Please fill out the pre-registration form below to complete Step 1 in the registration process. Step 2 will follow after you 'Submit' this form.
Permanent Address (Street & Number) City
Province/State Postal/Zip Code Country
Home Telepone Business Telephone Fax
Previous Education (please provide brief description of previous education)
I would like to register for the following Homeopathy Course:
Introductory Course - Correspondence ($ 495.00)
Homeopathic Certificate Course - Correspondence ($2,500.00)
Rejuvenation Course - Correspondence ($7,500.00)
Please choose a method of Payment:
I will pay through an online secure form - SSL encryption page.
(only VISA is accepted at this time)
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