A P P L I C A T I O N F O R M 2012 - 2013

Tick the appropriate box Tick the appropriate box

Master Degree Program in:

ARCHITECTURE

Applying as:

DIPLOMA STUDENT
4-year program in Dutch language

EXCHANGE STUDENT
English program in second/third year

1 st semester

URBANISM

EXCHANGE STUDENT
English program in second/third year

2 n d semester

GUEST STUDENT/FREE MOVER 1 st semester

English program in second/third year

LANDSCAPE ARCHITECTURE

GUEST STUDENT/FREE MOVER 2 n d semester

English program in second/third year

Personal details:
FAMILY NAME

FIRST NAME(S)

DATE OF BIRTH

PLACE OF BIRTH

NATI0NALITY

GENDER

PERMANENT ADDRESS

POSTAL CODE / TOWN

COUNTRY

POSTAL ADDRESS IN THE NETHERLANDS (IF APPLICABLE)

POSTAL CODE

TOWN

EMAIL PRIVATE

PHONE PRIVATE

MOBILE PHONE

A P P L I C A T I O N F O R M 2012 - 2013

Secondary education
TYPE OF EDUCATION NAME AND CITY EDUCATIONAL INSTITUTION

1 2 3
FROM UNTIL DATE DIPLOMA

1 2 3

Higher education
TYPE OF EDUCATION NAME AND CITY EDUCATIONAL INSTITUTION

1 2 3
FROM UNTIL DATE DIPLOMA

1 2 3

A P P L I C A T I O N F O R M 2012 - 2013

Working experience
WORKED WITH / WORKING WITH POSITION / TYPE OF WORK

1 2 3
FROM UNTIL EMPLOYED / OTHER

1 2 3

I have applied for enrolment at another educational institution: YES / NO

NAME INSTITUTION

TOWN

All information given is true and correct

SIGNATURE APPLICANT DATE

NAME HOME INSTITUTION (FOR EXCHANGE STUDENTS ONLY)

EMAIL

NAME CO-ORDINATOR OF INTERNATIONAL AFFAIRS (FOR EXCHANGE STUDENTS ONLY)

SIGNATURE CO-ORDINATOR

A P P L I C A T I O N F O R M 2012 - 2013

Specific questions should be addressed to the secretary of study, Mr. T. Peters E-mail: t.peters@ahk.nl

Sending in the application form

The application form, together with the following documents required, should be sent before June 1st, 2012 November 1st, 2012 - Diploma students (four years course in Dutch language) - Exchange / Guest students (first and/or second semester, English program in third year) - Exchange / Guest students (second semester, English program in third year)

Documents required: Copy of passport One passport size photograph (name written on the back side) or send an electronic photo to t.peters@ahk.nl Authorized list of courses/projects taken; all marks/grades achieved Curriculum Vitae Motivation Portfolio (color prints, max seize A3, max number of pages: 20) Letter of recommendation by home institution (only for exchange students)

Send to: Academie van Bouwkunst Amsterdam Waterlooplein 213 1011 PG Amsterdam The Netherlands Note: All documents may be sent via e-mail, as long as the documents are complete and in pdf format. Other formats are not accepted. Send to: t.peters@ahk.nl