REGISTRATION PROCEDURE

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1. COPY AND PASTE THE FORM IMMEDIATELY BELOW INTO AN EMAIL BY CLICKING HERE AND COPYING IT INTO THE BODY OF THE EMAIL.

REGISTRATION FORM FOR C.V.H. AND D.V.H PROGRAMS

Name:

Profession:

Home Address:

Office Address:

Office or Cell Phone:

Home Phone:

Email Address:

Fax number if Available:

How did you learn of our program?

I am registering for (paste in the correct choice):
A. The Certificate in Vitalistic healing program
B. The Doctorate in Vitalistic healing program.

Financial Agreement: Tuition for this program is $500 plus a $150 materials fee, for a total of $650. Lab and other materials will be sent to your home address unless otherwise specified. As the first session has been offered on a trial basis, no tuition refunds are offered after registration.

2. FILL OUT THE FORM COMPLETELY AND EMAIL IT TO WILLA.

3. WILLA WILL ANSWER YOUR EMAIL AND ARRANGE A TIME TO TALK WITH YOU BY TELEPHONE OR SKYPE.

3. PAYMENT OPTIONS:

A. Write a check payable to Caduceus Institute and mail it to Willa Keizer at P.O. Box 538, Aromas, CA 95004

B. VISA, MASTERCARD, or AMERICAN EXPRESS credit card information can be telephoned to 1-726-3190, or can be faxed to 1-831-726-3192. Include Name on Card, Visa/MC #, Expiration Date, 3 digit security code, and your signature if mailed or faxed.

C. PAYPAL payments can be made to Willa@homeopathyhome.net.