The Canadian Academy of Homeopathy provide educational programs of high standards in homeopathy since 1986 and has a very solid reputation world wide.

CANADIAN ACADEMY OF HOMEOPATHY
APPLICATION & REGISTRATION FORM FOR LIVE COURSES

Complete this form and send it to C.A.H. by clicking the "SENDIT" button below.

1. COMPLETE YOUR INFORMATION
All fields are required.
Name & first name:
Address:   City: 
State/Province:    Postal/Zip code:    Country: 
Phone: Day:    Cellular: 
Email:

EDUCATION
College/University:   Years :   Degrees: 

HOMEOPATHIC TRAINING
College/Organization:   Years :   Hours: 

OTHER INFORMATION
Contact person in case of emergency:   Phone: 
Professional degree(s)/specialities:
With which teacher/program have you
studied homeopathy:
How many years have you been studying
and/or practicing homeopathy:
How did you hear about these courses:
Are you a non-professional and auditing the course:
Are you planning on staying on campus residence:
Do you need hotel information:
Are you interested in CME credits:

2. CHOOSE YOUR LIVE COURSES

ILLUSTRATED COMPARATIVE MATERIA MEDICA PURA
Date: June 12 - 13, 2015
EARLY PRICE: $240 if purchased before April 1st.
REGULAR PRICE: $270

Will attend: LIVE


3. COMPLETE ALL FOR CONCLUSION
TOTAL:


NOTE: ALL PRICES ARE IN US DOLLARS AND DO NOT INCLUDE SHIPPING AND HANDLING.
Prices are subject to change with 30 days notice.

PAYMENT
We accept VISA, MASTERCARD, INTERAC E-TRANSFER, and personal check.

CREDIT CARD INFORMATION
VISA MASTERCARD
Name on the card:
Number on the card:   Expiration Date: 

INTERAC E-TRANSFERT
Email your e-transfert to: cah@videotron.ca
Transfering with the bank:
Security question asked:
Security response asked:

PERSONAL CHECK
For payment with a personal check, mail the completed form along with your check payable to the The Canadian Academy of Homeopathy
to 1173 boul. du Mont-Royal, Outremont (Québec) Canada H2V 2H6.

AGREEMENT
REGISTRATION AGREEMENT & PROTECTION OF INTELLECTUAL PROPERTY
I agree not to share viewing of the archives with anyone who has not been given direct permission by the Canadian Academy of Homeopathy for the rights to the intellectual material in this course.

I AGREE AND ACCEPT ALL THE TERMS ABOVE
 I agree and accept all the terms above.

4. YOUR COMMENTS/QUESTIONS
WRITE US HERE: