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Application form

Please fill application form and send it via e-mail or fax.

You can download application form here.
 

APPLICATION FORM

FOR ADMISSION AS A STUDENT AT LUGANSK STATE MEDICAL UNIVERSITY

  Family name or Surname (block letters):
  Other names:
  Date of Birth:  DD/MM/YY
  Country of Birth:
  Nationality:
  Country of normal residence:
  International Passport Number:
  Issued on:
  Valid to:
  Correspondence address:
  Telephone:
  E-mail:
  Home address if different from above:
  Educational background (indicate the educational institution, years of attendance and degrees/certificates obtained):
  Grade Point Average:
  Faculty or Department by which you wish your application to be considered:
  Degree or other qualifications which you wish to obtain from LSMU:
  Language of instruction:

 

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Admission Office:

Phone: +38-067-6892167.
Fax: +38-067-2368830.
Email: Lsmu.com@gmail.com

  

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