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National Research Lobachevsky

State University of Nizhny Novgorod


International Affairs Department

SUMMER SCHOOL APPLICATION FORM

GENERAL INFORMATION

Surname (s) Name (s)

Sex Date of birth __.__.____

Place of birth City (town) Country Citizenship

Passport №

Valid from __.__.____ Valid until __.__.____

Double allegiance or Permit of Residence in other countries (indicate


number of passport/ residence permit, the place and date of issue)

Russian Embassy (Consulate), where you plan to obtain Russian visa

Country City

Home address (in your native country)

Country Town (City) Street House № Flat №

Contact information Email Phone number

603950, Russian Federation, Nizhny Novgorod, Gagarin Avenue, 23.


tel.: +7 831 462 31 02, email: intdept@unn.ru
National Research Lobachevsky
State University of Nizhny Novgorod
International Affairs Department

EDUCATION

Is your participation in UNN summer school within the YES / NO


framework of Universities’ agreement?

Name of Home institution Country City

Level of studies at home university Bachelor / Master / Ph.D. Studies

The year of study Major (field) of studies Faculty

1st / 2nd / 3rd

Mother tongue

Foreign languages you know

English Advanced / Basic / Do not speak

Russian Advanced / Basic / Do not speak

(insert others if necessary)

603950, Russian Federation, Nizhny Novgorod, Gagarin Avenue, 23.


tel.: +7 831 462 31 02, email: intdept@unn.ru
National Research Lobachevsky
State University of Nizhny Novgorod
International Affairs Department

SUMMER SCHOOL

Which school Summer in Russia (8-26 July) ⬀


are you applying
to?
(choose one)
Practice in Android App Development and Using Big Data ⬀
(8 July - 2 August)

International Relations and Diplomacy (8 July - 2 August) ⬀

Doing business in Russia (1-14 July) ⬀

Approximate arrival date __.__.____

Approximate departure date __.__.____

Which Hostel (single or double room) 1 000 RUB* 15 USD** ⬀


accommodation
do you prefer?
(choose one)
Host family (meals included) 35 000 RUB 525 USD ⬀

Host family (meals NOT included) 15 000 RUB 225 USD ⬀


* The minimum priсe
**Please note, the prices in USD are approximate and depend on the current course.

FINAL DECLARATION

⬀ I declare that the information given on this form is true, complete & accurate and no information
requested or other material information has been omitted.
⬀ I am warned that failure to report all the true, complete & accurate information will invalidate my
application.
⬀ I am obliged to timely cover the tuition & accommodation fee.
⬀ I note that if I do not fully comply with these requirements, the UNN has the right to cancel my
application and I will no claim against the UNN in relation thereto.

«___» _______________ 2019 __________________ /________________________________________________/


Signature Full Name

Please send the signed and scanned copy of the form to intdept@unn.ru (Ms Elizaveta Vasina)

603950, Russian Federation, Nizhny Novgorod, Gagarin Avenue, 23.


tel.: +7 831 462 31 02, email: intdept@unn.ru

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