Registration

Continuing Education Registration Form

Name *

First

Last

Mailing Address *

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City

State

Zip Code

Country

Billing Address (if different than mailing address) *

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Line 2

City

State

Zip Code

Country

Email *

Phone Number *

License Number *

National Certification Number *

Course(s) of Interest *

Date(s) *

Fee(s) *

Payment Method: Cash/Check/Visa/MC ~~~~~~~If you prefer to enroll by phone, pay by phone or mail a check see phone number and address below or email ~~registration@sunshineinstitute.org *

Credit Card No *

Exp. Date *

CVS *

Electronic Approval Signature *

Will you need lodging? *

Do you have allergies or other needs? If so please advise us *

Where did you hear about Sunshine Institute? *

Please state prior experience or training in the healing arts. Include primary education and current modalities. *

You may upload a resume if you prefer by clicking on the link below *

Upload File *

Max file size: 20MB

Mailing Address: Sunshine Institute: 20 Fall Pippin Ln. Suite 200, Asheville, NC 28803 ~~~~ Phone Number: (828)785-1381 ~~~~ Please leave any comments below *

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