Name* Date of Birth Phone* Street Address/P.O. Box City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareWashington DCFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennslyvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code* Email* How will you provide payment today?I am paying the tuition in full ($2,650).I am paying the $250 deposit to qualify for Early Registration Discount If you are paying the $250 deposit. How will you pay for the remainder of your tuition?I will pay the balance of my tuition in full on March, 28 2020 ($2,300)I am interested in setting up a payment plan to finance the balance of my tuition ($2,300) Please provide a proposal here for your payment plan with payment dates and amounts. I am proposing to barter or trade for goods/services partial payment for the balance of my tuition ($2,300). See my barter/trade proposal below. If you are interested in trading or bartering for a partial payment of your tuition, please include a detailed description of your offering here. Please Tell Us a Little About Yourself How did you hear about this program? Have you studied herbalism before? If so, with whom? Where? Have you studied botany before? Do you currently use herbs for your own health care? Tell us about this. How do you hope to use the information you will receive in this program? Do you have any training in other healing modalities (medical license, massage therapist, acupuncturist, etc.)? Is there anything else you would like us to know about you before you submit your registration?