Haven Ridge School of Hypnotherapy

Advanced Course Admissions Form

Application Fee Deposit (Non-Refundable):

Perceptional Sexuality: $399 (Special enrollment pricing), Value: $699

Vaping Hypnosis Course and VGB – Virtual Gastric Band (TBD)

Classes take place in: Salmon Arm, British Columbia, CANADA or Online

Be 18 years of age or older
No criminal record
Interested in self-healing and helping others
Prepared to learn in a highly interactive environment, willing to be both the client and the student
Have a strong interest in Hypnotherapy

Advanced Course Selection

Last Name

First name

Name as it is to appear on certification

Mailing address

City

Province

Postal Code

Country

Phone Number

Emergency contact name

Emergency contact phone number

Current occupation

Highest level of education

Other relevant course work

how did you find this program?

Is there any reason why you would not be able to work in the healthcare industry?

Do you have a criminal record?

what interests you in taking this course or program?

Print Signature

Today's date