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Medicine Application

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OMAN MEDICAL COLLEGE

Founded in academic partnership with the West Virginia University

Application for Admission to Doctor of Medicine (M.D.) Degree Program

First Year: Second Year: Other:

Registration No. :……………….. Date of Receipt:


……………

1. Personal Data
Family Name (Surname) Personal Name (First Name) Other Names (middle, maiden etc)

Mailing/Current Address City:

State/Country:

Postal Code:

Permanent Address City:

State/Country

Postal Code:

Phone/Fax Numbers E-mail Address:


Home GSM Fax

Birthday Sex Nationality


Month Day Year Male Female

2. Thanawia Amma or its equivalent examination details

2.1 Name & Address of the Institution: …………………………………………………………

2.2 Transcript of Marks


Subject Marks obtained % of Marks
in figures in words
Biology
Chemistry
Physics
English
3. Marks or grade obtained in higher examinations
Name of Subject/s Grade/Percentage
Examination/Qualification of Marks

4. Standardised English Test Scores

4.1. TOEFL Score (If taken): Paper-based Computer-based

Date …………….

4.2. TWE Score (if taken): Date ……………….

4.3. IELTS Score (if taken): Date ……………….

5. Declaration of Truth

I certify that the information on this application is complete, accurate and true; and agree
to abide by the policies, rules and regulations of the Oman Medical College. I understand
that any information given falsely or withheld will affect the decision on my application
and may make me ineligible for admission and /or enrolment.

Applicants Signature ……………………… Date ………………..

6. Declaration by Parent

I …………………………………….. parent of ……………………………………


confirm that the information furnished above by my son/daughter are true. I understand
that after completion of the admission formalities, request for cancellation of admission
and refund of fees already remitted will not be entertained by the Oman Medical College.

Signature of Parent ………………………… Date………………


Check list of Documents to be attached with the application:

1. Demand Draft for RO 50/ towards registration fee

1. 3 copies of recent photograph

3. Passport/ID details

4. Copies of official transcripts/certificates

5. English Test Results (if applying for Advanced Placement)

Please mail the completed application together with the necessary enclosures to Office of
Admissions, Oman Medical College, P O Box 620, PC 130, Azaiba, and Muscat, Oman.

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