FREE Application Management Service for Partner Universities

First name*
Last name*
Date of Birth*
DD slash MM slash YYYY
Place of Birth*
Citizenship*

Email*
Phone Number*
Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

In which country did you attend high school (A-Levels or equivalent)?*
Please write down which subjects you took at high school (A-Level or equivalent) with the grades you received.*

I hereby would like to bindingly register for the following service supplied by London Medical Academy:*
- Application Management For 1 University - £499
Please note that for this service, there is initial payment to pay of £99.00, (which is included in the price of the package). This will cover your initial personal consultation (of up to 2 hours). Once you have had your consultation we will invoice you for the remaining amount, (less the £99.00 already paid). Please note that once the initial personal consultation has taken place, this payment of £99.00 is non refundable.
With this binding registration, I commit myself to purchase the selected package. All due fees are to be paid either by credit/debit card or bank transfer within 14 days of receipt of invoice.
One-off payment: I agree to pay the service fees within 14 days after receipt of the invoice.*
- One-off payment: I want to pay the registration and course fees within 14 days after receipt of the invoice.
You must click "ok" before submitting this application!*
- OK
I agree and expressly request that you begin to perform the service before the end of the cancellation period. If I wish to cancel during the revocation period after the payment has been made and the service has begun, I shall be obliged to pay an adequate amount that matches the proportion of services already rendered at the time of informing you about my decision to exercise the right of revocation as compared to the overall scope of service set forth in the contract. By clicking on "SEND" I accept the Terms and Conditions and acknowledge the Right To Withdraw and the Withdrawal Form.
I agree to the Privacy Policy GDPR.*
- I agree to the Privacy Policy GDPR.

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