Please, return to:

International Department

Siberian Federal University

82 Svobodny Prospect

Building «A», 4th floor

Krasnoyarsk 660041

Russian Federation

Tel.: [phone]

E-mail: [e-mail] or [e-mail]

International student application form

ALL sections must be completed. Please, print clearly using block letters. Enclose one set of supporting documents with this application – all documents must be originals or certified copies. This application will not be processed unless full documentation is attached.

1. Personal Details

Family name (as shown on student passport): Sighted.............................................................................

Given Name(s) (as shown on student passport): Falcon..........................................................................

Nationality: Peruvian......................................................................................................................................

Date of birth (dd/mm/yyyy): 24/05/1932.................................. Gender (M/F): M.............................................

Place of birth (country, city): Peru, Huacachi.........................................................................................................

Passport Number: 777777777...........................................................................................................................

Date of Issue (dd/mm/yyyy): 20/8/1950........................... Date of Expiration (dd/mm/yyyy): 20/8/2050...................

2. Applicant Contact Details

Phone: [phone]............................................................. Mobile: [phone].................................................................. E-mail: wisdom_of_ancient [e-mail].............................................................................................................................................

Full Home address

Number & street: Calle Juan C. Cavero 113............................................................................................................................

...........................................................................................................................................................

City/town/village name: Huacachi.................................................................................................................. State/ Region: Huacachi District..................................................................................................................................

Post/zip code: 8797779.............................................. Country: Peru..................................................................

Mailing address (if different from above)

Full Home address

Number & street: ............................................................................................................................

...........................................................................................................................................................

City/town/village name: .................................................................................................................. State/ Region: ..................................................................................................................................

Post/zip code: ............................................... Country: ..................................................................