Clinic Online Payment

You can use this form to make an instant payment by credit card (Visa, MasterCard, AmEx) or PayPal for a clinic for which you have already submitted an application and received confirmation.


* Required field

Select Category: *

Select Date: *

Prior to completing the information on this page and making a payment, it is mandatory that you have registered for this clinic on the
E2E Ref Centre Course Management website.

I have already registered for this clinic (required).


Participant's Name
(i.e. the name of the person taking the clinic)

Name: *


Additional Information

Please enter any additional information you wish to add (optional):



Checkout

Your browser will open a secure PayPal portal after you press CHECKOUT. You do not need an existing PayPal account, nor do you have to create one, in order to pay by credit card.

Email to send payment confirmation:
*


Review Details and Submit Your Payment

Please review your information on this form before clicking on the CHECKOUT button.

Please have your credit card or PayPal details handy.

To prevent misuse, please type 4-digits of *