Registration

Registration 2017-11-10T10:35:19+00:00
Register for Fall 2018

To reserve a spot in the course, please fill out the form below, then enter a credit/debit card to make your payment, then submit. You should receive a confirmation email, and pending your payment you’ll be registered for the Graduate Mentorship Program beginning in Fall 2018.

Registration

PERSONAL INFORMATION

City
State/Province
Zip/Postal
Country

PROFESSIONAL INFORMATION

(e.g. acupuncturist, massage therapist, MD, DO, etc.)

ACCOUNT INFORMATION

FOR ONLINE CLASSROOM ACCESS
CAN BE EMAIL ADDRESS OR SPECIFIC USERNAME
A temporary password will be generated for you via email when your online classroom account is set up. You will be able to reset that password.

PAYMENT ARRANGEMENT

MAKE YOUR PAYMENT TO REGISTER TODAY. WE NEED TO KNOW WHAT PAYMENT ARRANGEMENT YOU INTEND TO MAKE. PLEASE REVIEW THE PAYMENT PLAN DETAILS ON THE "COST AND PAYMENT" PAGE.

DISCOUNTS

IF YOU ARE APPLYING FOR THE 25% DISCOUNT, PLEASE UPLOAD YOUR RECEIPT(S) FROM THE APPROVED COURSE(S). SEE "DISCOUNTS" DETAILS ON THE COST AND REGISTRATION PAGE FOR MORE INFORMATION.
Drop a file here or click to upload Choose File
Maximum upload size: 67.11MB

MAKE YOUR PAYMENT

THIS WEBSITE IS SECURE. ALL PAYMENT DATA ON THIS WEBSITE IS TRANSMITTED USING 1028-BIT ENCRYPTION, AND WE NEVER STORE PAYMENT INFORMATION ON THIS WEBSITE.
16 DIGITS (NO SPACES)
MONTH
YEAR
3 DIGIT CODE ON THE BACK