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Stand: Juli 2015

Albert-Ludwigs-Universität Freiburg

Antrag auf eine Gästehauswohnung


Application for the Guest-Houses
Ich bewerbe mich um Aufnahme für:
I would like to apply for:

Gästehaus / Guest-House: Liefmann-Haus: Doktoranden:


(3 Monate – 3 Jahre) (1 - 6 Monate/Months) Oikos-Wohnheim
Sundgauallee: ☐1-Zimmer-Appartment (semesterweise):
☐1-Zimmer-Wohnung a single room apartment
☐Doktorandenzimmer in 4er und
a single room apartment ☐2-Zimmer-Wohnung
☐2-Zimmer-Wohnung a two room apartment 5er Wohngemeinschaften
a two room apartment ☐Große-2-Zimmer
☐3-Zimmer-Wohnung Galerie-Wohnung
two room spacious top Blücherstraße
a three room apartment
floor apartment (3 Monate – 3 Jahre)
☐4-Zimmer-Wohnung
a four room apartment ☐Doktorandenzimmer in 3er
Buggingerstraße:
Wohngemeinschaften
☐2-Zimmer-Wohnung
a two room apartment
☐3-Zimmer-Wohnung
a three room apartment

Bemerkungen: Bemerkungen: Bemerkungen:


Remarks: Remarks: Remarks:
Please enter your Remarks here. Please enter your Remarks here. Please enter your Remarks here.
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Persönliche Angaben / Personal Information:

Die Bewerbung bezieht sich auf die Zeit von: bis:


The application is for the period from: to:
Please enter your start date here. Please enter your end date here.

Name, Vorname, Titel: Status:


Surname, name, title: Your status in Freiburg:
Please enter your surname here. ☐Gastprofessor / guest professor
Please enter your name here. ☐Gastwissenschaftler / guest
Please choose your title here. researcher
☐Gastdozent / guest lecturer
☐Postdoc / postdoc
☐Doktorand / PhD student
Geschlecht/ Sex:
Please choose your gender here.

Geburtsdatum: Nationalität:
Date of birth: Nationality:
Please enter your date of birth here. Please enter your nationality here.
Zahl der begleitenden Personen:
Accompanying persons:
Please enter the number of Accompanying Persons here.
Name und Vorname des begleitenden (Ehe)Partners: Nationalität:
Surname and name of accompanying spouse/friend: Nationality:
Please enter the surname of your spouse/friend here. Please enter the natinality of your
Please enter the name of your spouse/friend here. spouse/friend here.
Zahl und Alter der begleitenden Kinder:
Number and age of accompanying children:

Please enter the number of accompanying children here.


Please enter the age of accompanying children here.
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Antrag Gästehauswohnung – Fortsetzung


Application Guest-Houses – Continued

Korrespondenzadresse: E-Mail:
Current mailing address: E-Mail:
Please enter your Current mailing address here. Please enter your E-Mail here.
Telefon:
Phone:
Please enter your Phone here.

Fax:
Fax:
Please enter your Fax here.

Finanzierung durch:
Supported by: Please choose Supported by here.
Stipendienorganisation:
Programme /organisation:Please enter your Programme / organisation here.

Gastgebende Institution: Anschrift:


Hosting institute /department: Address:
Please enter your department here. Please enter your department addresse here.

Ansprechpartner in Freiburg: Anschrift:


Contact person in Freiburg: Address:
Please enter your Contact person in Freiburg here. Please enter your Contact Person addresse
here.
E-Mail: Telefon:
E-Mail: Phone:
Please enter your Contact person E-Mail here. Please enter your Contact person Phone here.
Welchen Mietbetrag können Sie aufbringen? von / from bis / to
What amount will you be able to spend for the rent? Please enter your Please enter your max
min value here. value here.

Bitte senden Sie diesen Antrag an:


The application should be sent to:

E-Mail: guesthouse@io.uni-freiburg.de