07/03/2017
March 8
The school is closed for public holiday
01/03/2017
TRKI exams
The nearest exam dates are March, 28 and 29
22/02/2017
February 23
The school is closed for public holiday

1. Personal details

Family Name

Country of Birth

First Name

City of Birth

Sex

Nationality

Date of Birth

   

Contact tel.

E-mail

Who to contact in case of emergency during your stay in Russia

Possible arrival (dd/mm/yy)

Possible departure (dd/mm/yy)

Are you booking together with another student? (if yes, please write the name)

Do you need the visa support (an invitation letter from the school)?

Yes*

No

*if yes, fill in item 2, please

2. Visa Related Information

Occupation/job

Address and telephone number of your workplace or Name of the educational establishment

Where will you apply for the Russian visa(country, city)?

What cities in Russia are you planning to visit?

Home address

Please send the copy of your passport to the e-mail address lingv@derzhavin.com (important for getting Russian visa)

3. Accommodation

Homestay

Guest house/hostel/hotel/Apart Hotel

Organized independently

Shared flat

4. Airport transfer

Do you require airport transfer on arrival?

Yes

No

Arrival details:

Date of arrival

Flight number

Arrival time

Do you require airport transfer on departure?

Yes

No

Departure details:

Date of departure

Flight number

Departure time

5. Cource Details

Type

Lessons per week

Start date (dd/mm/yy)

Number of week

Standart Course

20

Intensive Course

30

Academic/Long-Stay

20

30

Business Russian

20

10

Exam Preparatory Course

20

10

One-to-one*

10

15

20

30

Evening Course

Mon/Wen

Tue/Thu

In-company

Individual lessons

Mini group lessons

10

15

20

Work and study

20

Other course type

*Special interests of study (only for One-to-one)

Native language

Other languages

How do you assess your level of Russian

Beginner (A0)

Elementary (A1.2)

Pre- Intermediate (A2)

Intermediate (B1)

Pre- Advanced (B2)

Advanced (C1)

Previous Russian languages courses - Please indicate year of study, place of study, course length and course intensity (hours per week):

How did you find Derzhavin Institute?

other:

4 + 3 = ?