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