1. No category

Application Form
University of Debrecen Medical School
Program of study for which you would like to apply:
In case of Basic Medicine Course, you would like to continue on:
Personal Info:
Family name:
Given name(s):
Mother's Maiden name (full name before marriage):
Personal Information:
Sex
Male
Female
Date of birth (day/month/year):
Place of birth(City/Country):
First Language:
Nationality:
Home Address (in your country):
Address:
City:
Country:
Postal/Zip Code:
Telephone:
E-mail:
Fax:
Address:
City:
Country:
Postal/Zip Code:
Telephone:
E-mail:
Fax:
Passport:
Passport number:
Issued By:
Diamond For Medical Education |
Valid till:
229 College St, Unit 101, Toronto, ON M5T 1R4 | T: 1 (647) 996-5050 | F: 1 (647) 547-9119 | E: [email protected] | www.dmei.ca
Other:
Education History:
High School:
From (year):
To
Grade completed:
University or College:
From (year):
To
Degrees/Diplomas
Important Notes:
cklist:
1. High school/college/university diploma, transcripts, course descriptions (if available)
2. Resume (Short CV)
3. Short letter of motivation ''Why I want to become a Physician?"
4. Copies of relevant pages of passport
5. Recent passport size photograph
6. Bank receipt of 150 $ non-refundable application fee
DECLARATION
I, the undersigned, hereby declare that (choose one option):
1. I would like to transfer to the University of Debrecen, and I hereby submit all available school documents with my application
for the purpose of evaluation of my previous studies.
2. I am applying as a freshman, and I do not want to apply for any exemptions.
I am aware that I will not be able to submit any more exemption requests to the Educational Sub-Committee throughout my
entire studies at the University of Debrecen.
Date
Diamond For Medical Education |
Signature
229 College St, Unit 101, Toronto, ON M5T 1R4 | T: 1 (647) 996-5050 | F: 1 (647) 547-9119 | E: [email protected] | www.dmei.ca