Application for a change to the purpose of residence, study

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I herewith apply for a residence permit for the maximum period of validity for myself. I have completed this form truthfully and I have checked all data completed by the IND and altered anything that was incorrect. I am aware that the personal details provided will be processed pursuant to the Aliens Act 2000 and will be passed on to the authorities that require this information to implement this Act. I will immediately notify the IND of any changes to the situation that relate to the right of residence. I grant permission to the educational institution mentioned in box 2 to notify the IND in the event that I am no longer studying there. I hereby give my power of attorney to the institution mentioned below to take the necessary actions in this procedure.

IND file number
Town Enschede
Date  I enclose (number) supporting documents with this form

My institute is submitting this application on my behalf based on the covenant between the institute and the IND.
The institute will pay the fee by automatic bank transfer.


Ministerie van Justitie

Immigratie- en Naturalisatiedienst

Submitting the application

1. Personal details of the foreign national (the applicant)

2. Details of the educational institution

3. Purpose of stay

Fax number

4. Declaration of awareness

3. Verblijfsdoel en bewustverklaring studie
Het doel waarvoor u een verblijfsvergunning aanvraagt, moet gelijk zijn aan het doel waarvoor u uw machtiging tot voorlopig verblijf (MVV) heeft gekregen. Bevestig hieronder de hoofdreden (doel) van uw verblijf en vul de bewustverklaring in
 het doel van mijn verblijf in Nederland (waarvoor de machtiging tot voorlopig verblijf is afgegeven) is

voorbereidend jaar / aanvullende examens met het oog op studie hoger onderwijs

  • verblijf in Nederland slechts wordt toegestaan voor het doel studie;

  • de vergunning voor de voorbereiding op de studie voor ten hoogste één jaar wordt verleend en niet kan worden verlengd;

  • het daaropvolgende verblijf voor studie wordt toegestaan voor de duur van een jaar of zoveel korter als de studie duurt. Indien de studie langer dan een jaar duurt dient ten minste vier weken voor afloop van deze periode bij de IND om verlenging van de geldigheidsduur te worden verzocht;

  • bij voltooiing of tussentijdse beëindiging van de studie, dan wel indien onevenredig lange duur daarvan wijst op geringe studieactiviteit, de aan mij verleende verblijfsvergunning kan worden ingetrokken c.q. de geldigheidsduur ervan niet verlengd wordt en ik Nederland dan zal dienen te verlaten.

Institute Universiteit Twente
Department/faculty International Office – Visa
Contact person M.A. Prins-Riemersma

Street Postbus 217 Number

Postcode 7500 AE City/Town Enschede
Telephone number 053-4894300

What is the purpose of your stay in the Netherlands?

A preparatory year before commencement of higher education in the Netherlands

X Higher education in the Netherlands

Study at an institute of higher education through an exchange programme

Please include with your application: A signed and stamped copy of the verklaring inschrijving / registratie student’ (or other proof of enrolment from the institute of higher education, e.g. university, polytechnic).

I declare that I am aware of the fact that:

my stay in the Netherlands is permitted only for the purpose of study;

I will have to leave the Netherlands upon completion of or choosing to terminate my unless I change the

purpose of stay;

The maximum period of stay for a preparatory course is one year; this period can not be extended;

I may only stay after a preparatory period if I change the purpose of stay to ‘higher education’;

The stay for higher education is permitted for a period of one year and an application for an extension of

this period must be submitted to the Immigration and Naturalisation Service no later than the day on
which this period expires;

My residence permit may be revoked, or its extension may be refused, upon completion or premature

termination of study, or in the case of poor commitment to my studies that has resulted in my taking a
disproportionately long time to complete these studies. In this case I will have to leave the Netherlands.

Surname as stated in the passport, identity card or any other

document satisfactorily establishing nationality «AO_SURNAME»

First names □ Male □ Female

Date of birth


Address in the Netherlands:
Street Number

Postcode Town/city

Telephone number


5. Financing study and stay

Please indicate below which situation applies to you.

Student has own financial means

Amount in €:

Include the following documents with your application:

– A copy of a bank statement of a bank account held jointly or solely in your name,
showing the balance available for the academic year in question; or

– An original statement from the bank (not a copy) confirming the monthly amount credited to you

by means of a transfer to a bank account held jointly or solely in your name

Student receives a scholarship

Organisation paying the scholarship:

Organisation granting the scholarship:

Monthly scholarship amount in €:

Starting date scholarship:

Ending date scholarship:

Include the following document with your application: a copy of the scholarship award letter

If the educational institution awards the scholarship on behalf of another party (the sponsor), a copy of the agreement between the educational institution and the sponsor must also be included

Financial support by a third party living abroad

Monthly amount in €:

Starting date financial support:

Ending date financial support:

Include the following documents with your application:

An original bank statement (not a copy), confirming the amount of money to be transferred

to your personal bank account on a monthly basis during your stay in The Netherlands, or

An original statement (not a copy) from your financer, in which he or she declares which

amount of money will be transferred to your personal bank account on a monthly basis
during your stay in The Netherlands, and

A copy of your financers passport, and

Proof that your financer is in a financial position to be able to transfer the money to your
personal bank account, for example a recent bank statement and/or account
specification showing the bank balance on your financers account

Financial support by a third party living in The Netherlands

Monthly amount in €:

Starting date of scholarship

Ending date of scholarschip

Include the following documents with your application:
- Appendix: Guarantor’s Declaration, completed and signed by your financier;
- An original extract (not a copy), not older than 6 months, from the municipal administration (GBA)
demonstrating your financier’s residential address and family composition;

  • Documents to provide evidence of your financer’s income and/or that of any spouse/partner, see Appendix: Proof of Income;

  • Copies of all pages of the financier’s identification papers and those of any spouse/partner if he/she is a Dutch citizen or of the front and back of the residence permit or of all pages of the passport in which the financier’s residence permit and that of any spouse/partner is endorsed
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  • Student has own financial means
  • Student receives a scholarship

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