778-552-3000 [email protected]

To enrol in the next class simply apply by filling out the registration form and emailing to [email protected]

 

 

Y.O.U. Academy of Advanced Hypnotherapy Inc

204-931 Brunette Ave

Coquitlam, BC V3K 1R1

778-552-3000

Certified Hypnotherapy Diploma (IMDHA.ICBCH Certification)

 

Full Time____________________

 

Part Time____________________

 

 

STUDENT INFORMATION

 

 

 

Student Last Name

 

Student First Name and Middle Name

 

 

 

Student Usual First Name

 

 

 

 

Mailing Address

 

 

 

 

 

City

 

Postal Code

 

 

 

How you heard of this course?

 

 

 

 

 

 

 

Student Telephone Number

 

Alternative Telephone Number

 

Student Main Email Address

 

 

 

 

 

 

 

 

 

 

 

Date of Birth:

 

 

 

 

 

 

 

 

 

Gender

 

          Male                                Female

 

Y

Y

Y

Y

M

M

D

D

PROGRAM INFORMATION

CERTIFIED HYPNOTHERAPY DIPLOMA    CERTIFIED PROFESSIONAL HYPNOTIST

Program Name

 

 

 

 

 

 

 

Program Duration in Hours

 

Program Duration in Weeks (or portion thereof)

 

Program Start Date

 

Program End Date

 

Credential Issued on Graduation

 

  Diploma

 

  Certificate

 

 

 

Program Delivery Method

(select all that apply)

 

  On-Site

 

  Distance

 

  On-line

 

 

 

 

 

 

 

Language of Instruction

ENGLISH

 

 

 

 

PRIVACY

 

Under the Personal Information Protection Act students are entitled to access their student file.

 

The personal information collected will only be used for the purpose for which it was originally collected or for a use consistent with that purpose, unless the student consents to other use.

 

 

PROGRAM ADMISSION REQUIREMENTS

 

  1. Applicants must be at least 19 years of age
  2. Applicants must also complete and submit a school admissions application form.
  3. Applicants must pay $500.00 non-refundable enrolment and registration fee upon acceptance into the course of study. 

4.       Applicants must have an interview with the dean of students for acceptance into the program

(Program admission requirements may not be waived by the student or the institution)

 

PROGRAM COSTS

 

Program Costs in Canadian Dollars ($CDN):

Amount

  • Tuition

$ 3895.00

  • Registration/Application Fee  

$ 500.00

  • IMDHA/ICBCH Student Association Membership Included

$ 0.00

  • Textbooks

$100.00

  • TOTAL PROGRAM COSTS

$ 3995.00

 

 

 

PAYMENT

All terms and conditions of payment must be included here.

 

Method Of Payment  Credit Card or E-transfer

 

Credit Card: ______________________________  Expiry:______________CSV:__________Postal Code______

 

I agree to have my credit card charged the amount of     ______________Deposit  ______________Tuition

 

Signature_________________________________Date signed:__________________________________

 

Payment plans available. $500.00 Non refundable deposit Required. 

5 equal payments of $719.00 commencing the acceptance of the contract

Late payments will be charged a $25.00 penalty

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STUDENT DECLARATION

I DECLARE THAT:

  • I have read, understood, and agreed to the terms and conditions of this enrolment contract;

·         The information provided is true and accurate and I am 19 years of age or older. 

·         I have included a copy of drivers licence or provincial identification

·         I do not have a criminal record

 

 

Student Signature

 

Date Signed

 

 

 

 

 

 

 

 

 

INSTITUTION DECLARATION

The institution agrees to deliver the program according to the terms of this contract.  The institution certifies that the student has met the admission requirements for the program of study.

 

 

 

 

Printed Name of Institution Representative

 

Position Title

 

 

 

 

Signature of Institution Representative

 

Date Signed

 

 

 

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