IIRT Payment Portal

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1. Have you ever enrolled in the program?

Full Name (English) *:

Email *:

Email (again) *:

Phone Number *:

Alternative Phone Number

Select Gender

Ocupation *

Full Address *

City

Country

Where did you first hear about us?

Full Name (English) *:

Student ID*:

Email *:

Phone Number *:

Please confirm information below

IIRT Arabic Intensive - Term 1 (financial support discount)

Name:
E-Mail:
Phone:
Address:
City:
State:
Country:

Name:
Student ID:
E-Mail:
Phone:

Please note: The Payment Charge is non-refundable.