Apply to GOUMS Non-degree Programs (Medical Electives & Short-term Training Courses)
[
Back to the form
]
(
*
) indicates required fields
-
Personal Details
1
Organization
2
Title
Select from list
Mr
Ms
Mrs
Miss
Master
Doctor
Proffesor
3
Last Name
4
First Name
5
Middle Name
6
Gender
Select from list
Female
Male
7
Date of Birth
Gregorian date:
8
Marital Status
Select from list
Single
Married
9
Country of Citizenship/Nationality
Select from list
Other...
Afghanistan
Azerbaijan
Cyprus
Georgia
India
Iraq
Kazakhstan
Lebanon
Libya
Pakistan
Palestine
Qatar
Russian Federation
Syria, Syrian Arab Republic
Tajikistan
Turkey
Turkmenistan
Uzbekistan
Yemen
10
If OTHER, Please Specify
11
Country of Residence
Select from list
Other...
Afghanistan
Albania
Algeria
12
If OTHER, Please Specify
13
Do you hold dual Citizenship?
Select from list
Yes
No
14
If YES, Pleas Specify
-
Contact Information
15
Telephone Number
16
Email Address
17
Correspondence Address
18
City
19
State/Province
20
Postcode
-
Program of Interest
21
Level of Interest
Select from list
Medical Electives (Internship)
Short-term Training Courses
22
Choose your Program
Select from list
Breast Surgery
Laprascopy
Education Course Rhemutology
Endoscopy / Colonoscopy
Bronchoscopy
Thyroid FNA
Osteoporosis Treatment and Prevention
Tissue Engineering
Other...
23
If Other, Please Specify
-
Supporting Documents
(All the documents should be in English)
24
Passport Photograph
Please attach the requested file to the form.
25
Copy of Passport
Please attach the requested file to the form.
26
Curriculum Vitae (C.V.) / Résumé
Please attach the requested file to the form.
27
Medical Elective Application Form
Template pdf
Template docx
Please attach the requested file to the form.
28
English Proficiency Certificate
Please attach the requested file to the form.
29
Certificate of Studies (Only for Short-term Training Programs)
Please attach the requested file to the form.
-
Additional Information
30
Please Upload Your Sponsership Letter
(if you have one)
Please attach the requested file to the form.
31
Are you applying through a GOUMS Official Agent?
Select from list
Yes
No
32
If YES, Please type in the Name or the Code of the agent
33
How did you hear about us?
Select from list
GOUMS Website
GOUMS International Students
Google Search
Newspaper Ad
TV Ad
GOUMS Brochures, Flyers
www.educationiran.com
Scholarship Websites
