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Apply to GOUMS NON-Degree Programs (Medical Electives & Short_term Training Courses)
Tracking code of this form:
P629-F681-U0-N552913
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Personal Details
Organization
Title
Please select...
Mr
Ms
Mrs
Miss
Master
Doctor
Professor
Last Name
First Name
Middle Name
Gender
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Male
Date of Birth
Gregorian date:
Marital Status
Single
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Country of Citizenship/Nationality
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Other
Afghanistan
Azerbaijan
Cyprus
Georgia
India
Iraq
Kazakhstan
Lebanon
Libya
Pakistan
Palestine
Qatar
Russian Federation
Syria, Syrian Arab Republic
If OTHER, Please Specify
Country of Residence
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Other...
Afghanistan
Albania
Algeria
If OTHER, Please Specify
Do you hold dual Citizenship?
yes
No
If YES, Pleas Specify
Contact Information
Telephone Number
Email Address
Correspondence Address
City
State/Province
Postcode
Program of Interest
Level of Interest
Medical Electives
Short Term Training Courses
Choose your Program
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Breast Surgery
Laprascopy
Education Course Rhemutology
Endoscopy / Colonoscopy
Bronchoscopy
Thyroid FNA
Osteoporosis Treatment and Prevention
Tissue Engineering
Other...
If Other, Please Specify
Supporting Documents
(All the documents should be in English)
Passport Photograph
Allowed extensions : jpg - Allowed file size : 1000 KB
Copy of Passport
Allowed extensions : jpg - Allowed file size : 1000 KB
Curriculum Vitae (C.V.) / Résumé
Allowed extensions : doc,docx,pdf,jpg - Allowed file size : 1000 KB
Medical Elective Application Form
Template pdf
Template docx
Allowed extensions : pdf,jpg - Allowed file size : 1000 KB
English Proficiency Certificate
Allowed extensions : pdf,jpg - Allowed file size : 1000 KB
Certificate of Studies (Only for Short-term Training Programs)
Allowed extensions : pdf,jpg - Allowed file size : 1000 KB
Additional Information
Please Upload Your Sponsership Letter
Allowed extensions : pdf,jpg - Allowed file size : 1000 KB
Are you applying through a GOUMS Official Agent?
yes
No
If YES, Please type in the Name or the Code of the agent
How did you hear about us?
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GOUMS Website
GOUMS International Students
Google Search
Newspaper Ad
TV Ad
GOUMS Brochures, Flyers
www.educationiran.com
Scholarship Websites
Other