Application form - IncLUsion programme - Leiden University

Use this form to apply for courses through Leiden University's IncLUsion programme.

Before you start, please read carefully:

We make admission decisions based only on this form. Make sure all answers are complete, clear and accurate.
Places are limited. We receive many applications and use a careful selection process.
Unclear question? Contact us first. If you don’t understand a question in this form, contact IncLUsion for help before applying via: inclusionstudents@sea.leidenuniv.nl
No additions after submission. Once you submit the form, you cannot add documents or extra information.

Your details

Full Name *

Street + number *

Postal code *

City *

Phone Number *

E-mail (not a Yahoo address) *

Residence status

Do you have a Dutch residence permit? *

Yes

Briefly explain why would you still like to participate in the IncLUsion programme, given that it is specifically intended for people without a residence permit. *

How did you find us?

How did you hear about the IncLUsion programme? *

Did you know there are also similar programmes at the universities of Utrecht (InclUUsion) and Wageningen (WURth-while)? *

Yes

If you live closer to Utrecht or Wageningen, why are you applying for IncLUsion Leiden?

Previous participation

Have you previously taken part in the IncLUsion programme, or a similar programme at another Dutch university (InclUUsion, WURth-while), or another programme at Leiden University? *

Yes

Provide details of the programme(s) you attended. Include the following:

Name of programme/university
Dates attended
Courses followed

Do you have a laptop? *

Yes

Other

Please explain

Your academic background

In which fields have you studied? Select all that apply. *

If you selected 'other', state which field

Have you obtained a university level diploma or PhD in this field / these fields? *

Yes

Provide details of your university diploma(s). Include the following:

Level of diploma (Bachelor, Master, PhD)
Title / field of study
University where diploma(s) obtained
Years of study

In which fields do you have professional experience (if applicable)? Select all that apply.

If you selected 'other', state which field

Provide details of your professional experience. Include the following:

Job title(s)
Type(s) of organisation
Duration

If you want to provide additional information about your academic and/or professional background, please add it here.

Your reasons for applying

Why do you want to follow courses through the IncLUsion programme?

This is your main chance to tell us about your situation, your motivation and how this programme fits your goals. Be specific and detailed. Your admission decision will be based only on this form and you cannot add information after submitting this form.

(75-500 words)

In which fields do you want to follow IncLUsion courses (subject to availability)?
Select all that apply. *

Travel information

Use the NS Journey Planner: https://www.ns.nl/en/journeyplanner to complete this section.

Departure: your home address
Destination: Rapenburg 70, 2311 EZ Leiden (Leiden University)

According to the NS Journey Planner:
What is the average one-way travel time to Leiden University? *

Less than 30 mins

30 to 60 mins

More than 60 mins

According to the NS Journey Planner:
How much is the cheapest one-way journey by public transport cost
from your home to Leiden University?

Are you able to pay these travel costs?

Before answering, please note:

For a small number of students who need it most, IncLUsion can reimburse travel costs of up to 60 euros per month. Reimbursements cannot not be granted to all students.
Due to limited funds, priority is given to students with lower travel costs or who can pay their own travel expenses.
Some IncLUsion courses may take place in The Hague. This may affect your travel costs.
If you indicate that you can pay your own travel costs, you cannot ask for reimbursements later.

Yes

We always handle your data with great care. By submitting this form, you grant Leiden University permission to process your data. If you would like your data to be deleted, you can send a request to inclusionstudents@SEA.leidenuniv.nl.

* = Input is required