Evolence tickets

Email

First name

Last name

Faculty

Charles University, First faculty of Medicine

Charles University, Second faculty of Medicne

Charles University, Third faculty of Medicine

Charles University, Faculty of Medicine in Hradec Králové

Charles University, Faculty of Medicine in PIlzen

Masaryk University

Palacký University

University of Ostrava

Year of study

Please select your preference #1 for Workshops (We will try our best to accommodate this preference, but it is not a gurantee)

Please select your preference #2 for Workshops (We will try our best to accommodate this preference, but it is not a gurantee)

Please select your preference #3 for Workshops (We will try our best to accommodate this preference, but it is not a gurantee)

Please select your preference #4 for Workshops (We will try our best to accommodate this preference, but it is not a gurantee)

Lunch option (Domino’s pizza)

Pizza Margherita

Pizza Pepperoni

Pizza Ted-Mex Chicken

Pizza Veggie

Would you like a physical certificate for a fee of 50 CZK?

Yes

No

UNITED INTERNATIONAL MEDICAL SCHOOLS