Theophil-Wurm-Haus 72762 Reutlingen

Theophil-Wurm-Haus
72762 Reutlingen
Evangelisches Studentenwohnheim Pestalozzistraße 35
Telefonnummer: 07121/230515
Application for Admission in Theophil-Wurm-Haus
Please note:
The Theophil-Wurm-Haus accepts students from the Fachhochschulen and the
Pädagogische Hochschule, Fachbereich Sonderpädagogik, in Reutlingen. The
application committee requests that the applicant provides exact and truthful
information on the following application. Your application will be kept
confidential. The application committee reserves the right to examine the
provided information.
Important information:
We ask you to hand in together with this application form a copy of your
resume/CV (including your educational background); also special circumstances
which the application committee could use as consideration for acceptance
should also be included.
Please hand in your application and CV/resume until 31.12. resp.30.06. at the
latest.
Incomplete and late applications can not be considered!!!
The monthly rent including all fees is presently as follows:
for a double occupancy 135.- €
and for a single occupancy 170.- €
The rental contract begins on 01.03./01.09. and ends on 28.02./31.08. for all
students.
The application documents are valid for one semester only. In case your
application is denied, we ask you to send a new application if you would like a
room at a later date.

Application for Admission in Theophil-Wurm-Haus
for winter semester ___/___
for summer semester ______
___________
TWH-Eingangsstempel
Personal Information:
Last name: _________________ First name: __________________
Date of birth: _______ Place of birth: _________ Gender: ________
Marital status: _______ Children: _____ Nationality: ____________
Home address: __________________________________________
__________________________ Telephone number: ____________
Are you a smoker? Yes □ No □
pass photo
To which address should we send the answer?
___________________________________________________________________________
At which university are you or will you be studying?
___________________________________________________________________________
Degree program?__________________________________________________
In which semester are you currently enrolled? ___________________________
When will you finish your studies? ________________________
Questions about your social situation:
Profession of father: ______________________ Employed □ Self-employed □
Profession of mother: _____________________ Employed □ Self-employed □
Age of father: ___________________ Age of mother: ____________________
Net income of parents/spouse (per month) in Euro:
Father: ____________ Mother: _______________ Spouse: ________________
Without proof of income resp. salary (photocopy) and without CV no rooms
can be allocated!! You can ask if you are accepted by calling the caretaker
during the office hours.
Special (financial) loans: ____________________________________
Number of siblings: _________________ of which in education: ___________
Type of education: _____________________________________________

Statement on financing your studies (per month) in Euro:
Support from parents:
____________________
Support from spouse:
____________________
Own income:
____________________
Have you applied for BaföG? Yes □ No □
____________________
Other sponsorships:
____________________
Orphan’s pension:
____________________
Other income:
____________________
Total income
____________________
Are you willing to integrate into the student community of Theophil-Wurm-
Haus?
Yes □ No □
How long do you intend to stay in the student dorm? ________________________
Please note: A new entrant may be allocated a double room in the first instance.
This may be exchanged for a single room after one semester.
Would you agree to that? Yes □ No □
If not, why not? ___________________________________________________
With who would you like to share a room? ______________________________
Questions concerning other activities
Volunteer work: ___________________________________________________
University-related work: ____________________________________________
Questions about your housing situation: ( beginners do not have to answer these questions)
Have you previously lived in a student dorm?
Yes □ No □
If yes, where and for how long? ______________________________________
Why do you want to move into the Theophil-Wurm-Haus?
________________________________________________________________
__________________________________________________________________________
Date: ____________________
Signature: ________________________