Correspondence Course Registration Form
*Use for Canadian orders only

Please enroll me in the following :
Price
Module 1 - Materia Aromatica, Essential Oil Profiles
$475.00
Module 2 - Anatomy/Physiology/Pathology
$325.00
Module 1 & 2
$725.00
 

Enclosed is payment by cheque or money order for courses listed above.
       
If you are taking Module 1 & 2, do you want to do them together? Yes  No
       
Do you plan to take the bodywork portion of the course? Yes  No
       
Name

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Birthdate

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Mailing Address

____________________________________________________________

       
Telephone

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Email

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Education ____________________________________________________________
   
  ____________________________________________________________
   
Present Occupation ____________________________________________________________
   
Marital Status ____________________________________________________________
     
Do you have any children?____________________

Their ages:

____________________
       

Do you have any previous training in aromatherapy?____________

____________________
 

________________________________________________________________________________

 
Please tell me about your interest in aromatherapy and what you expect from the course.
(Use back of form)

Return to:
JOYESSENCE AROMATHERAPY CENTRE
   88 Dean Avenue,
Guelph, ON, Canada N1G 1L6

 
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