Documente Academic
Documente Profesional
Documente Cultură
Personal data
Please fill out in block letters
Nationality Indonesian
other,...
Home address
Postal code
City
Country
Telephone
country city number
Fax
country city number
Mobile number
country number
Permanent address
City
Permanent country
My email address can be used for commercial purposes, such as brochures and newsletters from Stenden University
Representative data
For students who applied through a representative: Name company Contact person
Email address
www.stenden.com/bali
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Application data
I want to apply for the following (tick one box only) :
Location:
Bali
Other:
www.stenden.com/bali
Language abilities
What proof do you have of English Language competency?
Candidates, whose first language is not English, are required to take an English Language test, preferable IELTS or TOEFL For information on TOEFL and IELTS testing, please visit www.ielts.org and www.toefl.org IELTS: Score Date Score (dd/mm/yyyy)
TOEFL: Score
Educational data
Concerns only your studies at the secondary school, university or professional levels.
Name of school/university Type of school Location Years attended Diploma GPA score
Accommodation
Do you need us to arrange accommodation for you? Yes No
Application procedure
Your application to Stenden University Bali will be considered upon receipt of this form, including all the supplementary documents. For an overview of our application deadlines, please check www.stenden.com/bali
Signature
I hereby certify that I have provided accurate information on this application. I understand that any misrepresentations or omissions of facts in my application may justify denial of admission, cancellation of admission or withdrawal from the program. This is my honest statement.
Date (dd/mm/yyyy)
Place
Signature
www.stenden.com/bali
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Checklist
Documents to be handed in:
A completed and signed application form Two copies of your passport (valid during at least one year upon arrival in Indonesia, for International Students) Original copy of IELTS or TOEFL results from attesting your knowledge of English Certifed copy*of your diploma (in English) of your school/college/university education Certifed copy of grades-sheet (in English) Curriculum Vitae (in English) Four recent passport-type colour photos Two full sized photographs (formal dress code) Two copies of your KTP (for Indonesian students) Copy of academic awards of honours, if available
* A certified copy, which is authentically signed and stamped by an authorized representative of your school/university to prove the authenticity of the copy.
Address
Please send the documents mentioned in the checklist to the following address:
www.stenden.com/bali
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