Application Form PURE HEALTH SCHOOL OF NATURAL MEDICINE INT'L, BOULDER CO, USA Online Courses for SNM USA students: Full Payment & Discounted Options ONLINE COURSES NAME Address Zip or Postal Code Daytime Telephone Mobile Phone Profession Experience and Educational Background Please email an extended introduction to your background, what has drawn you to study natural medicine, and your goals and inspirations. • • • Iridology Course + 2 Iridology DVDs, 4 Books + Mentoring $1100 Herbal Medicine Course + 5 Element DVDs, 3 Books + Mentoring $1100 Naturopathy Course + 5 Reflexology & 2 Mystic Yoga DVDs, 5 books, Mentoring $1000 Naturopathy Diploma DISCOUNTED: 3 Online Courses + 5 Books, 14 DVDs, Mentoring – save $500 $2700 Naturopathy Diploma + Self Healing DISCOUNTED: 3 Courses - 6 Books, 14 DVDs + Self Healing Module (save $650), Mentoring $3700 Self Healing Module + Mentoring (see SH flyer) Experience the complete system of natural medicine in your life & body over 3 months of herbal nutrients, healing diets, flower essences, naturopathy treatments. $1150 Healing Diets Online Course Required for Diploma level ND, HD, HM and HD Courses. $1250 Quantum Botanicals Required for Diploma level ND, HD, HM and HD Courses from June 2015 $1250 Country Email Address • ! Print, complete, sign and email form, photo and ID to: faridasharan@purehealth.com or mail to School of Natural Medicine, 1307 Riverside Avenue, Boulder, Colorado 80304, USA. Advise payment choice option: bank wire, PayPal invoice, credit card, check, check and we will process your payment (handling and shipping fees are added). Email: faridasharan@purehealth.com for more information or call 720-746-9961 to ask questions, visit the school, or enroll in SNM USA Online Courses and in-person classes. Enrollment is subject to the Rules & Regulations of the Colorado State Board of Education Private Occupational School Division. Deposits, Lab Fees & Online Courses are non-refundable. ! TERMS AND CONDITIONS Course materials are copyrighted and are supplied for the educational purposes of the applicant only, and are not to be duplicated in any format, print, digital or web, without prior written consent of the author, Farida Sharan, or shared, transferred or resold. DVDs may not be broadcast in any format without prior written consent. Applications are accepted at the sole discretion of the School of Natural Medicine, Intl. Course fees are due in advance and are non-refundable. Mailings and handling costs are extra and based on destination of the course materials. By checking this box and signing below, I, the applicant, certify I am a student of SNM USA, and agree to the terms and conditions stated above, and confirm that the information on this application is true. I am of legal age and have full authority to apply for the course(s) as indicated. Total $ __________ Signature: Date: