Payment Details
Bank Transfer

Payer's payment details:

If your employer is paying for your course, enter your employer's billing information here.

First Name:

Last Name:

Titles before name: Titles aftere name:

Company (optional):

Street & No:

ZIP:

City:

Email:

ID:

VAT ID:

Select your Country: 
AlbaniaArgentinaAustraliaAustriaBahrainBelarusBelgiumBermudaBosnia & HerzegovinaBrazilBulgariaCanadaColombiaCosta RicaCroatiaCyprusCzech RepublicDenmarkEgyptEstoniaFinlandFranceFrench PolynesiaGeorgiaGermanyGreeceHong KongHungaryChileChinaIcelandIndiaIndonesiaIrelandIsraelItalyJapanJordanKosovoKuwaitLatviaLebanonLiechtensteinLithuaniaLuxembourgMacedoniaMalaysiaMaltaMexicoMoldovaMontenegroNetherlandsNew ZealandNorwayPanamaPeruPhilippinesPolandPortugalQatarRepublica DominicanaRomaniaRussiaSaudi ArabiaSerbiaSingaporeSlovakiaSloveniaSouth AfricaSouth KoreaSpainSwedenSwitzerlandTaiwanThailandTurkeyUkraineUnited Arab EmiratesUnited KingdomUruguayUSAOTHER - please specify: Please select

Please make sure the country is selected correctly.

Payment for the following participants:

For each participant all fields are required to be filled.
Enter the e-mail of the course participant here to send materials and information about the course.

There are only 2 free spots available in the course.

The course registration will be completed by the payment of this fee.

Payment request will be sent to your email.
Invoice will be sent to your email when we will receive your payment.

The Prague School registration fee is non-refundable.

I agree with General Terms and Conditions
I wish to be informed about Rehabilitation Prague School news