Enrolmentform Educational Center for Classical Homeopathy
Please fill in this form to enroll for the international homeopathy course
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Personal information
First name
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Surname
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Streetname & number
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Zipcode
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Place of residence
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Please write down the name of the town, city that you live in.
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Phonenumber
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Email
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Please make sure you verify the emailaddress
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Date of birth
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Place of birth
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IBAN number bankaccount
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Please fill in and verify the correct IBAN number of your bank account
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Previous education
Education
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What is your main education (partial and/or fully finalized)? Can you describe this briefly?
Your answer
Level
*
Please confirm that you have finalized a higher general secondary education.
Yes, I have finalized a higher general secondary education.
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Motivation
*
Please explain brtiefly why you would like to study homeopathy?
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Study load
*
How many hours per week can you spend on the course?
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Expectation
*
Can you please explain what you expect from the course and the start of your own practice?
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Location
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Please confirm in which town/country you would like to attend the classes.
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Netherlands
Sweden
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