Anmeldung Patenschaftsprogramm (Studierende)

Name / Surname *

Vorname / First Name *

Geburtsdatum / Date of Birth *

Geschlecht / Gender

Weiblich / Female

Männlich / Male

Divers / Diverse

E-Mail Adresse *

Telefonnummer / Mobile Phone *

Herkunftsland / Country of Origin *

Muttersprache(n) / Mother tongue(s)

Weitere Sprachkenntnisse/Further language skills

In Deutschland seit / in Germany since

Universität / University *

TU Dortmund

Fachhochschule Dortmund

Abschluss, Studienfach / Degree, Field of study

Studienbeginn - vsl. Studienende / Start of Studies - Expected Graduation Year *

Matrikelnummer / Matriculation Number *

Hobbies / Sports / Any additional information you would like to share

Stimmst du zu, unserer WhatsApp-Gruppe hinzugefügt zu werden? / Do you consent to being added to our WhatsApp group? *

Ja / yes

Nein / no

Hiermit bestätige ich, dass meine Angaben vollständig und wahrheitsgemäß sind /I confirm that the information provided is complete and accurate *

Richtigkeit der Angaben / Confirmation of Accuracy

I agree that photos and videos on which I can be seen can be published in the internet. *

Participants of the „Mentoring program between international and senior students“ can join different activities, like the weekly meetings in the IBZ, trips and excursions, and various events on campus. For documentation and marketing purposes, photos and/or videos are made. TU Dortmund University’s International Office would like to publish these online. With my consent, I assure that I transfer the copyrights for the pictures and videos for the purpose of informing other students to the International Office of Technical University Dortmund and the University of Applied Sciences Dortmund in order to publish these on the homepage and social media pages of the International Office. I know that the material will be available to a worldwide audience after publishing in the internet. Further use of the portrait by a third party cannot be excluded. The consent is valid from the day of the signature for an indefinite time. I know that I can withdraw my consent at any time. The withdrawal would mean that the published material would have to be deleted from the homepage of the International Office and the social media pages of the International Office of TU Dortmund University within seven days.

Yes, I have read the data protection regulations and agree to the necessary processing of personal data *

Personal data collected during registration for the "Mentoring Program for lnternational and Senior Citizen Students" will be processed in compliance with the applicable data protection regulations. ln particular, the North Rhine-Westphalia Data Protection Act (DSG NRW) and the General Data Protection Regulation (DSGVO) shall apply. The users agree that the personal data requested in the form may be stored. The data will be used exclusively for statistical and information purposes for the implementation of the project and for no other purpose. The data will not be passed on to third parties. Users have the right to information, authorization, deletion, restriction of processing as well as the right to data transfer of their own personal data. This consent is voluntary and can be revoked or withdrawn at any time. Please direct your request to the respective project coordinator (currently Irmgard Kucharzewski and Reinhard Schmidt: patenschaftsprogramm.fk17@tu-dortmund.de).