BASIC PERSONAL DATA Last Name / Surname (as in your passport)* First Name / Given names (as in your passport)* Sex* Male Female Date of birth* Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 1985 1986 1987 1988 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 Place, Country of birth* Nationality / Citizenship* Passport No.* Passport valid till* Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month 01 02 03 04 05 06 07 08 09 10 11 12 Year 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 Current position / employment Address of your school / employee Where will you apply for Russian Visa (City, Country)* CONTACT DETAILS Email* Current phone number* (with international code (+91-000-000-00-00) Current address* Street, City, Postal Code, State/Province, Country Phone number of parents / relatives (with international code (+91-000-000-00-00) Mother's full name* Father's full name* Relatives in Russia If you have any relatives in Russia? please give their details: Name, address and contact number) DOCUMENTS ATTENTION! File should be in .pdf or .jpg formats and should not exceed 2 Mb. 1) Attach application form for invitation 2) Attach a copy of your passport: The first page and page with address (translated in Russian language and notarized) 3. Attach a copy of your Higher Secondary School certificate (translated in Russian language and notarized)* 4) Attach a copy of "Certificate of Educational Equivalence" / Apostilled Higher Secondary School certificate (if you have) Certificate of Russian language proficiency (TORFL) (if you have) FACULTY PREFERENCE AND FINANCIAL SUPPORT Faculty in KSMU you wish to enroll:* Choose from the list Choose from the list Preparatory course General medicineDentistryPharmacyOther Who is going to pay for your education?* Choose from the list Self Parents or individual sponsor State or other organizers
