Applicationformforadmissiontostudiesforforeignapplicants

Applicantnumber:1676927

Semester:wintersemester2016(beginningofstudiesinseptember/october2016)
HigherEducationInstitute:Nordhausen,HochschuleNordhausen
Applicationformforcourseofstudy:

Bachelor(FH)PublicManagement
1.Informationonthedesireddegreecourse
1.1.Course1.choice(submitted)
TargetdegreeinGermany:Bachelor(FH)
Coursenumber

Coursename

Coursesemester

1.course

PublicManagement

2.Personaldetails
Surname/Familyname Agnisagar
First/Givenname(s) VishnuSimmha
Sex male

Dateofbirth 10.5.1986

Placeofbirth Bangalore
Nationality/Nationalities India

3.Correspondenceaddress
c/o
Housenumber/Street/Road 3SaiNilaya,3rdACross,
etc.
Postcode/Zipcode 560043

Town/City/Postal Bangalore
district

Country India
EMail vishnu.sairam1@yahoo.com
Telephone +919886461000
Mobilephone +919886461000

4.Schoolleavingcertificate
Date 20030513

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Originalname Sekundarschulabschlusszeugnisnach12Klassen
Country Indien

5.Youreducationalbackground
Alldetailsmustbeprovenbyenclosingofficiallycertified/attestedcertificates/supportingdocumentsand
officiallycertified/attestedGermanorEnglishtranslations.Itisessentialthatyouincludethesewithyour
application.ImportantNote.Somehighereducationinstitutions(HEIs)doacceptcertificates/supporting
documentsinotherlanguages(pleaseobservethedetailedinformationprovidedbytheHEIinquestion).

EducationalData
1stSchool:AttendedMM/YYMM/YY 06/200105/2003
Nameandplaceofschool BoardofsecondaryEducationMadhyaBharatgwalior
Country Indien
Nameandtypeofschool Sekundarschulabschlusszeugnisnach12Klassen
2ndSchool:AttendedMM/YYMM/YY 05/2001
Nameandplaceofschool vidyamandirBangalore
Country india
Nameofcertificate secondaryschoolleavingcertificate

Entranceexam
Studienkolleg/Feststellungsprfung
StudiescompletedataGermanuniversity/Germanuniversityofappliedsciences
StudiescompletedoutsideofGermany
Activitiespriortoapplication
IconfirmthattothebestofmyknowledgeandbeliefalltheinformationIhavegivenonthisformistrue,
completeandaccurate.BeyondthatIassurethatmyspecificationsaboutmyacademicbackgroundare
completeandthatIdidnotconcealanystudiesdoneatauniversity.Ihaveenclosedtherequireddocuments
(certificates,supportingdocuments,etc.).Iamawarethatintentionallyornegligentlygivingfalseinformation
constitutesanadministrativeoffenseandmayleadtoexclusionfromtheadmissionsprocedureorif
discoveredatalaterdatetothecancellationofmyadmissionorenrollment.IconfirmthatIhavereadthe
admissionsinformation.
Allentriescompleted?Pleaseprintoutformandsignit.Pleaseenclosealldocuments.

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Place

Date

Signature

Theaboveinformationwillbestoredandprocessedbythehighereducationinstitutions.Theyarefully
subjecttothedataprotectionregulationscurrentlyinforce.

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