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)

Middle Initial

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 (required)

Country of Birth

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

T2202 Receipts
Due to new CRA rules around issuing education tax receipts we will require your social insurance number as well as your approval to send the T2202 receipt electronically by email. This applies only for Canadian residents and temporary residents living in Canada from the US.
Social Insurance Number (Canadian residents only):
Yes - I approve sending T2202 receipt electronically to you via email

Your Message

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