ENROLMENT FORM Fill in the following form to register for the Postgraduate Certificate you wish to study: Expert Certificate in which I wish to enrol: *Expert Certificate in Cognitive NeuroscienceExpert Certificate in Neurological Speech TherapyExpert Certificate in Neuro-ophthalmologyExpert Certificate in NeurotologyExpert Certificate in NeuropsychologyExpert Certificate in Clinical AudiologyExpert Certificate in Hearing TherapyExpert Certificate in Clinical OptometryExpert Certificate in Vision TherapyExpert Certificate in Evaluation and Intervention in Speech-Language TherapyWe will change the title of "Postgraduate Certificate" to "Expert Certificate" from January 1st, 2025.NoteFirst Name *Middle NameLast Name *National ID Number or Passport Number *Email Address *Phone *Street Address *Apartment, suite, etc *City *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweI request, upon completion of my studies, the issuance of the certificate of... *Select an optionSAERA in digital format: FREESAERA in paper format: FREE + Shipping costsLucentum Universitas in digital format: 140 €Lucentum Universitas in paper format: 140 € + Shipping costsUniversity Isabel I: 240€ + Shipping CostsI am interested in paying in: *Select an optionPay in full: 1200€2 instalments (interest-free): 600€3 instalments (interest-free): 400€You must submit: copy of your CV (resume), copy of your Diploma or Degree, copy of your passport or national ID (The number must correspond to the number you recorded on this enrollment form) and a passport size picture.Drag and Drop (or) Choose FilesI accept privacy policy and terms of useBy checking this box, you are agreeing to our privacy and data protection policyRead privacy policy and terms of use by clicking hereWe will contact you to confirm your registration and inform you about payment methods.Submit
