| First
Name |
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| Last
Name |
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| Street
Address |
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| City |
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| State |
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| Zip |
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| Country |
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| Social
Security # |
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| Date
of Birth |
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| Program |
Holistic
Health Practitioner Training
Advanced
Holistic Health Practitioner Training
Naturopathic Practitioner Training
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| Citizen
of what nation |
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| Phone |
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| Fax |
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I understand that this agreement becomes a legally
binding document
after I sign it and it is accepted by the school.
I understand the total amount of the course of instruction for
is $
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Continuing Education Statement
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Our
Advanced Holistic Health Practitioners Training is a Continuing Education
Training. This means an educational service or program offered in any
of the following circumstances.
- Only
in subjects licensees are required to take as a condition to continue
licensure, and solely for that purpose.
- Only
in subjects necessary to continue to practice or work in an occupation
or profession such as law or medicine, and that are offered solely
for that purpose.
- To
persons who are already in a particular profession, trade, or job
category for the sole purpose of enhancing their skills or knowledge
within that particular profession, trade, or job category.
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Loan
Disclosure
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Government
Loan Information
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As
a participant in the Student Tuition Recovery Fund, we are obligated by
California law to collect the name of the source of each loan, if you
have one or more governmentally guaranteed or insured loans for tuition
purposes outstanding. |
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Loan
No. 1:
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Loan
No. 2:
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Administrative Offices:
643 Third Street, Suite 407, Encinitas, CA, 92024
Phone: (800)
421-5027 •
Fax: (818) 222-0535
Instruction Sites:
Mail
or Fax to ICN
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801
Ladera Lane, Santa Barbara
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15601
Sunset Blvd., Los Angeles
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