Application Form for a STIBET-Scholarship _________

To:
Universität Koblenz-Landau
Präsidialamt / Referat 13
Postfach 1864
55008 Mainz

Application for Degree Scholarship

1. Personal Data

Surname:       Firs name:      

Date of birth       Place of birth /      

(dd.mm.yyyy): Country of birth:

Nationality(s):       Gender: Male Female

single Number and      

Martial status: age of children:
married
     

Street:       House number:      

Post/Zip Code:       Town:      

E-Mail:      
Telephone
landline number
     
and mobile number      

2. Bank details

Bank (Name):       Account holder:      

IBAN:       BIC:      

3. Details about your studies

Campus:      
 Application Form for a STIBET-Scholarship

Courses of studies / Field of      

study:

Intended degree: Bachelor Master

others (Diplom, Staatsexamen):
Enrolled at University of
      Enrolment number:      
Koblenz-Landau since:

In which semester you will be      

enrolled in Summer Semester:

Expected date of your dregree: Month       Year      

Achieved ECTS up to now       Grade point average      

(according to KLIPS-Statement): (GPA):

Topic of your final paper:      

Academic supervisor:      

Time frame for your final paper: from       to       (dd.mm.yyy))

4. Financing of your studies

How much money do you have       €

available per month?

Earned income       € per month

Maintenance from private persons (Parents,       € per month

relatives, spouse,…)

Scholarship / Funding by other institutions       € per month

If yes, which one?      
When is it expected to end?      

Other income       € per month

Will your situation yes no

change soon?
If yes: Why? How much money will you have availabel then (per
month)?
     

Did you apply for yes no

another scholarship?
If yes, which one?      
When will the decision be made if you can get the funds?      

2
 Application Form for a STIBET-Scholarship _________

Which amount will it have?      

Do you receive BAföG yes no

payments?

5. Please substantiate your application. Why do you need financial support?

Why should you be selected for the scholarship? (max. 5000 characters)
     

Requested documents to attach to the application:

Current certificate of enrolment at University of Koblenz-Landau

Evidence of completed modules/courses and exams (KLIPS-Statement)
CV with a passport photo (max. 2 pages)
Copy of passport or identity card
Evidence of current finances (e.g. statement of your bank account from the last 3
months), see “4. Financing of your studies”
Confirmation of registration of the topic of your final paper or final examination(s)
Provisional time-table for the completion of your degree (in monthly steps, max 1
page)

I hereby affirm that the details stated above are complete and accurate and that, to the
best of my knowledge, I haven’t omitted any information. I commit to inform the
International Office of every change of my personal data and the financial situation
during the application period, if I am getting funds, until the end of the benefit period.
I know that culpably wrong or missing information, notably to the financial questions,
can result in a loss of aid and the obligation to repay the funds I already received.

________________________ ______________________________
City, Date Signature

Please note:
The application form must be sent with all requested documents by post to the International Office.
Applications sent by e-mail cannot be accepted.