Application Form

Personal Information

Your Name (First/Given, Last/Surname):

Native Language:

Gender: Male Female

Date of Birth:

Permanent Address:

Street, Apartment/Flat #

City/Town/Village:

State/Province (if applicable):

Zip/Postal Code:

Country:

Contact telephone (including country and area code):

Fax number (if available):

E-mail:

Visa Support Information
for a full list of countries that need a visa to Russia please click here

Citizenship:

Passport #

Date of Expiry:

Occupation:

Employer/School Name:

Employer/School address:

When do you plan to arrive to Russia (up to a week before the beginning of your course):

When do you plan to leave from Russia (up to a month after the end of your course):

Port of entry into Russia (i.e. St. Petersburg, Moscow, etc.):

Cities that you are planning to visit during your stay in Russia:

Will you be traveling outside Russia during you course period: Yes No

Course Information:

Your current level of Russian:

Course type:

Starting Date::

Ending Date:

Accommodation:

Type of accommodation:

Re you a smoker?

Will you need an airport/train station pickup? Yes No

Comments/Questions & Additional Requests (please keep it short):