karlsruhe-hector school application form 2015 edition filled

KIT University of the State of Baden-Wuerttemberg and National Research Center of the Helmholtz Association 1

Company

Department

Position

Street Street number

Address supplement

Postal Code

City Country

Phone

E-mail

Application Form

For Admission to the Master of Science Degree Program

Personal Details

Business Contact

Please mark the appropriate Master Program.

Electronic Systems Engineering & Management (ESEM)

Energy Engineering & Management (EEM)

Financial Engineering (FE)

Green Mobility Engineering (GME)

Management of Product Development (MPD)

Production & Operations Management (POM)

Service Management & Engineering (SME)

Salutation

Academic Title

Last Name

First Name

Date of birth . . (dd/mm/yy)

Place of birth

Nationality


1. Duration (mm/yy) / - /

Company / Institution

Department

Position

City Country



Department

Position

City Country



Department

Position

City Country



Department

Position

City Country

Street Street number

Address supplement

Postal Code

City Country

Phone

E-mail

The following address is to be used for email & postal communication:

www.hectorschool.com

Private Contact

Employment Record, if applicable (Qualified Employment only)

Business Contact Private Contact



Educational Institution

City Country

Final Degree Grade

Qualification

Result

Date (mm/yy) /

City Country



City Country

Final Degree Grade


Institutions of Higher Education attended (College / Graduate School / University, etc.)

High School Education 2

1. Country

Reasons for visit or residence abroad

Duration (mm/yy) / - /

2. Country

Reasons for visit or residence abroad

Duration (mm/yy) / - /



City Country

Final Degree Grade

Travel record (list periods i.e. for continued education or in foreign country projects)

1 Attach academic certificates (School certificate/diploma, University transcripts or degree certificate). 2 Where the grading system does not follow the British (1st, 2nd, 3rd), U.S. (A, B, C) or German guidelines, an explanation of the grading system has to be attached.


References 3

English Language Proficiency 4 (Only if your mother tongue is not english)

My mother tongue is English.

TOEFL IBT 5 Skill Score Range

Reading

Listening

Speaking

Writing

TOEFL PBT 6 Skill Score Range

Listening

Structure/Written Expression

Reading

IELTS 7 Band Scale

Which references have been submitted with a letter of recommendation for this application?


1. Name of the reference

Company

Date of the recommendation letter (mm/yy) /

Recommendation is enclosed will be sent separately

2. Name of the reference

Company

Date of the recommendation letter (mm/yy) /

Recommendation is enclosed will be sent separately

3 Please include two letters of recommendation, a job reference certificate, a proof of extra-curricular activities4 Attach proof (TOEFL 95 ibt or better or IELTS band 6,5 or better)5 Test of English as a Foreign Language Internet-Based Test6 Test of English as a Foreign Language Paper-Based Test7 IELTS: International English Language Testing System


Online (which website?)

Exhibition

Company

Others

Recommendation

Financial Arrangements

Further Details

I recognized, that the tuition fee is 30.000 (matriculation fee not included)

I will pay all expenses myself (please give proof of financial sources)

I have applied for financial support to: (state clearly which organization/ institution) 8

All expenses will be paid by (please give proof of financial sources):

Did you apply recently for another academic program elsewhere or do you intend to do so?

If so, where?

How have you learned about HECTOR School?

What are your specific reasons to apply for admission to the Technology Business School of the KIT? 10

yes

8 Attach a supporting statement from the sponsoring organization if already available. Otherwise, notify us immediately about any decision of the sponsor (positive as well as negative).


no


I certify that I have answered the above questions truthfully and completely to the best of my knowledge.

I agree to report any relevant alteration in the information given above.

I recognized, that the tuition fee is 30.000 . Enrollment fee for KIT/semester is to be paid additionally.

I agree that this application and accompanying documents shall remain with the HECTOR School Technology

Business School of the KIT.

I have read the general terms and conditions and accept them.

Will your employer grant you a leave for the module periods of the master program?

Affirmation

Signature


Place, Date

yes no



Note: Please send your complete application form and all supporting documents by E-Mail and by mail to:

International Department des Karlsruher Institut fr Technologie gGmbH

HECTOR School of Engineering and Management

Schlossplatz 19

76131 Karlsruhe

Germany

If you would like to have your documents returned in case of non-acceptance, please enclose three International

Postal Coupons.

Checkbox Appendencies

Do not enclose original documents but notarized copies. Pdf files only!

Curriculum Vitae

Certificates

Job Reference Letters

Language Certificates

Financing Proof

In case of further questions please contact:

HECTOR School Admissions

Phone: +49 721 608 - 47876

Fax: +49 721 608 - 47882

E-mail: [email protected]

Place Date: Gruppieren1: EEM

Salutation: Mr.Academic Title: B.Eng. Bachelor of EngineeringLast Name: Rifki SMFirst Name: RahmatDay: 06Month: 04Year: 1991Place of Birth: Aceh BesarNationality: IndonesianStreet: Jl. Rasuna SaidStreet no: Kav 3-4Address suplement: Kel Kuningan timur, Kec. Setiabudi, Jakarta SelatanPostal Code: 12950Country: IndonesiaPhone: +6287888632246E-Mail: [email protected]_privat: Jl. Kapt TendeanStreet no_privat: 37AAddress suplement_privat: Kel. Kuningan barat, Kec. Mampang, Jakarta SelatanPostal Code_privat: 12710Phone_privat: +6285277706650E-Mail_privat: [email protected]: BC

Position: Associate EngineerCompany: Daewoo Shipbuilding and Marine EngineeringDepartment: EngineeringCity_privat: JakartaCountry_privat: IndonesiaCompany1: Inti Karya EngineeringDepartment1: Civil EngineeringPosition1: Civil EngineerCity1: JakartaCountry1: Indonesiamm1: 09yy1: 12Country2: IndonesiaCity2: Jakarta Position2: Civil EngineerDepartment2: Civil EngineeringCompany2: Daewoo Shipbuilding and Marine Engineeringyy21: 15mm21: 06yy2: 13mm2: 05mm3: yy3: mm31: yy31: Company3: Department3: Position3: City3: Country3: mm4: yy4: mm41: yy41: Company4: City4: Country4: mm5: 06yy5: 08mm51: 06yy51: 12Educational Institution1: University of IndonesiaCity5: JakartaCountry5: IndonesiaGrade1: 2.99Final Degree1: Bachelor of EngineeringFinal Degree2: City6: Country6: Educational Institution2: yy61: mm61: yy6: mm6: Educational Institution3: City7: Country7: Final Degree3: Grade3: Grade2: Department4: Position4: Qualification: Sciencemm8: 06yy8: 08City: JakartaCountry8: IndonesiaCity8: Aceh BesarCountry 9: Country 10: Result: 8.9Resons for visit or residence abroad: mm9: yy9: mm91: yy91: mm7: yy7: mm71: yy71: yy101: mm101: Resons for visit or residence abroad 2: mm10: yy10: mm11: 04yy11: 13Gruppieren3: 0

Name of the reference: Putut Panji UtomoCompany5: Daewoo Shipbuilding and Marine EngineeringName of the reference2: Company6: mm12: yy12: Gruppieren4:

Gruppieren5: 1

Kontrollkstchen9: Text5: 1: Indonesian Education Scholarship2: 3: 4: 5: 6: 7: 8: 9: Studying in Germany has been my dream ever since I am thinking of pursuing higher education. I have heard a lot of good experience from friends who study there and compared to USA, Germany has a lot more to offer in terms of history and culture which make my decision to study in Germany even easier since I like enjoying europe long history. I chose KIT University because it is amongst top Germanys best university. Then, I chose Energy Management and Technology in accordance with my career in near future, as energy expert.

Gruppieren6: 2

Kontrollkstchen8: JaKontrollkstchen6: 1: Ja2: Ja3: Ja4: Ja5: Ja

Gruppieren7: yes

Kontrollkstchen7: 1: 2: 3: 4: 5:

mm111: 05yy111: 15IELTS: 6TOEFL5: TOEFL7: TOEFL6: TOEFL1: TOEFL2: TOEFL3: TOEFL4: Unterschrift:

karlsruhe-hector school application form 2015 edition filled

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