Faculty of Medicine - Registration

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E-Mail*:

Please enter your e-mail address.

E-Mail confirmation*:

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This application is intended for enrollment in*:

Last Name*:

First Name(s)*:

Gender*:

Date of Birth*:

(dd.mm.yyyy)
Please indicate date as "day.month.year" (dd.mm.yyyy).

City of Birth*:

Please enter your city of birth

Country of Birth*:

Please select "Country of birth" and "Nationality" (name of country) from the pull-down menu.

Nationality (Country)*:

Intern / Extern*:

In case you earned your bachelor degree at the Georg-August University please select "intern" and enter your current matriculation number. Otherwise select "extern" and leave matriculation blank.

Matriculation Number:

Discipline of Application*:

*Fields marked with an asterisk are mandatory.