Application Form - TECH Czech Republic

Enrollment form

Name

Surname 1

Surname 2

E-mail

Telephone

National Identity Document

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Proceed to secure payment

Payment Modes and Methods

Select the payment method

Cash payment

Split payment

Deadlines

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Credit card

Account

Internship program Diabetes

Start: to choose

Cash price

151.260 Kč

Installment price

70.720 Kč of tuition + 5 fees of 21.250 Kč

Total amount

Initial payment

Installment fees