Ko‘p bosqichli Ariza — 1-bosqich Admission application form 1Personal information 2Education 3Previous education 4Family information Tip: Fill all fields in capital letters Personal information Last name First name Middle name Date of birth (dd.mm.yyyy) JSHSHIR (14 digits) Gender Select… Male Female Phone number Additional phone number * Email * Nationality Select… Uzbek Tajik Russian Afghan Tatar Turkmen Other Nationality (other) Place of birth Country Region District / City Region (text) District/City (text) Passport information Passport series Passport number Issue date Issued by Higher education availability Do you already have higher education? Select… Yes No Documents to upload Passport copy (PDF) Residence registration (PDF) Photo 3.5x4.5 (JPG) Next Step Current education institution information Institution name Education level Select… Bachelor Master Study Mode Select… Full-time (day-time) Evening Part-time Online Specialty Select… General medicine ⬅ Back Next step Language of education Select… Uzbek Russian English Recommendation type Select… Accepted on a tuition fee basis Previous education information Country Region District / City Region (text) District/City (text) Type of Educational Institution Select… Secondary school Hight school Academic lyceum / Vocational school Technical school / Vocational sollege Other educational institution Name of educational institution Years of study (Start) Years of study (End) Certificate or diploma series and number Average certificate/diploma score Upload a scanned copy of the certificate or diploma with attachments (PDF) * ⬅ Back Next Step Home address Country Region City Street & House No. Current residence Country Republic of Uzbekistan Other Region Select… Andijan Region Bukhara Region Fergana Region Jizzakh Region Namangan Region Navoiy Region Kashkadarya Region Republic of Karakalpakstan Samarkand Region Syrdarya Region Surkhandarya Region Tashkent Region Tashkent City Khorezm Region District Select… Region (text) District/City (text) Living address 📍 My location Latitude Longitude Father’s Information Last Name First Name Middle Name Phone Number Workplace Position Passport Copy (PDF) Mother’s Information Last Name First Name Middle Name Phone Number Workplace Position Passport Copy (PDF) CV, Resume (docx file only ⬅ Back Submit Application Submitted Full name: — Application number: 0000 Your application has been successfully received. Please save your application number!