Online application form

Name and Surname *

First

Last

Email *

Phone number *

Address *

Qualification *

Place of work

Accommodation required

Yes (single room)
Yes (double / twin room)
No

Online payment date *

Please indicate when the online payment was made (dd/mm/yyyy)

Where did you hear about us?

I hereby authorise European Academy of English for Health Professionals to use and process my personal details *

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The online application form is considered valid when the relative course fees are paid. Please note that European Academy of English for Health Professionals will reject the application forms submitted without any payment of the course fees after 7 days.