Ruhr-Universität Bochum Dezernat 2/Welcome Center Gebäude SSC 1/223 Universitaetstr.150 ,44801 Bochum, Germany Beate Seidemann Tel.: +49(0)234 32 – 22279 Fax: +49(0)234 32 – 14640 E-Mail: [email protected] Application for Guest Houses of Ruhr-Universität Bochum Personal Data of the Guest: Family Name: _______________________ First Name(s): _______________________________ Sex: Date of birth: ________________________________ Female Male Nationality: ________________________________________________________________________ Home Address: ____________________________________________________________________ E-mail: ___________________________________________________________________________ Accompanying persons: _____________________________________________________________ Number and age of accompanying children: ____________________________________________ Invoice: self-pay insitute Supported by (programme/organisation): _______________________________________________ Hosting Institute: Name of Hosting Institute:___________________________________________________________ Address: __________________________________________________________________________ Contact person at RUB: ______________________________________________________________ Telephone-No.: __________________________ E-mail: ____________________________________ Planned duration of your exchange from:_______________ until: ___________________________ Rooms are rented for entire calendar months only; max. stay 12 months Guest Houses 1-room – Apartment (approx. 22-51 sqm suitable for one person) 2-room – Apartment (approx. 42-63 sqm; suitable for 1-2 persons) 3-room –Apartment (approx. 65-75 sqm; suitable for 2 persons or a family; two bedrooms) 1-room in a shared flat (approx. 12-25 sqm; own apartment; shared kitchen & bathroom) My preferences/comment: ______________________________________________________________________________________ ______________________________________________________________________________________ (Here you can note if you have any preferences concerning your accommodation, e. g. a special Guest House. We try to reserve the required room for you but cannot give a guarantee.) ___________________ Date ___________________________________ Signature of applicant 1
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