APPLICATION FORM

1. Country ___________________________________________________________
2. Surname ___________________________________________________________
3. Name (underline the one often used) _____________________________________
4. Sex: male or female __________________________________________________
5. Date of birth ________________________________________________________
6. Place of birth _______________________________________________________
7. Present address _____________________________________________________
8. Your profession and place of work at the moment of application _______________
   __________________________________________________________________         

9. What languages do you know? (English, French, Spanish, etc.) To what extent do you
   know foreign languages? (writing, reading, conversation) ____________________
   __________________________________________________________________

10. Mother language ____________________________________________________
11. Education (names of schools or colleges, place, date of entering and graduation or
    ceasing studying there, certificates and their dates)__________________________
    __________________________________________________________________
    __________________________________________________________________
    __________________________________________________________________
12. Subjects successfully passed:
    

    Establishment	Subjects	Date	Mark
    _________________	_____________	__________	_______
    _________________	_____________	__________	_______
    _________________	_____________	__________	_______
    _________________	_____________	__________	_______
    _________________	_____________	__________	_______
    _________________	_____________	__________	_______
    _________________	_____________	__________	_______

13. Have you studied in any kind of higher learning establishments? (where, what kind
    and when) ________________________________________________________________
    __________________________________________________________________
14. What speciality do you choose to be trained in Russia and what educational
    establishment do you prefer to enter?_____________________________________
    __________________________________________________________________
15. What are your plans for future: profession, kind of work etc __________________
    __________________________________________________________________
    
    
    

    Place and date of application

    Signature