Dear Applicant

Please remember to fill out and attach this page to the application

Documents when you send them.

Family Name, Given Name (In Block Letters)

Nationality :

Representative :

Place and date of exam (or transfer) :

Please put an "X" in the appropriate boxes.

Item of documents	Semmelweis Univ.	Szeged Univ.	Univ. pecs	Premedical course	English course	Medical College
Chosen faculty
Application form
CV
Transcripts
School Leaving Certificate
Copy of Pasport
Medical report -HIV test -Hepatitis B vaccin -dyslexia (only for Semmelweis Univ)
Recommendation Letters
Number of photos
Application fee
Other
Evaluation form
Test papers

Date :