Kirov State Medical University

Main Application Form

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Phone for information: +7 977 144 73 57

Your full name (as it is written in your passport)

Date of Birth

Gender

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Nationality (Citizenship)

Country of residence

Passport number

Passport day of expire

Your full address (Country, city, province, street, building)

Place of the Russian Embassy where you will apply for a visa

Father's name

Mother's name

Desired education level

Preparatory course Preparatory course + Undergraduate degree (BA) Preparatory course + Specialist Degree Preparatory course + Postgraduate degree (MA) Preparatory course + Research Degree Undergraduate degree (BA), (I already speak Russian) Specialist Degree, (I already speak Russian) Postgraduate degree (MA), (I already speak Russian) Research Degree, (I already speak Russian)

English proficiency

I do not speak English Elementary Intermediate Advanced

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Course you want to study

Desired language of instruction

Educational background

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E-mail

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