Download application form here
First name* _________________________
Middle name_________________________
Last name*_________________________
Are you ready to pay for my service? *_____________
Sex* (male, female)
Date of birth*_________________________
Place of birth*_________________________
Citizenship*_________________________
Home address*
Country_________________________
City_________________________
Postal Code (Zip Code)_________________________
Street_________________________
Phone/fax_________________________
Place of work or study*_________________________
Name of company/college; position*_________________________
Mailing address of company/college*_________________________
Passport number*_________________________
Passport expiration date*_________________________
Address for your invitation
Country_________________________
City_________________________
Postal Code (Zip Code)_________________________
Street_________________________
Phone/fax_______________________
Level of Russian* (None, Beginner, Good, Excellent)_________________________
City and country, where you will apply for Russian visa*_________________________
Programme of study*_________________________
Preparatory courses
General Medicine
Dentistry
Pediatrics
Pharmacy
Nursing
Prosthetic Dentistry
Time to start training and its duration*_________________________
Accommodation* (Dormitory for two persons, Dormitory for three persons)_________________________
Do you have a disability/special needs/medical condition? (please,
specify)_________________________
Your comments and wishes_________________________
