Application form undergraduate

Application Form Undergraduate Certificate Programmes 2008-2009 1. Name First name(s) First name of preference Family name 2. Programme Please indicate the Undergraduate Certificate Programme (UCP) you wish to apply for: UCP in Humanities and Social Sciences Please indicate the cluster(s) you are interested in: Asian Societies and Cultures Conflict, Cultural Diversity and the Law Culture and Modernity Development and Planning Dutch Society and Culture Ethnicity, Migration and Nationalism European Society and Culture Gender Sexuality and Society International Relations and Globalisation Media, Communication and Film Politics, Governance and Democracy UCP on Law, Culture and Society (non-U.S. students only) 3. Study period Full year: September 2008 - June 2009 First semester only: September 2008 - January 2009 Second semester only: February - June 2009 4. Personal data Gender: female male Please check our website www.ishss.uva.nl for regular updates and for the latest version of this application form. Please read the information and instruction sheet before completing this form. Please type or write in black or dark blue ink. Incomplete, incorrect and/or illegible applications cannot be processed. Students applying for an Undergraduate Certificate Programme This form is intended for students who wish to apply to the ISHSS as independent, fee-paying and full-time students for one of the undergraduate programmes. U.S. students applying for the Law, Culture and Society Programme U.S. students who wish to enrol in the Law, Culture and Society programme, can only do so through the Institute for International Education of Students (IES). For more information, please contact: IES Chicago 33 N. LaSalle Street, 15th Floor Chicago, IL 60602-2602 USA Email: info@IESabroad.org Phone: +1 800 995 2300 or +1 312 944 1750 Fax: +1 312 944 1448 Website: www.iesabroad.org Students applying for a Summer Programme Students interested in the ISHSS Summer Institutes can find the relevant application form on our website www.ishss.uva.nl/summer.html. Students applying for individual courses Students who wish to sign up for individual courses can only apply if they are already registered at the UvA as feepaying students. They should contact their faculty study advisor for the specific course registration form. For more information, please contact the Registrar's Office: ISHSS Registrar Prins Hendrikkade 189-B 1011 TD Amsterdam The Netherlands Email: S.Brunekreef@uva.nl or I.Vuurmans@uva.nl Phone: +31 20 525 3526 Fax: +31 20 525 3778 Exchange students Exchange students who wish to apply for an ISHSS programme should contact the study abroad office or the international relations office of their home university on exchange possibilities. Exchange students who are already accepted and registered as UvA students and who wish to take courses at the ISHSS should contact their UvA exchange coordinator for the specific course registration form. Date of birth (day/month/year) Place of birth Country of birth Nationality Passport number Second nationality if applicable Second passport number if applicable Marital status 5. Passport Please enclose a photocopy of the identity page of your passport or a photocopy of your birth certificate. 6. Curriculum vitae Please enclose a curriculum vitae with your application. 7. Visa Do you need a visa to enter the Netherlands (see the information and instruction sheet)? yes no Do you wish the ISHSS to start a shortened visa application procedure on your behalf? yes no Application Form Undergraduate Certificate Programmes 2008-2009 (continued) 8. Permanent mailing address Email Address City State if applicable Postal code Country Phone Fax 9. Secondary education transcripts and diploma Please enclose photocopies of your secondary/pre-university school transcripts and diploma. Application deadlines Starting in September 2008 (first semester) Students with foreign or non-regular Dutch academic qualifications: 1 April 2008 Students with regular Dutch academic qualifications only: 1 May 2008 Notification period: 15-30 June 2008 Starting in February 2009 (second semester) Students with foreign or non-regular Dutch academic qualifications: 1 August 2008 Students with regular Dutch academic qualifications only: 1 September 2008 Notification period: 15-31 October 2008 Early notification needed? Students who are applying for a scholarship or other financial funding and therefore need early notification of admission, are advised to apply at least 3 months before the desired date of notification, and before applying for the scholarship or other financial funding itself. Please indicate on this form (section # 18) the date by which you need to receive notification. Timely handling will be aimed for, but cannot be guaranteed. Late applications Applications received after the application deadline will not be refused but will be processed for the next possible moment of enrolment. Prompt confirmation of receipt cannot be guaranteed. Academic calendar 2007-2008 First semester 1 September 2008 – 1 February 2009 Second semester: 2 February 2009 – 3 July 2009 10. Higher education transcripts and diplomas Please enclose official transcripts for each higher education institute attended, listing all courses and examinations already completed and currently enrolled in, and grades and credits obtained. If available, European students should submit a transcript listing both local and ECTS grades and credits. Transcripts should be submitted in a closed envelope, sealed by the university. Transcripts submitted in any other way will not be accepted. If not mentioned on the transcript itself, an explanation of the local grading and credit system should be added. Please enclose photocopies of all higher education diplomas already obtained. If the degree is not mentioned on the transcripts, the photocopy should be certified by the university. Official translations in English made by a sworn translator, should be submitted along with transcripts and diplomas stated in any other language than English, Spanish, French, German, Dutch or Latin. 11. Current/most recent higher education Institute City State if applicable Country Principal/major subject of study Title of degree/diploma Attended from (day/month/year) Date of (expected) graduation Language of instruction I attended more than one institute and will enclose a chronological overview in my curriculum vitae including all the information as asked for above. 12. Motivation Please use a separate sheet to describe - in about 300 words - why you wish to attend the programme. Application Form Undergraduate Certificate Programmes 2008-2009 (continued) 13. English language proficiency A student is considered a native English speaker depending on his/her nationality. Please refer to our website www.ishss.uva.nl for a list of nationalities considered by the ISHSS to be native English speaking. All non-native speakers are required to submit a valid English test score as stipulated on our website. Scores should be sent directly to the ISHSS by the testing organisation. If you took the test more than two years ago, please provide a photocopy instead and indicate in a separate letter to the admissions committee any relevant experience, showing that you have been practicing your English since the time the test was taken. The admissions committee will then decide whether a waiver of this requirement can be granted. I am a native speaker of English non-native speaker of English If non-native speaker, name of test: TOEFL (international) IELTS BLTC-ISHSS Cambridge CAE Cambridge CPE Score (if already available) Date test (day/month/year) 14. Application fee Applicants with an academic background in a non-EEA country have to pay a refundable fee of € 100. The fee is refundable in case of acceptance and enrolment. If applicable, please indicate how you will pay the application fee. Bank transfer Credit card (We can only accept Master Card, American Express or Visa. Please use the separate credit card form) Cheque 15. How did you first hear about the programme? Internet Brochures/flyers Education fair (please specify) Family/friends NUFFIC ISHSS staff Advertisement (please specify) ISHSS students The Netherlands embassy/consulate Other (please specify) 16. Financial plan Please indicate how you plan to finance your studies. State the values in Euros. Own contribution/personal savings Family contribution Scholarships (please specify) Loans (including IBG) Expected (summer) earnings Other resources Total resources € € € € € € € 17. Other applications Please indicate which other institutes you have applied to (if applicable): Application Form Undergraduate Certificate Programmes 2008-2009 (continued) 18. Early notification If you need to be notified earlier than the notification period, please indicate this below. Timely handling will be aimed for, but cannot be guaranteed. I wish to be notified before this date (please allow for 3 months handling time): Date (day/month/year) Reason 19. Checklist I have included the following documents with my application form: Photocopy of passport (identity page) or birth certificate Curriculum vitae Photocopies of secondary/pre-university transcripts and diploma Official higher education transcripts in a closed envelope, sealed by the university (plus official translations if applicable) Photocopies of higher education diplomas already obtained (plus official translations if applicable) Statement of motivation English language test score if applicable (sent directly from the testing organisation to the ISHSS) More information If you have any questions after reading the information and instruction sheet that comes along with this form, that are not answered by the Frequently Asked Questions section on our website www.ishss.uva.nl/FAQ/index.html, please contact the Admissions Office. Email correspondence is preferred. Admissions Office ISHSS Email: application-ishss@uva.nl Phone: +31 20 525 5366 Fax: +31 20 525 3778 Website: www.ishss.uva.nl Privacy policy The information submitted by applicants is for internal use only by the ISHSS only. Disclaimer We have tried to make this form as accurate as possible, nevertheless the information may not be exhaustive. The ISHSS cannot be held responsible for the contents of the information on the application form or for any consequences resulting from its use. No rights can be obtained from the information on this application form. Please check our website www.ishss.uva.nl regularly for updates. Credit card form if applicable Please do not staple any of the documents you will include 20. Declaration and signature I declare that the information provided by me is correct and complete. I understand that incomplete information will delay the application process and I accept that incorrect information will render the application invalid. I authorize the ISHSS to verify my documents. Date (day/month/year) City/country Name Signature