Application Form 2011

Den Koordinerede Tilmelding

Send this form to all the institutions where you want to be enrolled. Please write legibly using a typewriter or CAPITAL Letters. Reserved for the institution

CPR-number (ddmmyy)

1. Personal data
First name(s) Family name Address Country code Country Postal code City E-mail Phone number Mobile phone number

2. Citizenship
Country code Danish Name of institution Other Country Do you have a Danish residence permit? Yes. If yes please enclose a copy of the permit Name of programme No

3. Application for admission to

Admission area no.

Standby If I am not admitted to this programme I apply for standby Name of entry qualification Adress Web site

Line of study, training location or practical training location if applicable Postponement of study start Name of institution Country Grade point average from your secondary school Year

4. Upper secondary education/Entry qualification

I give my permission to the educational institution that the instiution can contact relevant educational institutions and authorities in the country of education as well as relevant authorities in Denmark about my education.

5. Current or previous enrolment on higher education programmes, if applicable

Higher education programmes where you are or have been enrolled but have not completed the programme No. of programmes I already hold a post-graduate degree (Second cycle higher education degree)

6. Order of priority
Priority Admission area no. Name of programme

1 2 3 4 5 6 7 8
Documentation
Do not submit original documents but send certified photocopies. The educational institution might ask you to submit original diplomas.

Signature
Under liability according to Danish Law, I hereby declare the information I have given to be truthful and accurate. Date Signature of applicant

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Application Form 2011

Admission area no.

CPR-number (ddmmyy)

7. Post-secondary education. Please state exams, study periods etc. from higher education. Official transcripts must be included.
Name of degree 1. 2. 3. 4. Name of institution Adress Country Web site Start (date) End (date)

8. Examinations passed supplementary to the upper secondary education/entry qualification

Name of course 1. 2. 3. 4. 5. 6. Name of institution Adress Country Web site Start End (ddmmyy) (ddmmyy)

9. Work experience. Documentation is required.

Employer 1. 2. 3. 4. 5. 6. Adress Country Web site Nature of work Start (date) End (date) Hours weekly Total no. of months

10. Extra-Curricular activities

Institution/Organisation 1. 2. 3. 4. Nature of activity Start (date) End (date) Hours weekly Total no. of months

11. Residence outside your home country including former periods of residence in Denmark
A. Periods of former residence in Denmark 1. 2. 3. B. Other countries 4. 5. 6. 7. Purpose of stay Start (ddmmyy) End (ddmmyy) Purpose of stay Start (ddmmyy) End (ddmmyy)

12. Knowledge of Danish Language. Documentation is required.

Name of language test you have passed or registered for Study Test in Danish as a Second Language (Studieprven i dansk som andetsprog) Other: Other: Yes No Date of language test

13. Knowledge of English Language. Documentation is required.

Name of language test you have passed or registered for TOEFL IELTS Cambridge Proficiency Certificate Other: Other: Yes No Date of language test

Signature
Under liability according to Danish Law, I hereby declare the information I have given to be truthful and accurate. Date Signature of applicant

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