Registration


Online registration
 
   

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.

 
   

Dr. Mr. Mrs. Ms.        E-mail:

          
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)
Detoxification and 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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