EXAM APPLICATION FORM

for application of the Bachelor exam

Student number: ………………....…….……

I, the undersigned, Education:...……………...……......................

Name, initials: ..…………………………………………………….........…………………...........................

Address: …………………………………………………………………...…………............................

Postal code / city: ………………………………………………..…………………………….............................

request to be admitted to take the Bachelor exam and declare to have fulfilled all my legal and
financial obligations.

After graduating for the Bachelor exam I wish to:

be registered for the following Master program ...........................……………...…….................
sign out at the TU Delft as of (date) 1 ………………………………................………..........................
(for tuition fee restitution, please contact the Central Student Administration,
Jaffalaan 9a, 2628 BX Delft).

Place Date Signature

…………………………… ………………………. …………………………………….............

Attention:

- If, having obtained your Bachelor’s degree, you wish to transfer to a Master’s degree program within the TU Delft, you are
requested to submit an application for enrolment in that program via www.studielink.nl. As soon as your final results for
the Bachelor’s program have been registered with the Central Student Administration and you have met any additional
conditions, your application for enrolment will be converted into an enrolment in the Master’s program.
- If you no longer wish to be enrolled for your study program(s) at the TU Delft, you should un-enroll yourself through your
Studielink account (www.studielink.nl). It is possible to unenrol by the first of the month succeeding the month in which
the request for unenrolment was made. It is also possible to request a different month of unenrolment, as long as
this period is in the future.
- If you terminate your enrolment as of 1 July or 1 August you will not be entitled to a refund. Visit the
website for more information: www.csa.tudelft.nl / Unenrolment.

For more information or questions about un-enrolment and/or restitution please visit www.csa.tudelft.nl or contact
CSA@TUDelft.nl.

NOT TO BE FILLED IN BY APPLICANT

In te vullen door de Onderwijsadministratie, alvorens het formulier aan de Centrale Studentenadministratie wordt gezonden:

Betrokkene heeft deficiënt: ja/ nee:

onafgebroken ingeschreven gestaan als student.

geen gebruik gemaakt van onderwijs- en / of examenvoorzieningen in periodes waarin niet was ingeschreven,
en evenmin van onderwijsvoorzieningen in periodes waarin ‘als extraneus’ was ingeschreven.

wél gebruik gemaakt van onderwijs- en of examenvoorzieningen in bedoelde periode, te weten:

………………………………………………………………………………………………………….…………….……
…………………………………………………………………………………………………………………………..…
Datum: Handtekening (Onderwijsadministratie):

……………………………. …………………………………………………..
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In te vullen door de Centrale Studentenadministratie: deficiënt: ja/ nee

Akkoord : ……………………………………………………………..…..

Aan de Onderwijsadministratie: de bovenvermelde aanvrager is examenbevoegd (vereiste vooropleiding), heeft voldaan aan
de bij de wet gestelde financiële verplichtingen en kan worden toegelaten tot het afleggen van het gevraagde examen.

Datum: Namens het College van Bestuur,

Hoofd Centrale

Studentenadministratie…………………………….. ………………………………………………………