Your Data

Title Mrs. Ms. Mr. --

First Name

Name   For handling your request we need your name (mandatory)

E-Mail-Address   For handling your request we need your e-mail-address (mandatory)

Application or Enrolment Number   For handling your request we need your application or enrolment number (mandatory)

Date of Birth   For handling your request we need your date of birth (mandatory)

Year -- 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 / Month -- January February March April May June July August September October November December / Day -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31  

Place of Birth   For handling your request we need your place of birth (mandatory)

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Topic

Please choose a topic (mandatory).

Topic   Please choose a topic (mandatory). PLEASE CHOOSE Application at HU (via uni-assist) Re-enrolment Forms, e.g. part time, leave of absence, leaving New PIN Accreditation Visiting student status

Your request

Your Request   Please note that this side is encoded and will be transmitted with encryption. Our answer otherwise won't be encoded. Please don't use semicolons or bullet points (mandatory)

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