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APPLICATION FORM FOR RUSSIAN LANGUAGE COURSES REALIZED IN ONLINE MODE

Please fill in the form (all fields). The Institute will contact you by email within 10 days of getting your application form. If you didn’t receive any answer from the Institute within 10 days, please send an email with your first and last name, country, and the date of filling out the application to GNKuptsova@pushkin.institute.

    Family Name (in Russian letters - if you have got Russian visa):

    First Name (in Russian letters - if you have got Russian visa):

    Family Name (as in the passport):

    Name (as in the passport):

    Sex:

    Date of birth (day/month/year):

    Country of birth:

    City of birth:

    Citizenship:

    Passport number:

    Date of issue (day/month/year):

    Expiry date (with prolongation, day/month/year):

    Home address with post/ZIP code:

    Contact phone:

    E-mail (please note: the Institute will contact you using this email address):

    Place of study/work:

    Address of study/work with post/ZIP code:

    Occupation:

    Consulate to apply for visa (city):

    Have you ever studied Russian language?

    Your study at the Pushkin Institute starts (day/month/year):

    Your study ends (day/month/year):

    Type of accommodation:

    Personal requests:

    Attach, please, the file:

    Please note that your application will be successfully sent only after you give your permission by clicking ДА/YES.