Name *

First Name

Last Name

Phone *

This will be used for communications during the course (Whatsapp group)

Country

(###)

###

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I am looking for ways to fund this course, would you be willing to contribute 250 USD if you are from a high income or upper middle income country and 50 USD if you are from a lower middle income or low income country? (WB definition applies) *

Yes

No