Bernburg
Dessau
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Application for Final Thesis
Hochschule Anhalt
Anhalt University of Applied Sciences
Student Service Center
To be filled in by the student:
Last name, first name: ____________________________________________________________________________
Student number: _______________ Degree program: __________________________________________________
Degree: Bachelor‘s Master‘s
I herewith apply – according to the valid examination and study regulations - for admission to my final thesis. A list of my
pending exams (exported from QIS) and the enrollment certificate are enclosed.
Preliminary title (In case of a collective work, the names of the candidates must be added here.):
I am entitled to take the examination as I have not completed/not failed an attempt in the aforementioned degree
program.
Please underline: I have not/have once cancelled a thesis topic.
1. Examiner: ____________________________ Department: _____
2. Examiner: ____________________________ Department: _____
Admission and the latest date for submission is published in your QIS Transcript of Records, examination number 8000. Signatures from
both examiners and representatives of the Examination Committee must be collected by the student prior to submission in the SSC.
Date: ________________ Signature: ____________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
To be filled in by examiners:
We herewith confirm the aforementioned thesis topic, and we have agreed to be its examiners.
(Optional: External secondary examiner/s is confirmed by the primary academic examiner: Yes No)
Starting date: ________________
Date: ________________ 1. Examiner Signature: ____________________________
Date: ________________ 2. Examiner Signature: ____________________________
Required information about external examiner/s, academic degree: ______________________________
Address: __________________________________________________________________________________
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
To be filled in by the Departmental Examination Board:
The examinee’s application has been:
approved rejected (see reasons on extra sheet)
The Departmental Examination Board approves the aforementioned thesis topic as well as both examiners. Head of
the Examination Committee is appointed: ____________________________
Latest submission date: ________________
Date: ________________ Signature: ____________________________
SSC Dessau: Antrag Zulassung Geprüft Erfasst
Abschlussarbeit V03 (18.02.2020) Prüfungsamt: .......................... SSC: ..............................
