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Personal Information 2

This document is a personal information form for students applying to Tehran University of Medical Sciences. It requests basic contact information, demographic details, education history, and a signature acknowledging the minimum English language requirements.

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Hasan Ali
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35 views1 page

Personal Information 2

This document is a personal information form for students applying to Tehran University of Medical Sciences. It requests basic contact information, demographic details, education history, and a signature acknowledging the minimum English language requirements.

Uploaded by

Hasan Ali
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Personal Information Form

Tehran University of Medical Sciences


Office of Vice-Chancellor for Global Strategies and International Affairs Division of International Student Admissions

SECTION 1. PERSONAL INFORMATION


Full Name as appears on your passport
First Name: ______________________________________

Middle Name: ____________________________________

Last Name: ______________________________________

Passport Number: _________________________________

Nationality (Country that issued your passport): ___________________________


Other Nationalities (if applicable): _______________________________________

Residence Address in Iran: ___________________________________________________________________


Residence Address in your Country: ____________________________________________________________
Home Phone: ___________________________________ Cell Phone: ______________________________

Email Address: ______________________________________________________________________________

SECTION 2. CONTACT INFORMATION (in case of emergency)

Name: __________________________________
Relationship: _____________________________
Postal Address: ______________________________________________________________________________
City and Country: ____________________________ State/Province: ______________________________
Zip Code: __________________________________
Cell Phone Number: __________________________ Phone Number: ______________________________

SECTION 3. DEMOGRAPHIC INFORMATION

Date Of Birth: Day_______ Month_______ Year_______ Marital Status: Married  Single 


Gender: Male  Female  Official language of your country: __________________
Country of Birth: ________________________________ Mother Tongue: _________________________________
SECTION 4. EDUCATIONAL INFORMATION at TUMS-IC (Specifications of your admission)
Name of your School: _____________________________ Level of Studies: _______________________________
Name of your Department: ____________________________________________
Name of Supervisor (if applicable): ______________________________________

SECTION 5. SIGNATURE
I acknowledge that I know a minimum IELTS score of 5.5 (or equivalent TOEFL score) is required.
I hereby acknowledge that the information provided in this form is correct.

Full Name Saniy E Zehra Zaidi Signature Date 24/06/2023

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