Student Registration Form

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I understand that I am registering as a student of the College of International Holistic Studies (C.I.H.S.) and agree to pay the non-refundable registration fee of Seventy-five dollars ($75.00) upon completion of this registration form.


Please Fill Out The Form Below


First Name (required)

Last Name (required)

Permanent Address (required)

City (required)

Province (required)

Postal (required)

Country (required)

Mailing Address
 Same as above Different - please fill out below

Primary Tel(required)

Alternate Tel

Your Email (required)

Year of Birth

Country of Birth

Language of Instruction

Admission Requirements
 Have an Ontario Secondary School Diploma or equivalent At least 18 years of age Proficient in the English language

- I have reviewed and understand the policies and procedures manual, which includes the refund policy, payment schedule (if applicable), complaint procedure and grading

- I have paid $75.00 non-refundable fee

L.I.F.E. # (if applicable)

Date Purchased

Your Message

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