This questionnaire is intended to keep our database up to date so that we can keep in contact with you

Date / Place of birth

Sex	Male Female

Residential Address
Tel No.
Mobile No.
Email Address

Office Address
Tel No.
Fax No.

Mailing Address Preference

Office Address Residential Address

Field of Study
Area of Specialization:

Current Employment
Present Position

Year & Duration of Visit

German Institute/s visited	Host at the German Institute/s

Duration of other visits to Germany	Programme	From To

Research Co-operations/Contacts with German Partners

Partner in Germany	Institution	Scope of Cooperation

Are you interested in receiving additional information from DFG? If yes, please specify:
 General Information on DFG Programmes  German Research Magazine
 DFG Annual Time Planner

I herewith give my consent to the DFG for storing my personal details for the purpose of carrying out follow-up contact work and keeping in contact with me as part of the alumni activities. The DFG will not pass on my details to any third parties.

Date / Place: ____________________________________ Signature: _______________________________

Please note that you are free to choose whether or not you wish to fill out and sign the above the above declaration of consent. If you choose to consent, all the details you provide in this questionnaire will be stored for the alumni activities of the DFG. You are also free to choose not to answer individual points of the alumni sheet. Choosing not to fill out the questionnaire or not to have yours details stored will be of no disadvantage to you.
Your details will be stored permanently, although you can choose to revoke your declaration of consent at any time without indicating reasons. This will result in all details relating to you being deleted immediately.