Student Registration Form

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.

Agreement:I Agree

Please Fill Out The Form Below

Diploma/Certificate
AromatherapyAnatomy and PhysiologyBioterrain AnalysisBotanical MedicineBiofeedbackChanneling and MediumshipDark Field MicroscopyEnergy MedicineGemmotherapy and OligotherapyMedical TerminologyOrthomolecular NutritionNatural MedicineRadical Self DefenseRaindrop TherapyReflexology

First Name (required)

Last Name (required)

Permanent Address (required)

City (required)

Province (required)

Postal (required)

Country (required)

Mailing Address
Same as aboveDifferent - 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 equivalentAt least 18 years of ageProficient in the English language

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

fees - I have paid $75.00 non-refundable fee

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

Date Purchased

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