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Apply Now: VSMA Application Form

Please contact the VSMA Representative in your country or complete the following Application Form, in order to process your request and receive further guidance.

First Name*
Last Name*
Sex
Passport No.
Date of Birth*
Home Phone
Email*
Fax:
Permanent Address*:
City*:
Zip or Postal Code*:
Nationality*:
Country*:
High School Name, City & State:
Year of Graduation:
Freshman or Transfer:
If Transfer, Last University Attended:
Anticipated Enrollment:
Anticipated Major (Faculty):
Source of Financial Support :	A) Sponsoring yourself
	B) Sponsored by family
	C) Sponsored by your employer
Name: (Name of person or body that responsible for payment of your fees)
If (B) or (C) please fill-up the following details:
Address:
Phone No.:
Fax No.:
Email Address:
Comments:

* Clauses obligatory to fill in.

Note:

You have to complete the application form and send it with copies of your passport and academic certificates.
All the documents should be attached to postmaster@studymedicinedirectory.com
It takes 5 - 8 days to process your application.
If you are qualified we will inform you and send you your Offer Letter by fax or email.