Student Application

Form International Office

Academic year: 2022/2022

 Winter term (01.10.-14.02.)
 Summer term (15.03.-31.07.)
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Field of study: _______________________________

Sending institution: _______________________________
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Erasmus Coordinator: Cornelia Eichinger ________________

Personal data:
Family name: ____________________________________________________
First name(s): ____________________________________________________
Date of birth: ____________________________________________________
Place of birth: ____________________________________________________
Sex: _________________________________________ (male/female)
Address: ______________________________________________________
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Nationality: ______________________________________________________

Telephone: ______________________________________________________
E-Mail: ______________________________________________________

Abteilung Amberg: Kaiser-Wilhelm-Ring 23, 92224 Amberg, Tel.: (09621) 482-0, Fax: (09621) 482-4991
Abteilung Weiden: Hetzenrichter Weg 15, 92637 Weiden i. d. OPf., Tel.: (0961) 382-0, Fax: (0961) 382-2991
E-Mail: info@oth-aw.de / Internet: http://www.oth-aw.de
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University entrance
qualification:__________________________________________________
Last school of secondary education:
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Year of university entrance
qualification:_____________________________________________

German language proficiency: O A1 O A2 O B1 O B2 O C1 O C2

Please note that German language proficiency at the level B1 is crucial as most of
our courses are taught in German.

English language proficiency: O A1 O A2 O B1 O B2 O C1 O C2

Briefly state the reasons why you wish to study abroad:

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Date Signature student

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Date Signature Erasmus coordinator

Please send this form to

Ostbayerische Technische Hochschule Amberg-Weiden