Application form for admission to studies for foreign applicants

Applicant number: 1603343

Semester: summer semester 2016 (beginning of studies in march/april)

Higher Education Institute:

Chemnitz, Technische Universitt Chemnitz (TU)

Application form for course of study:

Master Automotive Software Engineering

1. Information on the desired degree course
1.1. Course 1. choice (submitted)
Target degree in Germany : Master
Course number

Course name

Course semester

1. course

Automotive Software Engineering

2. Personal details
Surname/Family name Sharma
First/Given name(s) Abhishek
Sex male

Date of birth 15.9.1986

Place of birth Mokamah

Nationality/Nationalities India

3. Correspondence address
c/o Flat No G-202/203,
House number/Street/Road Green Valley Complex,kaikhali Kolkata, P.o-Rajarhat Goplapur
etc.
Postcode/Zip code 700052

Town/City/Postal Kolkata
district

Country India
E-Mail helloabhishek.in@gmail.com
Telephone
Mobile phone +91-9051473733

4. School leaving certificate

Date 2004-05-26
Original name ALL INDIA SENIOR SECONDARY SCHOOL CERTIFICATE EXAMINATION,

2004
Country Indien

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5. Your educational background

All details must be proven by enclosing officially certified/attested certificates/supporting documents and
officially certified/attested German or English translations. It is essential that you include these with your
application. Important Note. Some higher education institutions (HEIs) do accept certificates/supporting
documents in other languages (please observe the detailed information provided by the HEI in question).

Studies completed at a German university/ German university of applied sciences

Studies completed outside of Germany
1st apprenticeship/study course/work placement - from MM/YY 1ST SEMESTER/2006 - 8TH SEMESTER/2010
to MM/YY
Name and place of institution (in the original language in latin India - KALINGA INSTITUTE OF INDUATRIAL
script!) TECHNOLOGY, BHUBANESWAR
Specify the field/subject(s): COMPUTER SCIENCE
Name of qualification/position of employment/placement Bachelor of Engineering/Bachelor of Technology
Pass? yes
2nd apprenticeship/study course/work placement - from 01/11 to 05/14
MM/YY to MM/YY
Name and place of institution (in the original language in latin COGNIZANT TECHNOLOGY SOLUTIONS PRIVATE
script!) LIMITED
Name of qualification/position of employment/placement PROGRAMMER ANALYST
3rd apprenticeship/study course/work placement - from MM/YY 05/14 to till date
to MM/YY
Name and place of institution (in the original language in latin WIPRO INFOTECH
script!)
Name of qualification/position of employment/placement SOFTWARE ENGINEER

Activities prior to application

Length of activity (from MM/YY to MM/YY) 05/01 to 05/02
Type of activity Secondary School (10th)
Length of activity (from MM/YY to MM/YY) 05/03 to 05/04
Type of activity Senior Secondary School (12th)
Length of activity (from MM/YY to MM/YY) 06/04 to 05/06
Type of activity Going under preparations Engineering Entrance

Examinations
Length of activity (from MM/YY to MM/YY) 06/06 to 06/10
Type of activity Pursuing BTECH from KIIT University
Length of activity (from MM/YY to MM/YY) 07/10 to 12/10

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Type of activity Job Search

Length of activity (from MM/YY to MM/YY) 1/11 to till date
Type of activity 01/11 to 05/14 working as Programmer Analyst in

Cognizant and from 05/14 to till date working as Software

Engineer in Wipro Infotech

German language skills

Do you have any knowledge of German? no
Have you completed any of the following standards tests? --Are you currently enrolled on a German course? no

Details of English language skills

Do you have any knowledge of English? yes
By which means have you learnt English? (e.g. secondary SECONDARY SCHOOL
school, language school, university, native language, second
language, official language of administration in home country)

Other languages
1st other language that you speak HINDI
By which means have you learnt this language? (e.g. SECONDARY SCHOOL
secondary school, language school, university, native
language, secondary language, official language of
administration in home country)
What is your level in this language? --What is your level in this language? --What is your level in this language? ---

Other relevant questions for admission (in keeping with German federal regulations
regarding allocation of study places)
Have you been granted asylum in the Federal Republic of no
Germany? (If yes, please attach proof)
Is your chosen course of study also available in your home no
country?
Do you belong to an official German-speaking minority no
abroad?
Are you taking part in an exchange programme with our no
university?
Please enter the exact name of your home university here KALINGA INSTITUTE OF INDUSTRIAL TECHNOLOGY

Studienkolleg und Feststellungsprfung

Are you applying for admission to the next available no
"Studienkolleg" course?
Have you already been examined for admission to a no

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Studienkolleg course?
Would you like to be registered for the next available external no
examination for admission to a "Studienkolleg" course (prior to
actually taking part in the course)?
Would you like to be registered for the next available no
supplementary examination (if you have already taken a
"Feststellungspruefung" test for a different major course of
study)?

Pre-study preparatory German course and DSH language test

Are you applying for admission to the next available pre-study no
preparatory German course at the university you have applied
to?
Are you applying for admission to the next available DSH no
language test ("Deutsche Sprachpruefung fuer den
Hochschulzugang")?

I confirm that to the best of my knowledge and belief all the information I have given on this form is true,
complete and accurate. Beyond that I assure that my specifications about my academic background are
complete and that I did not conceal any studies done at a university. I have enclosed the required documents
(certificates, supporting documents, etc.). I am aware that intentionally or negligently giving false information
constitutes an administrative offense and may lead to exclusion from the admissions procedure or if
discovered at a later date to the cancellation of my admission or enrollment. I confirm that I have read the
admissions information.
All entries completed? Please print out form and sign it. Please enclose all documents.

Place

Date

Signature

The above information will be stored and processed by the higher education institutions. They are fully
subject to the data protection regulations currently in force.

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