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<h1><span style='font-size:11.0pt;font-weight:normal'>Matrikelnr.: 081579</span></h1>
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<p class=MsoNormal><span style='font-size:7.0pt;font-family:Arial'>Alexander
Schwarz� </span><span style='font-size:7.0pt;font-family:Wingdings'>Ÿ</span><span
style='font-size:7.0pt;font-family:Arial'>� Innsbrucker Str. 53� </span><span
style='font-size:7.0pt;font-family:Wingdings'>Ÿ</span><span
style='font-size:7.0pt;font-family:Arial'>� 70329 Stuttgart</span></p>
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<p class=MsoNormal><span style='font-size:11.0pt;font-family:Arial'>FH-Ludwigsburg</span></p>
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36</span></p>
<p class=MsoNormal><span style='font-size:11.0pt;font-family:Arial'>71364
Ludwigsburg</span></p>
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<h1> </h1>
<h1>Praktische Ausbildung im Vorbereitungsdienst</h1>
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<h1>Antrag auf Zuweisung zu den Ausbildungsstellen</h1>
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<p class=MsoNormal><b><span style='font-family:Arial'>Ausbildungsstelle</span></b></p>
<p class=MsoNormal><b><span style='font-family:Arial'>Anschrift</span></b></p>
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<p class=MsoNormal><b><span style='font-family:Arial'>Ausbildungsinhalt</span></b></p>
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<h1>Pers�nliche Erkl�rung</h1>
<p class=MsoNormal style='margin-left:18.0pt;text-indent:-18.0pt'><b><span
style='font-family:Arial'>1. � Die Hinweise der Fachhochschule Ludwigsburg zur
praktischen Ausbildung gem. � 17 Abs. 1 AprOVw gD (Praxisjahr) habe ich zur
Kenntnis genommen.</span></b></p>
<p class=MsoNormal style='margin-left:18.0pt;text-indent:-18.0pt'><b><span
style='font-family:Arial'>2.�� F�r die Zeit einer Zuweisung au�erhalb
Baden-W�rttembergs verzichte ich auf die Erstattung etwaiger Reisekosten sowie
auf die Verg�tung von Umzugskosten und Trennungsgeld.</span></b></p>
<p class=MsoNormal style='margin-left:18.0pt;text-indent:-18.0pt'><b><span
style='font-family:Arial'>3.�� Das Einverst�ndnis aller o.a. Ausbildungsstellen
liegt mir vor.</span></b></p>
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style='font-family:Arial'> </span></p>
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<p class=MsoNormal style='margin-left:35.25pt;text-indent:-35.25pt'><span
style='font-family:Arial'>Datum, Unterschrift</span></p>
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