Summer Course on German Language and Culture

University of Oldenburg, Germany

July 17 to August 14, 2019

Application Form
(Application deadline is March 7, 2019)
A. Personal Information

Name (first name, last name)

Current Mailing Address

Permanent Address

Phone Number

Email

Sex: Male Female Diverse Preferred pronouns

Date of birth (dd/mm/yyyy)

B. Emergency Contact

Name

Relationship

Phone Number

Email

C. Passport Information

Country of citizenship

Current passport number

Place of issue

Date of issue (dd/mm/yyyy) Expiration date (dd/mm/yyyy)

D. Academic Information

College/University currently attending

Major

Minor

Expected graduation date (dd/mm/yyyy)

E. Information on German Language Proficiency

Numbers of years of college German

Other German instruction

How would you estimate your German language skills on a scale from 1–7 (1= absolute beginner and 7= native or native like speaker)?

Please provide information about your exposure to the German language, culture and/or German speaking people (apart from classroom
activities)?

Proof of language proficiency Please submit proof of language proficiency (e.g. transcript, recommendation letter, …)

E. Medical Information
You will be required to have international medical insurance coverage for the time of your stay in Oldenburg. Participants are encouraged to
purchase insurance prior to their arrival in Germany. For certain medical conditions, you may be required to provide written consent from a
physician or to demonstrate that you have sought a physician’s advice about appropriate precautions to take on this trip and to bring an
adequate supply of any prescribed medications. (If uncertain as to fitness for participation, make sure to consult your personal physician.)

F. Liability
The University of Oldenburg accepts no liability for the participants in the Summer Course on German Language and Culture in Oldenburg.
Participants are responsible for themselves at all times. All participants must be at least 18 years of age by the first day of the program.

G. Data protection
With my signature I authorise the University of Oldenburg to use my personal data exclusively for the purpose of processing my stay
in Oldenburg. The data will be securely stored on servers of the University of Oldenburg and will not be passed on to third parties.
For further information on the handling of personal data, please visit: Privacy Policy of the University of Oldenburg

I certify that all the above information is true and correct to the best of my knowledge. I have read, understood and fully accept all of
the above terms for participation in the Summer Course on German Language and Culture in Oldenburg, Germany.

X__________________________________________________________________________ __________________
Signature of Applicant Date Signed

Declaration by Coordinator at Home University

I confirm that the applicant is in good standing with the university and will be participating in the language program as part of the
exchange agreement with University of Oldenburg.

X__________________________________________________________________________ __________________
Signature and Stamp of Study Abroad Advisor Date Signed

Keep in mind that every participant has to apply through his or her home university. Please note: Your application doesn't mean that you are selected
automatically! A selection panel will evaluate each set of application carefully. An important selection criteria is your language skill. The successful
candidate will be contacted by email confirming his/ her acceptance in the program shortly after the application deadline.

After completing and signing the form, please submit this document to the study abroad advisor at your university,
who will be mailing the application no later than March 7, 2019 as a pdf-attachment (one document) to Ms Tina Grummel
(summercourse@uol.de).