Application form for admission to studies for foreign applicants

Applicant number: 1585434

Semester: winter semester 2015 (beginning of studies in september/october 2015)

Higher Education Institute:

Kleve, HS Rhein-Waal

Application form for course of study:

Master of Science International Management and Psychology (Kamp-Lintfort)

1. Information on the desired degree course
1.1. Course 1. choice (not submitted)
Target degree in Germany : Master of Science
Course number

Course name

Course semester

1. course

International Management and Psychology

2. Personal details
Surname/Family name del Solar Velarde
First/Given name(s) Marita Jimena
Sex female

Date of birth 5.8.1991

Place of birth Peru

Nationality/Nationalities Peru

3. Correspondence address
c/o
House number/Street/Road Camino Real Avenue #108 Int / B-303
etc.
Postcode/Zip code

Town/City/Postal Cusco
district

Country Peru
E-Mail jimdsv@hotmail.com
Telephone +5184251966
Mobile phone +51941409150

4. School leaving certificate

Date 0000-00-00
Original name
Country Peru

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5. Your educational background

All details must be proven by enclosing officially certified/attested certificates/supporting documents and
officially certified/attested German or English translations. It is essential that you include these with your
application. Important Note. Some higher education institutions (HEIs) do accept certificates/supporting
documents in other languages (please observe the detailed information provided by the HEI in question).

Studies completed at a German university/ German university of applied sciences

Studies completed outside of Germany
1st apprenticeship/study course/work placement - from MM/YY 5 years
to MM/YY
Name and place of institution (in the original language in latin Peru - Universidad Nacional de San Antonio Abad del
script!) Cusco
Specify the field/subject(s): Communication Science
Name of qualification/position of employment/placement Bachelor in Communication
Pass? yes
2nd apprenticeship/study course/work placement - from Event and Btl Cordinator - From August 2013 to May
MM/YY to MM/YY 2015
Name and place of institution (in the original language in latin Activa Marketing y Comunicaciones S.A.C. ,Peru
script!)
Specify the field/subject(s): Marketing
Name of qualification/position of employment/placement Event and Btl Cordinator
Pass? yes

Activities prior to application

Length of activity (from MM/YY to MM/YY) no particular activity

I confirm that to the best of my knowledge and belief all the information I have given on this form is true,
complete and accurate. Beyond that I assure that my specifications about my academic background are
complete and that I did not conceal any studies done at a university. I have enclosed the required documents
(certificates, supporting documents, etc.). I am aware that intentionally or negligently giving false information
constitutes an administrative offense and may lead to exclusion from the admissions procedure or if
discovered at a later date to the cancellation of my admission or enrollment. I confirm that I have read the
admissions information.
All entries completed? Please print out form and sign it. Please enclose all documents.

Place

Date

Signature

The above information will be stored and processed by the higher education institutions. They are fully
subject to the data protection regulations currently in force.

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