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Yanka Kupala State University of Grodno

Department of Language Training

of Belarusian and Foreign Citizens

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Your current level of Russian

First Name

Last Name

Sex

MaleFemale

Date of Birth

Place of Birth

Citizenship

Passport number

Date of issue (passport)

Date of expiry (passport)

Current address

Tel

E-mail address

Place of study or place of employment and position

Mother Tongue

Other Languages

Visa support needed

YesNo

Visa receiving city (Consulate)

Accommodation needed

YesNo

Why do you study Russian (tourism, hobby, work, other)?

Where did you get the information about the School? (indicate the source)

Here you can write your wishes and expectations regarding the School

Contact person’s name, his/her phone and e-mail (will be used only in case of emergency)

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Contacts

230005, Grodno, Belarus,

Vrublevskogo str., 33-116

Phone: +375 (152) 680229

phone/viber: + 375 (29) 569 88 12

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