Application form (7 pages) 04/08

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1 Application form (7 pages) 04/08 Photo International Joint Master of Science (M.Sc.) Regional Development Planning and Management Technische Universität Dortmund Faculty of Spatial Planning SPRING Programme 44221 Dortmund Germany Kwame Nkrumah University of Science and Technology (KNUST) Department of Planning The Director of the SPRING Programme Kumasi, Ghana University of the Philippines School of Urban and Regional Planning (SURP) Director of Graduate Studies Diliman, Quezon City 1101 Philippines Ardhi University (ARU) School of Urban and Regional Planning P.O.Box 35176 Dar es Salaam, Tanzania Universidad Austral de Chile Faculdad de Ciencias Economicas y Administrativas Valdivia, Chile 1. Personal data Family name... First name... Sex male ( ) female ( ) Date of birth... Place of birth... Nationality... Marital status single ( ) married ( ) No. of children... 2. Mailing address Street and House No. or P.O. Box... Town... Country... Telephone / FAX... E-mail... 3. Preferred university for the second year ( ) Kwame Nkrumah University of Science and Technology (KNUST), Ghana. ( ) School of Urban and Regional Planning (SURP), The Philippines. ( ) University College of Lands and Architectural Studies (UCLAS), Tanzania. ( ) Universidad Austral de Chile (UACH), Chile. 4. Which SPRING target group do you belong to? ( ) Experienced district / regional planner (with at least 4 years experience). ( ) Junior district / regional planner (with at least 2 years experience). ( ) Experience in planning related field (with at least 2 years experience).

2 5. Academic record Pre-University Qualifications Certificate Date Place of issue......... University qualification Subject... University... Date of award... Highest achieved degree Final grade ( ) B.A., B.Sc., B. ( ) 1st class, A, distinction ( ) M.Sc., MBA, MA ( ) 2nd class upper, B+ ( ) PhD ( ) 2nd class lower, B- ( ) Diploma, Adv. Dipl. ( ) 3rd class, C, pass ( ) Others ( ) Others Training courses Subject Date/Period Place 6. Knowledge of English language ( ) By attending an English language course with certificate (TOEFL score of minimum 540 (paper-based) / 220 (computer-based) / 80 (internet-based) or IELTS minimum 6.0 or MELAB test 78 points. Enclose copy) ( ) Basic knowledge (without certificate or test score less than required above) 7. Employment In which way does your employer support your application? (enclose confirmation) ( ) My study will be fully sponsored by my employer. ( ) I am nominated for the study by my employer (including full payment of salary during study and job guarantee). ( ) I take an official study leave with job guarantee. ( ) Employer supports my application. ( ) Others

3 Employment record Period (mm/yy mm/yy) Employer Position of the applicant What is your main activity / responsibility at your present job? ( ) Agricultural extension ( ) Building, planning and construction ( ) Computer application, GIS ( ) Consultancy ( ) General administration ( ) Land use planning, natural resource planning ( ) Planning and implementation of rural development projects ( ) Preparation of district / regional plans ( ) Research ( ) Sector planning at regional / district level (agriculture, finance, etc.) ( ) Sector planning at national level ( ) Teaching ( ) Town and urban planning ( ) Others Write in brief the nature of your current professional activities and how they are related to district / regional planning. No additional sheet of paper

4 8. Essay Write a short essay describing your specific motivation for your application to the SPRING-programme. What do you want to learn here and what are your professional plans after you return to your home country? No additional sheet of paper

5 9. Scholarship Please note: Admission to the programme does not include the award of a scholarship. Therefore, applicants have to seek financial aid from their own countries, employer or from other sponsors. Qualified candidates who apply for such an external scholarship will be supported by the SPRING-programme and admitted if the scholarship application is successful. However, the initiative for the scholarship application has to come from the applicant SPRING cannot provide address lists, forms, etc. or reply individual inquiries. Private sponsors (family, husband) or the study with private means is accepted under the condition that sufficient financial means can be proved before final admission. The German Academic Exchange Service (DAAD) awards a strictly limited number of German scholarships on a highly competitive basis. (Age limit is 36 years.) ( ) External two-year scholarship Sponsor details...... ( ) Applied ( ) Scholarship already awarded (enclose confirmation) ( ) I want to apply for a DAAD / SPRING - scholarship. The DAAD scholarship application form is available at: Deutscher Akademischer Austauschdienst (DAAD), Kennedyallee 50, D-53175 Bonn, Germany or the German Embassy or can be downloaded from the DAAD homepage (http://www.daad.de/) or the SPRING homepage. DAAD scholarships cannot be granted for applicants from Ghana, since Kwame Nkrumah University of Science & Technology at Kumasi offers the entire two year SPRING Programme at Kumasi, Ghana.

6 10. Applicants contribution to DAAD / SPRING scholarship DAAD/SPRING scholarships require that the scholarship holders bear all travel expenses on their own. DAAD encourages self-contribution of scholarship holders. In case of equal qualification, preference will be given to the applicant with higher self contribution. Please indicate your self-contribution. Base your choice on a realistic assessment of your own financial capabilities. Tuition fees of the second year Yes ( ) No ( ) 11. Additional questions (if yes, enclose confirmation) Are you already living in Germany? Yes ( ) No ( ) Have you been granted asylum in Germany? Yes ( ) No ( ) Are you a refugee? Yes ( ) No ( ) Are your parents foreigners living in Germany? Yes ( ) No ( ) Do you speak the German language? Yes ( ) No ( ) From whom or through which institution/media you have learnt about the SPRING Programme (e.g. SPRING Alumni, DAAD, German Embassy, Internet, etc.)? Please specify:.. 12. Enclosure (Applications can only be processed if the following documents are included) 1. A typed Curriculum Vitae including personal data, academic progress and related work experience 2. Officially notarized copy of university certificate 3. University issued official transcript of courses and grades (or notarized copies) including an explanation of grades 4. Two relevant letters of recommendation (professional and academic) 5. Official proof of English proficiency (TOEFL, IELTS) 6. Copy of A-level or high school certificate 7. A completed DAAD application form (if DAAD scholarship is desired) Translations and Notaries: All translations and notarizations of documents must be made by a certified translator or notary, respectively. For translations, a notarized copy of the original document must be attached to the official translation.

7 13. Further information Documents cannot be returned. You should therefore send no originals but certified copies of all supporting documents, certificates, etc. Late arriving or incomplete applications will not be acknowledged. All applicants will be informed about the final result of the selection in December. Individual inquiries cannot be answered. 14. Deadlines Deadline for application is the 15th October. Philippine, Tanzanian and Chilean applicants must direct their applications respectively to SURP / Philippines, ARU / Tanzania and UACH / Chile. (Deadline: 30th September.) Applicants for the 2 year SPRING Programme in Ghana must direct their applications to KNUST / Kumasi The SPRING Programme at Dortmund starts in September next year. I hereby declare that I have answered all questions correctly and to the best of my knowledge. The appropriate supporting documents are enclosed. I am aware that any careless or incorrect answers may lead to the exclusion from the application procedure and - if discovered subsequent to admission at SPRING - to exclusion from the course.......... Place Date Signature Send original signed sheets to: Via regular postal delivery: Technische Universität Dortmund Faculty of Spatial Planning SPRING Programme 44221 Dortmund Germany Via express courier, e.g. DHL, fedex, etc. Technische Universität Dortmund Fakultät Raumplanung Fachgebiet Raumplanung in Entwicklungsländern/SPRING GB I, 3. OG, Raum 1.404 Attn.: Rhoda Lynn Gregorio August-Schmidt-Straße 6 44221 Dortmund Germany Fax: +49 231 755 4398 (only for provisional cross check)