cz
eng
ru
+420 774 058 550
+420 608 260 868
euromedprague@gmail.com
< Back
Program
Location
Registration
registration form
Name *
Surname *
Date of birthday
Address *
Telephone *
E-mail *
Confirm email *
Payment is made by company or by individual
Individual
Company
What is the country of the company
Czech Republic
The country - a member of the European Union
The country - NOT a member of the European Union
Company name
VAT Number
Now please choose if you want to pay full amount or just a 300 euro non-refundable deposit:?
*
Please note that deposit payment 300 euro is not refundable!
Entire amount
Non-refundable deposit
Now please specify the number of participants
for 1 person, €
Number
Total
Training: 12.04.2019
[Deposit]
500
Number of persons:
500
TOTAL, €:
500
VAT 21%, €:
105
TOTAL WITH VAT, €:
500
I agree to the processing of personal data
