Application Form Premed Registration 2024-2025

I apply to the following premed:

I apply for:

Select the premed you apply for:

April 2025 Premed Online ₪3500

October 2025 Premed- Ramat Gan₪3500

October 2025 Premed - Budapest₪750

October 2025 Premed - Szeged ₪0

Personal Information:

I would like to study

First Name

Last name

Citizenship

Passport number

Mobile Number

Place of Birth (Country & City)

Do you have A Language Certificate? such as (IELTS, TOEFL, CAMBRIDGE, ETC...)

What is your English Level in your opnion ?

Address:

Street Address

City

Postal / Zip code

Country

Contact Person in case of Emergency: Choose someone who is close to you, such as a Parent or sibling)

First Name

Last Name

Mobile Number

Street Address

City

Postal / Zip code

Country

Mother's Maiden Name: (Your Mother family name before marriage It's important for identification purposes)

Mother First Name

Mother Maidn Name

Declaration:

I declare and aware of the following (please check the box):

University International studies (UIS) is my official representative and caring out my application.

I aware that application fee is nonrefundable after payment.

All discount for the Premed in Israel will be reduced from tution fee payment

Upload here the documents:

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File Type: PDF , DOC

Download: Premed Terms and Regulation

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File Type: PDF, DOC

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Full Name

Date picker

Your Signature

שדה החתימה ריק.