Please print out and mail
this form if you would like to register for our program. You can also register by phone by calling 800-396-9778 if you are in the United States, or fax this form to: 831-726-3192.Mailing Address:
Caduceus Institute of Classical Homeopathy
P.O. Box 538
Aromas, CA 95004
Name____________________________ Profession ________________________
Home Address_______________________________________________________
Office Address ______________________________________________________
Office Phone _____________________ Home Phone _______________________
Email Address _________________________ Fax number ______________________
Where did you learn of our program? ___________________________________
Number of years in practice and modalities used __________________________
Previous homeopathic training an
d experience__________________________________I am registering for:
__ Module One - Acute Homeotherapeutics
__ Module Two - Chronic Case Taking and Analyses
__ Module Three - Chronic Case Management
__ Module Four - Miasms and Nosodes
__ Module Five - Advanced Topics
__
Financial Agreement
Tuition for module
s one through five is $500 each and is due on registration. Tuition for the clinical module is $850. Registration fee for one or more modules at one time is $100. Payment in two or three installments is possible by special arrangement. A refund of the full tuition is offered if you notify us in writing, within 8 days of our mailing of the first session's materials, that you do not wish to continue the course. In this case, the first session's materials are yours to keep and no further materials will be sent. After that time, no refunds are offered. The registration fee is non-refundable. Our school does not participate in the tuition recovery program. Checks, Visa, Mastercard, and American Express are accepted.Bureau for Private Postsecondary and Vocational
Education
Department of Consumer Affairs
400 R St. Suite 5000
Sacramento, CA 95814-3517
(916) 445-3427
Enclosed is my payment of ___________ by (circle one) check / credit card
Visa/MC
/Amex #______________________________
______________________
Signature
Date