Admission Form


Tracking code of this form: P16-F20-U0-N25769          
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:: Application For Admission
1 Title
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2 Last Name:
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3 First Name:
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4 Middle Name:
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5 Gender:
Male
Female
6 ID NO:
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7 Field of study requested :
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8 Date of Birth:
Gregorian date:
9 Country of Birth:
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10 City of Birth:
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11 Country of Residency:
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12 Marital Status:
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13 Religion:
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:: Contact Details
14 Mailing Address :
15 Postal Code :
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16 Town/City :
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17 State :
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18 Country :
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19 Cell Phone :
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20 Work Dial :
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21 Home Dial :
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22 E-mail Address :
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23 Work/Home Fax :
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24 Program Name :
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25 School :
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26 Degree :
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:: Academic qualification & Work History
27 Please attach the following:
1- your C.V. (resume) 
2- a copy of the first page of your passport
3- copies of your high school diplomas and the related report cards (transcripts).
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Allowed extensions : doc,docx,pdf,rtf,xls,ppt,jpg,gif,png - Allowed file size : 30000 KB
:: Declaration
- I have fulfilled all requirements required to be eligible for consideration.
- To the best of my knowledge, the information given in this application is correct and complete.
- I understand that submitting false or misleading information may result in any offer of a place withdrawn at any stage, including after a course has commenced.
- I understand that the University reserves the right to vary or reverse any decision made on the basis of incorrect or incomplete information.
- The University is under no obligation to consider an application submitted after the due date.
- I acknowledge and accept the full enrolment terms and conditions that govern this application form.
- I understand that Gonabad University of Medical Sciences collects, stores, and uses personal information in accordance with the University's Privacy Policy.
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