Fragebogen/fragebogen.htm
2023-02-23 10:53:04 +01:00

647 lines
35 KiB
HTML
Executable File

<?PHP
echo "
<html>
<head>
<meta name='GENERATOR' content='Microsoft FrontPage 6.0'>
<meta name='ProgId' content='FrontPage.Editor.Document'>
<meta http-equiv='Content-Type' content='text/html; charset=windows-1252'>
<title>Fragebogen zum Auslandspraktikum</title>
<style>
<!--
h2
{margin-bottom:.0001pt;
text-align:center;
page-break-after:avoid;
font-size:20.0pt;
font-family:Arial;
margin-left:0cm; margin-right:0cm; margin-top:0cm}
h1
{margin-bottom:.0001pt;
page-break-after:avoid;
font-size:12.0pt;
font-family:Arial;
margin-left:0cm; margin-right:0cm; margin-top:0cm}
-->
</style>
</head>
<body>
<h2>Fragebogen zum Auslandspraktikum</h2>
<p align='center'>
<img border='0' src='images/aespa_logo.jpg' width='493' height='132' align='center'></p>
<p align='center'>&nbsp;</p>
<form method='POST' action='--WEBBOT-SELF--'>
<div align='center'>
<table border='0' width='80%' id='table1' style='border-collapse: collapse' bgcolor='#EAEAEA'>
<tr>
<td colspan='4' style='border-left-style: solid; border-left-width: 2px; border-right-style: solid; border-right-width: 2px; border-top-style: solid; border-top-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<b><font face='Arial'>Persönliche Angaben<br>
</font></b><font face='Arial' size='1'>Deine persönlichen Daten
werden streng vertraulich behandelt und dienen in erster Linie nur
uns, um dir eventuelle Rückfragen zu stellen!</font>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<br>
<span style='font-size: 10.0pt; font-family: Arial'>Vorname</span>
</td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<br>
<input type='text' name='vorname' size='80'></p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Nachname</span>
</td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='nachname' size='80'></p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>AG</span>
</td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='ag' size='2'> / <input type='text' name='agjahr' size='2'>
</p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Geburtsdatum</span>
</td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='tag' size='2'>.<input type='text' name='monat' size='2'>.<input type='text' name='jahr' size='4'></p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Strasse, Nr.</span></td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='strasse' size='80'></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>PLZ, Ort</span></td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='plz' size='5'>,
<input type='text' name='ort' size='70'></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Emailadresse</span></td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='mail' size='80'>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'></span></td>
<td width='82%' colspan='3' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='checkbox' name='eiver_rueckfr' value='ON'>
<span style='font-size: 8.0pt; font-family: Arial'>Ich bin damit einverstanden, dass meine <u>Emailadresse</u> für eventuelle Nachfragen veröffentlicht wird.</span>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px; border-bottom-style: solid; border-bottom-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</td>
<td width='82%' style='border-bottom-style: solid; border-bottom-width: 2px; border-right-style:solid; border-right-width:2px'>
<p style='margin-left: 3px; margin-right: 3px'>
&nbsp;</td>
</tr>
</table>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</div>
<div align='center'>
<table border='0' width='80%' id='table2' style='border-collapse: collapse' bgcolor='#EAEAEA'>
<tr>
<td colspan='2' style='border-left-style: solid; border-left-width: 2px; border-right-style: solid; border-right-width: 2px; border-top-style: solid; border-top-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><b>Allgemeines zum Praktikum<br>
</b><span style='font-size: 8pt'>Bitte fülle die Kontaktfelder
so genau wie möglich aus, damit man später die richtigen
Personen erreichen kann! Wenn Du die Kontaktadresse nicht
auswendig parat hast (wahrscheinlich ist das so), dann schicke
sie uns bitte an
<a href='mailto:AESPAeV@gmail.com'>
AESPAeV@gmail.com</a> ! Dankeschön!</span></font></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<br>
<font size='2'><span style='font-family: Arial'>Zeitraum</span></font></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<br>
<input type='text' name='von_tag' size='2'>.<input type='text' name='von_monat' size='2'>.<input type='text' name='von_jahr' size='4'> <font size='2'><span style='font-family: Arial'>bis</font> <input type='text' name='bis_tag' size='2'>.<input type='text' name='bis_monat' size='2'>.<input type='text' name='bis_jahr' size='4'>
</p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font size='2'><span style='font-family: Arial'>Land</span></font></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='land' size='90'></p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font size='2'><span style='font-family: Arial'>Stadt</span></font></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='stadt' size='90'></p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font size='2'><span style='font-family: Arial'>Kontaktadresse</span></font></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='zeitraum0' size='90'></p>
</td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font size='2'><span style='font-family: Arial'>Ansprechpartner</span></font></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='zeitraum1' size='90'></p>
</td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'><br>
<font size='2'><span style='font-family: Arial'>Wie hast du Deinen Praktikumsplatz gefunden?</span></font></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='praktikum_find' size='118'></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'><br>
<span style='font-size: 10.0pt; font-family: Arial'>Wie hast du
die Reise organisiert und wie teuer war diese etwa?</span></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font size='2'><span style='font-family: Arial'>- Visum</span></font><span style='font-size: 10.0pt; font-family: Arial'>.</span></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='visum' size='90'></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'><font size='2'>
<span style='font-family: Arial'>- Transport</span></font></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='transport0' size='90'></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'><font size='2'>
<span style='font-family: Arial'>- Unterkunft</span></font></td>
<td width='82%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='unterkunft' size='90'></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'><br>
<span style='font-size: 10.0pt; font-family: Arial'>Wann hast du
mit den Vorbereitungen für das Praktikum begonnen?</span></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='vorbereitungsbeginn' size='118'></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial' size='2'><br>
Hast du einen Auslandskostenzuschlag beantragt und wie hoch war
dieser?</font></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='auslandszuschlag' size='118'></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial' size='2'><br>
</font><span style='font-size: 10.0pt; font-family: Arial'>In
welchen Bereich kann man deinen Praktikumsplatz einordnen?</span></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px' align='left'>
<font face='Arial'><input type='radio' value='V1' name='R1'><font size='2'>Öffentliche
Verwaltung<br>
</font>
<input type='radio' value='V2' name='R1'><font size='2'>Freie
Wirtschaft<br>
</font>
<input type='radio' value='V3' name='R1'><font size='2'>Sonstiges</font></font></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'><br>
<span style='font-size: 10.0pt; font-family: Arial'>Bitte
beschreibe die Stelle kurz:</span></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<textarea rows='3' name='stellenbeschreibung' cols='118'></textarea></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'><br>
<span style='font-size: 10.0pt; font-family: Arial'>Deine
Aufgaben bei dieser Stelle waren:</span></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='aufgaben' size='118'></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px; border-bottom-style: solid; border-bottom-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</td>
<td width='82%' style='border-bottom-style: solid; border-bottom-width: 2px; border-right-style:solid; border-right-width:2px'>
<p style='margin-left: 3px; margin-right: 3px'>
&nbsp;</td>
</tr>
</table>
</div>
<div align='center'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</div>
<div align='center'>
<table border='0' width='80%' id='table3' style='border-collapse: collapse' bgcolor='#EAEAEA'>
<tr>
<td colspan='2' style='border-left-style: solid; border-left-width: 2px; border-right-style: solid; border-right-width: 2px; border-top-style: solid; border-top-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<b><font face='Arial'>Zur Unterkunft</font></b></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'><br>
<span style='font-size: 10.0pt; font-family: Arial'>Wo hast du
gewohnt und wie hast du die Wohnung gefunden? </span></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<textarea rows='2' name='wohnung_find' cols='118'></textarea></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial' size='2'><br>
</font><span style='font-size: 10.0pt; font-family: Arial'>Wurde
dir von Arbeitgeberseite bei der Suche geholfen oder gar eine
Unterkunft zur Verfügung gestellt?</span></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='auslandszuschlag0' size='118'></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' height='27' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'><br>
<font face='Arial' size='2'>Was hat dich deine Wohnung gekostet?</font></td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p style='margin-left: 3px; margin-right: 3px'>
<input type='text' name='aufgaben0' size='118'></td>
</tr>
<tr>
<td width='17%' style='border-left-style: solid; border-left-width: 2px; border-bottom-style: solid; border-bottom-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</td>
<td width='82%' style='border-bottom-style: solid; border-bottom-width: 2px; border-right-style:solid; border-right-width:2px'>
<p style='margin-left: 3px; margin-right: 3px'>
&nbsp;</td>
</tr>
</table>
<div align='center'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</div>
<div align='center'>
<table border='0' width='80%' id='table4' style='border-collapse: collapse' bgcolor='#EAEAEA'>
<tr>
<td colspan='2' style='border-left-style: solid; border-left-width: 2px; border-right-style: solid; border-right-width: 2px; border-top-style: solid; border-top-width: 2px'>
<h1>Bewertung deiner Stelle<font face='Arial'><b><br>
</b></font>
<span lang='EN-GB' style='font-size: 8pt; font-weight: 400'>Gib
auf einer Skala von 1 bis 10 an wie sehr diese Aussage auf deine
Stelle zutrifft! 10 heißt dabei, dass es genau so war, eine 1
bedeutet, dass es das Gegenteil der Aussage war. Bleib objektiv
;)<br>
&nbsp;</span></h1>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Ich wurde
sehr gut in die tägliche Arbeit mit eingebunden</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><input type='radio' name='R1' value='V7'><font size='2'>1&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V8'><font size='2'>2&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V9'><font size='2'>3&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V10'><font size='2'>4&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V11'><font size='2'>5&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V12'><font size='2'>6&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V13'><font size='2'>7&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V14'><font size='2'>8&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V15'><font size='2'>9&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V16'><font size='2'>10</font></font></p>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Ich fühlte
mich auch unter den Kollegen gut aufgenommen</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><input type='radio' name='R1' value='V17'><font size='2'>1&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V18'><font size='2'>2&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V19'><font size='2'>3&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V20'><font size='2'>4&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V21'><font size='2'>5&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V22'><font size='2'>6&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V23'><font size='2'>7&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V24'><font size='2'>8&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V25'><font size='2'>9&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V26'><font size='2'>10</font></font></p>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Die mir
gestellten Ausgaben waren interessant</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><input type='radio' name='R1' value='V27'><font size='2'>1&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V28'><font size='2'>2&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V29'><font size='2'>3&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V30'><font size='2'>4&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V31'><font size='2'>5&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V32'><font size='2'>6&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V33'><font size='2'>7&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V34'><font size='2'>8&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V35'><font size='2'>9&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V36'><font size='2'>10</font></font></p>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Ich fühlte
mich gefordert</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><input type='radio' name='R1' value='V37'><font size='2'>1&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V38'><font size='2'>2&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V39'><font size='2'>3&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V40'><font size='2'>4&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V41'><font size='2'>5&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V42'><font size='2'>6&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V43'><font size='2'>7&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V44'><font size='2'>8&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V45'><font size='2'>9&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V46'><font size='2'>10</font></font></p>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Ich habe
etwas dazulernen können</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><input type='radio' name='R1' value='V57'><font size='2'>1&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V58'><font size='2'>2&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V59'><font size='2'>3&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V60'><font size='2'>4&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V61'><font size='2'>5&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V62'><font size='2'>6&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V63'><font size='2'>7&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V64'><font size='2'>8&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V65'><font size='2'>9&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V66'><font size='2'>10</font></font></p>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px' height='25'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Ich hatte
keinerlei Probleme mit der Sprache</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px' height='25'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><input type='radio' name='R1' value='V67'><font size='2'>1&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V68'><font size='2'>2&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V69'><font size='2'>3&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V70'><font size='2'>4&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V71'><font size='2'>5&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V72'><font size='2'>6&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V73'><font size='2'>7&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V74'><font size='2'>8&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V75'><font size='2'>9&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V76'><font size='2'>10</font></font></p>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px' height='25'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Ich konnte viele gute Erfahrungen sammeln</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px' height='25'>
<p style='margin-left: 3px; margin-right: 3px'>
<font face='Arial'><input type='radio' name='R1' value='V77'><font size='2'>1&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V78'><font size='2'>2&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V79'><font size='2'>3&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V80'><font size='2'>4&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V81'><font size='2'>5&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V82'><font size='2'>6&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V83'><font size='2'>7&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V84'><font size='2'>8&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V85'><font size='2'>9&nbsp;&nbsp;&nbsp;&nbsp;
</font><input type='radio' name='R1' value='V86'><font size='2'>10</font></font></p>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px' height='25'>
<p style='margin-left: 3px; margin-right: 3px'>
<br>
<font size='2'><span style='font-family: Arial'>Eventuelle
Schwierigkeiten</span></font></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px' height='25'>
<br>
<input type='text' name='schwierigkeiten' size='65'></td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px; border-bottom-style: solid; border-bottom-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</td>
<td width='56%' style='border-bottom-style: solid; border-bottom-width: 2px; border-right-style:solid; border-right-width:2px'>
<p style='margin-left: 3px; margin-right: 3px'>
&nbsp;</td>
</tr>
</table>
</div>
<div align='center'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</div>
<div align='center'>
<table border='0' width='80%' id='table5' style='border-collapse: collapse' bgcolor='#EAEAEA'>
<tr>
<td colspan='2' style='border-left-style: solid; border-left-width: 2px; border-right-style: solid; border-right-width: 2px; border-top-style: solid; border-top-width: 2px'>
<h1><font face='Arial'><b>Freizeit<br>
&nbsp;</b></font></h1>
</td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>
Lebensunterhaltskosten/Woche ca.</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<input type='text' name='lebenshaltungskosten' size='65'></td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>
<span style='font-size: 10.0pt; font-family: Arial'>Was konnte
man unternehmen?<br>
(Tagsüber und Nachts)</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<textarea rows='2' name='unternehmen' cols='49'></textarea></td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<span style='font-size: 10.0pt; font-family: Arial'>Konntest du
Kontakte knüpfen?</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<input type='text' name='kontakte' size='65'></td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px'>
<span style='font-size: 10.0pt; font-family: Arial'>War dies
eher leicht/schwer?</span></td>
<td width='56%' style='border-right-style: solid; border-right-width: 2px'>
<input type='text' name='kontakte_schwierigkeit' size='65'></td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px; border-bottom-style: solid; border-bottom-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</td>
<td width='56%' style='border-bottom-style: solid; border-bottom-width: 2px; border-right-style:solid; border-right-width:2px'>
<p style='margin-left: 3px; margin-right: 3px'>
&nbsp;</td>
</tr>
</table>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</div>
<div align='center'>
<div align='center'>
<table border='0' width='80%' id='table6' style='border-collapse: collapse' bgcolor='#EAEAEA'>
<tr>
<td colspan='2' style='border-left-style: solid; border-left-width: 2px; border-right-style: solid; border-right-width: 2px; border-top-style: solid; border-top-width: 2px'>
<h1>Deine abschließenden Worte<br>
<span style='font-weight: 400'><font size='2'>Was du einem
Studenten mit auf den langen Weg ins Ausland geben möchtest! Ein
paar gute Tipps vielleicht?</font></span><br>
&nbsp;</h1>
</td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<textarea rows='5' name='letzte_worte' cols='118'></textarea></td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px; border-bottom-style: solid; border-bottom-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</td>
<td width='56%' style='border-bottom-style: solid; border-bottom-width: 2px; border-right-style:solid; border-right-width:2px'>
<p style='margin-left: 3px; margin-right: 3px'>
&nbsp;</td>
</tr>
</table>
</div>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;<div align='center'>
<table border='0' width='80%' id='table7' style='border-collapse: collapse' bgcolor='#EAEAEA'>
<tr>
<td colspan='2' style='border-left-style: solid; border-left-width: 2px; border-right-style: solid; border-right-width: 2px; border-top-style: solid; border-top-width: 2px'>
<h1>Unsere abschließenden Worte</h1>
<h1>&nbsp;</h1>
</td>
</tr>
<tr>
<td width='99%' style='border-left-style: solid; border-left-width: 2px; border-right-style:solid; border-right-width:2px' colspan='2'>
<p class='MsoBodyText2'><font face='Arial' size='2'>Wir möchten
uns ganz herzlich bei Dir dafür bedanken, dass Du die Mühe auf
dich genommen hast, diesen Bogen auszufüllen und somit allen
Studierenden nach dir einiges an Sorgen und Ängsten genommen
hast!</font><span style='font-size: 10.0pt; font-family: Arial'><br>
Wenn Du Lust hast, schau einfach mal rein auf die Seite des
Akademischen Auslandsamtes. Dort wird demnächst neben allerlei
hilfreichen Dingen auch ein Forum und das Ergebnis dieses Bogens
zu finden sein! Wir wünschen Dir noch viel Freude und auch viel
Erfolg auf Deinem weiteren Weg!&nbsp;&nbsp;&nbsp; </span>
<span lang='IT' style='font-size: 10.0pt; font-family: Arial'>
AESPA</span></td>
</tr>
<tr>
<td width='43%' style='border-left-style: solid; border-left-width: 2px; border-bottom-style: solid; border-bottom-width: 2px'>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</td>
<td width='56%' style='border-bottom-style: solid; border-bottom-width: 2px; border-right-style:solid; border-right-width:2px'>
<p style='margin-left: 3px; margin-right: 3px'>
&nbsp;</td>
</tr>
</table>
</div>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</div>
<p style='margin-left: 3px; margin-right: 3px'>&nbsp;</div>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
<p>&nbsp;</p>
</form>
</body>
</html>";
?>