Name:

Local Address:
    

Phone:
Email:

Person to Contact (during semester)
in Case of Emergency:

Contact's Address:
    

Contact's Phone:

Foreign Languages and Level of Fluency (Strong, Moderate, Weak):

References (small section/seminar teachers, other teachers who know you well):

Activities in law school:

Employment (in last five years):

Brief Statement why you want to participate in program (how the semester at Bucerius would fit into your study and career plans):

Additional Information (anything else you wish us to know):