Application Form - TECH Indonesia

Enrollment form

Name

Surname 1

Surname 2

E-mail

Telephone

KTP (Kartu Tanda Penduduk)

I have read and accept the Privacy Policies

Proceed to secure payment

Payment Modes and Methods

Select the payment method

Cash payment

Split payment

Deadlines

Select the payment mode After selecting the payment method, you will be redirected to the selected payment gateway

Credit card

Account

Internship program Neuro-Ophthalmology

Start: to choose

Cash price

Rp.117,093,232

Installment price

Rp.54,746,576 of tuition + 5 fees of Rp.16,453,267

Total amount

Initial payment

Installment fees