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    International Student Application Form: University of Split School of Medicine

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    klumer_x
    This document is an application form for international students applying to the University of Split School of Medicine. The application requests personal information such as name, date of birth, citizenship, and contact details. It also requests information about the applicant's parents, previous education history including secondary school attended and grades achieved, English language proficiency through standardized tests or previous education, a declaration of psychophysical fitness, and a signed declaration that the information provided is accurate.

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    International Student Application Form: University of Split School of Medicine

    Uploaded by

    klumer_x
    36 views2 pages
    This document is an application form for international students applying to the University of Split School of Medicine. The application requests personal information such as name, date of birth, citizenship, and contact details. It also requests information about the applicant's parents, previous education history including secondary school attended and grades achieved, English language proficiency through standardized tests or previous education, a declaration of psychophysical fitness, and a signed declaration that the information provided is accurate.

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    Application Form1

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    This document is an application form for international students applying to the University of Split School of Medicine. The application requests personal information such as name, date of birth, citizenship, and contact details. It also requests information about the applicant's parents, previous education history including secondary school attended and grades achieved, English language proficiency through standardized tests or previous education, a declaration of psychophysical fitness, and a signed declaration that the information provided is accurate.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    36 views2 pages

    International Student Application Form: University of Split School of Medicine

    Uploaded by

    klumer_x
    This document is an application form for international students applying to the University of Split School of Medicine. The application requests personal information such as name, date of birth, citizenship, and contact details. It also requests information about the applicant's parents, previous education history including secondary school attended and grades achieved, English language proficiency through standardized tests or previous education, a declaration of psychophysical fitness, and a signed declaration that the information provided is accurate.

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    UNIVERSITY OF SPLIT SCHOOL OF MEDICINE

    INTERNATIONAL STUDENT
    APPLICATION FORM

    PERSONAL DATA
    ___________

    ________________

    _______________

    Given Names

    Family Name

    Date of Birth

    ___________________

    ________________

    _______________

    Country of Birth

    Nationality/Citizenship

    Sex: Male/Female

    Marital Status: _______________________

    Passport Information:

    _________________

    _______________

    Country of Origin

    Passport No.

    Social Security/Personal Identification No.________________________


    Mailing Address: ________________________________
    Phone: ___________________________

    E-mail: ____________________________

    Father surname, first name, permanent address, year of birth, occupation, nationality, citizenship:
    __________________________________________________________________________________
    __________________________________________________________________________________
    Mother surname, first name, permanent address, year of birth, occupation, nationality, citizenship:
    __________________________________________________________________________________
    __________________________________________________________________________________

    EDUCATIONAL HISTORY
    ___________________________

    _________________

    Secondary/High School Attended

    Year Finished

    Cumulative GPA ____________________


    Please indicate the required pre-med courses that you have completed:

    UNIVERSITY OF SPLIT SCHOOL OF MEDICINE


    Credits

    Grade

    Chemistry

    __________________

    _________________

    Biology

    __________________

    _________________

    Physics

    __________________

    _________________

    ENGLISH LANGUAGE PROFICIENCY


    Yes, I have completed the English language test attached:
    TOEFL
    IELTS
    CAE
    Please indicate your test score (if applicable)
    I am applying without an English language Test and would like my previous education
    considered as evidence of my English language.
    I do not need to do the English Language Test. English is my first language.

    DECLARATION OF PSYCHOPHYSICAL FITNESS


    I hereby declare under penal and material responsibility that I am psychophysically fit for attending
    the course of medical studies at the University of Split School of Medicine and that I have no history
    of mental illnesses that might impair my normal functioning as a medical doctor.

    Signature _______________________

    Date____________________________

    DECLARATION AND SIGNATURE


    I certify that the information submitted in these application materials is complete and accurate to
    the best of my knowledge.

    Signature _______________________

    Date____________________________

    Note: Any false or misleading information supplied by an applicant will be grounds for withdrawing
    any acceptance issued or future dismissal from the University of Split School of Medicine.

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