Students

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General declarations
Time of entering the dwelling house 12345678910111213141516171819202122232425262728293031 123456789101112 201220132014 Estimated home outlet 123456789101112 20122013201420152016	Work Worker Student Additional Information Subject of your study School / University Street Zip code / City
Type of room: Single Room Twin Room
Smoker No Yes
Parking space No Yes
License plate number
Personal Data	Next of kin
Title Mr. Ms.	First name
First name	Last name
Last name	Date of Birth (Day Month Year) 12345678910111213141516171819202122232425262728293031 123456789101112 194019411942194319441945194619471948194919501951195219531954195519561957195819591960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002
Date of Birth (Day Month Year) 12345678910111213141516171819202122232425262728293031 123456789101112 1960196119621963196419651966196719681969197019711972197319741975197619771978197919801981198219831984198519861987198819891990199119921993199419951996199719981999200020012002	Street
Street	Zip code / City
Zip Code / City	Telephone Number
E-Mail	E-Mail
Telephone Number	Job
Religion	Employer
Citizenship
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