A Herbal Healer Academy - naturopathic application

HERBAL HEALER ACADEMY INC.

This online application form may only be used by
Naturopathic students who ARE NOT applying for exemptions.
If you have previous certificates that may qualify for exemption in the
Naturopath program, you must use the Naturopath application form in your
membership catalog. Send copies of certificates,
the Naturopath application form and your $25 registration fee by
mail to Herbal Healer Academy:

HERBAL HEALER ACADEMY INC.
127 McCain Drive
MT. VIEW, AR. 72560

Submit this application online by pressing the submit button.
Then make sure you pay the $25 registration fee online.
Important: your application will not be reviewed without this fee.

You must be a member to submit this application. Click here for membership application form.

Your Name:
Email Address:
Date:
Member Number:
Home Address:
City:	State: Zip:
Home phone:
Business Address:
City:	State: Zip:
Business phone:
Birth Date:
Birth Place:
U.S. Citizen?:	Yes No
SS #:
Highest Grade Completed:
College Degrees:

Male Female

Have you ever been convicted of a felony?
Yes No

Do you have any physical or mental disabilities or afflictions which might
affect your ability to function as a Naturopath?
Yes No

If yes,explain:

Previous Education and Certificates may credit to this program.
Please mail copies of your certificates for evaluation. Do not send originals.
List courses and dates certified or accredited below:

List your practical experience with friends, if any.

What are your goals as a Naturopath?

EVALUATION:
We will review this application and let you know in writing if you have been accepted to the Naturopathic Program. Allow two to three weeks. You must include the non-refundable $25.00 evaluation and registration fee with this application. This fee will be refunded only if this application is rejected. You may submit payment through our shopping cart on the next page after completing this form.

This information I have given is true and this application is made out to the best of my ability.

Signed:

HERBAL HEALER ACADEMY INC.

Minimum shipping charge is $8.00. (Ships 1-3 pounds U.P.S.).
For larger packages, correct shipping charges will be added in our office
at the time of your order, depending on the weight and location.

Call in Order Line
1-870-269-4177
Monday thru Friday
9:00a.m. to 4:30p.m. CST
(Closed Saturday & Sunday)
Email Herbal Healer
(Email closed Saturday & Sunday)
Orders may be Faxed to
1- 870-269-5424

Herbal Healer Academy Inc.
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