………………………..................................................................................... Please return the application form and supporting documentation to: Georg Simon Ohm Management Institute Kressengartenstraße 2 90402 Nuremberg/Germany 5/7 General Terms and Conditions for the Participation in Courses of the Georg Simon Ohm Management Institute 1. Scope of these terms and conditions These terms and conditions apply in connection with the relevant application forms, and cover all courses offered by the Georg Simon Ohm Management Institute (abbr. GSO-MI). More specific information covering the rights and obligations of the students and GSO-MI in respect of individual courses will be issued in the information material for those courses or in other notices of GSO-MI. 2. Application and Admission 2.1. Training courses and courses of advanced education are frequently offered with a restricted number of places. Applications for admission must be made in writing and are evaluated to ensure the applicant satisfies the admission requirements. Where there are no stipulated admission requirements, the applications are considered in the order they are received. GSO-MI reserves the right to reject any application, independent of its place in the order of receipt, in order to achieve a sensible didactic balance for the course in the interest of the accepted students and/or to rejects applicants. 2.2 The completed and signed registration form should be sent to GSO-MI at the address printed on the form. The written application can be submitted by post or by telefax. The submission of the application for enrolment to the stipulated course is contractually binding for the applicant and subject only to the notification of admission to the course through GSO-MI. The participant is bound by his signature. Acceptance that the participant may participate in a GSO-MI course occurs in writing (confirmation of participation). 2.3 The applicant agrees to accept and abide by these terms and conditions through the submission of the application. Additional agreements to these terms and conditions are only valid when they have been expressly stipulated and agreed to in writing by both parties. Unilateral reservations or conditions in connection with the application have no contractual validity. 3. Course services and facilities 3.1 Details of the contractual scope of the services and facilities for the individual training courses and courses of advanced education are given in the information material specific to the particular course and in the application form. 3.2 If the time and venue for a specific event is not included in the information material or on the relevant application form, GSO-MI undertakes to make this information available at least two weeks before the event. 3.3 The scope of the services and facilities for the individual training courses and courses of advanced education includes, in addition to the lectures, the preparation of course materials and, where notice of such has been given, catering at the location of the lectures. Accommodation and transport costs are to be paid by the participants themselves. 4. Changes to course services and facilities 4.1. The courses offered by GSO-MI are planned well in advance and are subject to frequent quality audits. Maintaining quality requires continual adjustment. GSO-MI therefore reserves the right to further develop and change the services and facilities – including the content of courses, the events, venues, times and lecturers. Such changes and other necessary short-term changes do not entitle students to compensation. GSO-MI will promptly notify the students of the changes. 4.2 The holding of an event for individual training courses and courses of advanced education course is dependent on a minimum number of students. If this number is not reached, GSO-MI can postpone or cancel the event. GSO-MI will promptly notify the students of the postponement or cancellation, giving details of the new time, or else refunding the paid fees for the event. 4.3 GSO-MI has the right to change the venue of an event; the change is to be promptly notified to the students at least eight days before the start of the event. 4.4 In case of individual lectures being cancelled, the student is not entitled to demand either alternative lecture dates or a refund of fees. If the cancellation involves an event (i.e. a full day from an event lasting at least 2 days or a complete seminar), GSO-MI will endeavour to arrange an alternative date for the event. If the student is unable to attend on the alternative date, he will be entitled to claim back part of his paid fees. 4.5 The student agrees to maintaining an email address for the duration of the course and to receiving course information and course material at this email address and/or to use an Internet-address of GSO-MI to retrieve course information. Insofar as it is not specified differently in the course information, the venue for course services and facilities is Nuremberg, Bavaria. 6/7 5. Conditions for Payment of Fees 5.1 The student pays GSO-MI the course fee as stated on the application form. Where it is not otherwise specifically stated, the given fee is to be paid plus value added tax. The services and facilities to be provided for the fee are as stated in 3.3. 5.2 A registration fee – usually 500 € – is due with the registration to a GSO-MI course. This fee is included in the course fee. Further details are provided in the information material covering the conditions applying to the individual course. 5.3 The course fee for GSO-MI courses becomes due on receipt of the notification of admission to the course and must be paid by the specified date. For advanced courses spanning numerous semesters it is possible to pay the fee in instalments, payment being due before the commencement of each semester. Further details are provided in the information material to the individual course or in the rules and regulations of fees and study specific to that course. 5.4 In the case of a repeated participation in a written examination and/or re-runs, GSO-MI is authorised to charge a participation fee. Further regulations are included in the participation conditions of each course of study. 5.5 A prerequisite for the participation in a GSO-MI course is the payment of the complete course fee. If at the commencement of the course the fee has not been paid, the student can be barred from the course and is liable to payment of compensation equivalent to the registration fee. The right to prove minor damages against the student is discretionary. 6. Withdrawals and non-attendance 6.1 Until he receives a confirmation of admission to a GSO-MI course, the applicant can, in writing, withdraw his registration, without any costs falling due. 6.2 For a cancellation received up to 4 weeks before the start of the course, compensation equivalent to the registration fee will be payable. 6.3 For a cancellation received within 4 weeks of the start of the course or non-attendance at the course. The complete course fee will be payable. A cancellation has to be sent in writing either by post, fax or email. The applicant may name a proxy to attend the course. This is only possible with the consent of GSO-MI. The admission of a proxy may be denied by GSO-MI, especially if the person named does not fulfil the prerequisites for the course. If a proxy is admitted to the course, he (or she) and the original applicant are jointly liable for the payment of the course fees. 7. Liability 7.1 GSO-MI is only liable in cases of criminal intention or wilful negligence. No responsibility is accepted for consequential or indirect damages. Claims for compensation expire if they are not made in writing to GSO-MI within three months of knowledge of the injury or damage. 7.2 GSO-MI accepts no responsibility for injury or damage incurred during travel to or from the venue of a course, nor for any arising at the venue. GSO-MI also disclaims any liability in cases of theft, loss or damage of objects, especially valuables, brought by students to the course. 8. Further Provisions 8.1 In cases of force-majeure (Acts of God), GSO-MI ceases to be liable to fulfil its obligations for the duration of the emergency. Cases of force-majeure encompass fire, strikes, lockouts and such situations not caused by GSO-MI, but which make their fulfilment of obligations either extremely difficult or impossible. 8.2 For the purpose of processing applications and organising courses, the information provided by applicants will be filed, assessed and, if necessary to fulfil the contract, made accessible to third parties. GSO-MI and third parties offering similar courses are also interested in sending information of future courses and events to the students. At any time the student can request that such information cease to be sent to him. 8.3 Should any individual clause of these terms and conditions cease to be valid, the validity of the remainder of these rules will not be effected. In place of an invalid clause, a rule will be substituted, which attempts in a legally acceptable manner, to fulfil the economic aim of the original clause. Should it transpire, that under these conditions something has been overlooked, the parties will adopt a rule which covers the matter in a manner they would have agreed to, had they not overseen the deficiency. 8.4 This agreement is subject to the laws of the German Federal Republic. All disputes arising from contracts based on this agreement are to be decided within the jurisdiction of the courts in Nuremberg, Bavaria. Nuremberg, 2009 7/7