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									                                                    APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY




              MASTER OF SCIENCE IN INTERNATIONAL HEALTH
                      AT HEIDELBERG UNIVERSITY
        Please read the “Information regarding your application & application requirements” at the
         end of this document carefully before completing the form.
        Please fill out by computer if possible.
         Handwritten applications are accepted
               (if filled out by hand, please write clearly and in block capitals).
        Handwritten signature required

A P P L I C A T I O N F O R M for the academic year: _______________
Please indicate clearly for     European track (tropEd)        (1 – 5 years)
which track you are
applying.                       Residential track              (1 year)


1. PERSONAL DATA
      (Please use exactly the same names as in your passport.)

Surname (Last name)


First name/s

Academic Title

Sex


Marital status

Date & country of birth

Nationality


Number of child/ren

Postal address :
institution, department,
street, city, postcode

Telephone

Fax

E-mail
                                                       APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY


2. HIGHER EDUCATION                      (degree awarding institution)

                             Bachelor Degree          Master Degree          Other
                                                      ( if applicable)       ( if applicable)

Study Period
(mm/yy – mm//yy)


No of semesters

Discipline


Institution

Country


Name of Degree

Date of Degree

Result of Final Exam

Any distinction?

Please add an extra sheet if necessary.



3. OTHER TRAINING
        (incl. specialised short training courses of at least 2 weeks)

Title

Date (mm/yy, from/to)

Duration

Topic/s




Institution

Country

Degree / Award

Result of Final Exam

Please add an extra sheet if necessary.
                                                            APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY


4. RESEARCH EXPERIENCE
Type of Research

Country

Period

Results or
publications




Please add an extra sheet if necessary.


5 . E N G L I S H P R O F I C I E N C Y (attach proof)
Please     Kind of proof                                      confirmation to be found where
tick



           Official language of instruction at University

Test                    Minimum requirement                   Score     confirmation to be found where

           Toefl        Computer based >237

                        Paper based >580

                        Internet based >90

           IELTS        > 6.5



6. COMPUTER SKILLS
Programme                           Experienced               Some experience       No experience

Microsoft Word

Excel

PowerPoint

Epi Info

Other ___________________
                                                 APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY


7. PROFESSIONAL WORK EXPERIENCE
    (after completion of first degree studies)

7.1 Present Occupation

Since                                            Country

Employer                                         Type of
                                                 Organisation

Main Responsibilities




7.2 Previous Occupation

From – to                                        Country

Employer                                         Type of
                                                 Organisation

Main Responsibilities:




7.3 Previous Occupation

From – to                                        Country

Employer                                         Type of
                                                 Organisation

Main Responsibilities:




Please add an extra sheet if necessary.
                                                    APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY



8. LEADERSHIP EXPERIENCE
    Please explain in which form you have taken over leadership responsibilities before and,
    where applicable, refer to 7.1 ff.

Occupation             Duration      Leadership components & skills




Please add an extra sheet if necessary.


9. INFORMATION              REGARDING REFERENCE                   LETTERS
Name of referee (1)

Position

Address

Phone/Fax

Email contact


Name of referee (2)

Position

Address

Phone/Fax

Email contact
                                                      APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY


10. FINANCING             YOUR       STUDY
The University does neither grant any scholarships for course fees (currently 14.095 €), nor for personal
subsistence. Please state how you plan to finance your study:




11. HOW         DID YOU LEARN ABO UT THE COURSE ?




 12. DECLARATION (PLEASE                          READ AND SIGN BELOW )

 I certify that I am not currently enrolled or pursuing an examination process in a Masters
 Study course in International Health or in study courses with basically the same content at a
 domestic or foreign university.

 I certify that I have not lost my examination rights in such Masters Study course.

 I certify that the statements made by me on this form are correct and complete.

 I understand that, if admitted to the University of Heidelberg, the University will not be able to
 provide any financial assistance.
                                                          APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY

                           INFORMATION REGARDING YOUR APPLICATION
                                 & APPLICATION REQUIREMENTS

                             Before completing the MSc course application form,
                               please read the following information carefully.


                       CRITERIA FOR ELIGIBILITY FOR THE MSCIH IN HEIDELBERG


1. Academic Eligibility

To be eligible for a postgraduate study at Heidelberg University, you have to have had
         at least 12 years of schooling (primary and secondary school)
          having gained the right of entry to higher education in the applicant's home country
         + at least a 4 year university study (e.g. Bachelor) (usually 8 full time semesters)
Potential Exception:
           If in your country the number of years of schooling before entering higher education is less than
            12 years, the study period has to be at least one year longer.


2. Work Experience

Candidates are expected to have at least two years of working experience in low and middle-income
countries in a field relevant for the course.


3. Proficiency in English

It is mandatory that students whose first language is not English have an adequate command of the
English language.
        If an applicant's first language is English or his/her studies at the university level have been
            conducted wholly in English (written proof from the University is required), he/she is exempted
            from providing an English language proficiency test.
        In all other cases, proof of proficiency in the English language is required by providing evidence of at
           least a 6.5 IELTS score or a TOEFL computer based version (CBT) score of at least 237 or a
           paper based version (PBT) score of at least 580 or a Internet Based version (IBT) score of at least
           92-93.
Please note
        Scores are valid only if received directly from Educational Testing Service (ETS).
        As the University of Heidelberg does not have an institutional code for TOEFL reports (please note
          that the university mentioned in the TOEFL bulletin is the private Schiller University), applicants
          should ask the ETS to send an official score report directly to the MSc course administration by
          mail.
        We do not accept photocopies handed in by the applicant


                                         LANGUAGE OF DOCUMENTS

The completed application form and the required documents must be submitted in English.
Documents in languages other than English or German must be submitted with an authenticated
translation in English.
                                                          APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY
                          FURTHER DOCUMENTS REQUIRED FOR THE APPLICATION
        Please submit the following documents together with the completed application form:


Complete curriculum vitae + recent photo

The CV should be up to date and include a recent photo. Please give dates as mm/yy.



Motivation Letter: why do you want to join this programme

We are especially interested in your personal view on why you want to join this course and how you see
your future career in international health.
      Why are you interested in our training in International Health?
      How do you expect to use the knowledge acquired in your future work?
      What is your career perspective?


Qualification Certificates

The following documents are required as certified copies or originals:
      School leaving certificate giving the right of entry to higher education in the applicant's home country
      All university end-of-year exam certificates with individual grades (academic transcript/record)
      University degree certificate (indicating the final grade if applicable).
Academic records must be accompanied by an explanation of the grading system.
Document copies (submitted preferably on DIN A4 or A5 paper) must be authenticated as true copies of
the originals with a stamp and signature by one of the following authorities:
      The German Embassy or Consulate,
      A notary,
      The university which conferred the degree.
If certificates are not issued in the English or German language, an authenticated English translation must
be submitted.


Evidence of present post from the employer

Describing fields of work and main responsibilities, period of employment.


Declaration of re-employment

By present or future employer (if available)


Reference Letters

2 references from your professional and/or academic background



Proficiency in English

Please refer to eligibility criteria for details



Financing

Prove of capability to pay the course fees or a confirmation of a scholarship
                                                      APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY

                                              DEADLINES

 SELF                DAAD                                  EED & KAAD          OTHERS
 FINANCING
         th                                                          st
 April 30            German Embassy:        July 31        January 1           Please check with
 of the year the     OR                                    of the year the     your sponsor, but not
 course will take    DAAD Bonn:             August 31      course will take    later than
 place               AND                                   place               April 30th
                     Heidelberg Uni         October 15                         of the year the course
                     of the previous year                                      will take place
                     before the course begins


In the following you will find some further information regarding the respective kind of applications:


                               WHERE TO SEND WHICH DOCUMENTS

 For Private Financing:
 Please send ALL the documents to:
        Course Office / Claudia Bertram
         MSc in International Health
         Institute of Public Health, University of Heidelberg
         Im Neuenheimer Feld 324, D - 69120 Heidelberg, Germany


 For DAAD scholarship:
 Please send ONLY the application form of the University of Heidelberg to the following address:
        Course Office / Claudia Bertram
         MSc in International Health
         Institute of Public Health, University of Heidelberg
         Im Neuenheimer Feld 324, D - 69120 Heidelberg, Germany
 All other documents need to be send ONLY to:
        DAAD
         Deutscher Akademischer Austausch Dienst
         Kennedyallee 50, 53175 Bonn
         Postfach 20 04 04, 53134 Bonn


 For EED or KAAD (or other scholarships):
 Please send all the documents to the University of Heidelberg (see address above)
 AND to the respective sponsor (as required)
        KAAD
         Katholischer Akademischer Ausländer-Dienst
         Hausdorffstr. 151, 53129 Bonn
        EED
         Evangelischer Entwicklungsdienst e.V. (EED)
         Stipendienreferat
         Ulrich-von-Hassell-Str. 76, 53123 Bonn
        Other (documents requested by your sponsor may vary)
                                              APPLICATION FORM MSCIH AT HEIDELBERG UNIVERSITY


                               CHECKLIST MSCIH APPLICATION
         Applications have to be submitted in the order of the following checklist.
                 Please arrange your documents accordingly. Thank you.


Arrange in the order from top to bottom      Self pay   DAAD     KAAD    EED      Other
     Application form Heidelberg             X          X        X       X        X
            Application form to sponsor                 X        X       X        ?
            Research Proposal                           X        X       X        ?
     Complete CV with Photo                  X          X        X       X        X
     Motivation Letter                       X          X        X       X        X
     Proof of Proficiency in English         X          X        X       X        X
     (if applicable)
     School leaving certificate giving the   X          X        X       X        X
     right of entry to higher education
     All university end-of-year exam         X          X        X       X        X
     certificates with individual grades
     University degree certificate           X          X        X       X        X
     Explanation of grading system           X          X        X       X        X
     (if not already on certificates)
     Evidence of present post                X          X        X       X        X
     Statement of re-employment              X          X        X       X        X
     (if available)
     Reference letter (1)                    X          X        X       X        X
     Reference letter (2)                    X          X        X       X        X

								
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